To Prevent Attachment Disorders, Start Early

Healing attachment disorders is a popular topic in foster care. My workshops on the subject have been well attended.

Why does foster care produce so many attachment disorders in the first place? A more important focus would concern ways to prevent them.

Here’s how it all works. A connection to another human being is an attachment. When the connection between two human beings becomes significant in both lives, that attachment becomes a bond. A bond is a significant reciprocal attachment which both parties want and expect to continue and which is interrupted at peril to the parties involved.

Is life to be trusted? Anxiety and worry may be hard to verbalize. Anger and misbehavior are a common reaction. Even more dangerous is the tendency to turn emotions off and protect oneself by not caring. Multiple moves within the foster care system compound this turmoil.

Experiencing the love and caring of good foster parents may encourage the child to attach. So far so good. However, when left in a loving relationship, bonding is likely to occur. Now we have another relationship which may end up being severed.

What happens when bonded relationships are disrupted? Earlier attachments or their absence predetermine the quality of later relationships. Attachment insecurity increases the risk for childhood and adult psychopathology. Foster children who remain in the system a long time or who age out can develop mental health challenges, spend time in jail, and are homeless at significantly disproportionate rates.

So how long is too long in foster care? Using extensive research, ASFA (the Adoption and Safe Families Act) in 1997 set some time limits which coincide with the timeline for bonding described above. Unless reunification is deemed inadvisable from the start, ASFA requires that it be pursued with vigor initially for at least six months. If no progress has been made, the permanency plan can be changed at that point. In any case, a termination of parental rights (TPR) must be filed after a child has been in foster care for 12 consecutive months or 15 of the past 22 months.

Unfortunately, the letter of the ASFA law is ignored about as often as it isn’t. Federal statistics from 2012 show that the average time spent in foster care nationally was almost 23 months. Why should that be when we know better?

Despite our professed concern for children, we lack a sense of urgency. Too often, we don’t begin the process of monitoring and home-finding until the deadline is near. Here are five recommendations that would help children find permanence earlier and lessen attachment pathology:

• Start early. Provide the birth mother with an initial reunification plan within 24 hours of removal.
• Monitor progress weekly.
• Develop a contingency alternative within a few weeks of removal.  Every important venture has a “rainy day plan.”
• Make every placement as if it were the last one necessary. This may mean placement with a family open to adoption when reunification appears unlikely.
• Provide some reward for caseworkers who through early planning, regular monitoring, and home-finding are able to achieve permanence within “child time.”  Whether through reunification or adoption, every child has the right to a permanent home.