Mesothelioma is a cancerous disease that affects the serous linings of various internal organs in the human body. Among them, the lungs, heart and the stomach are the mostly affected.

It is estimated that each year, 2,000 new cases of Mesothelioma are reported. The patients suffering from this cancerous disease have had prior exposure to asbestos, which is considered to be the only known cause of Mesothelioma. Mesotheliomic patients are often told of the short survival duration of 6 – 12 months. But doctors specialized in treating malignant Mesothelioma at leading cancer centers expect better survival rates. Though Mesothelioma causes immense pain and suffering to the victim along with short life expectancy, certain treatments have resulted in the successful reduction and removal of the cancerous tumors of Mesothelioma. Radiation Or Rado Therapy is one of the Mesothelioma treatments available to patients suffering from the asbestos-related cancer (Mesothelioma).

RADIATION or RADIO THERAPY:
Radiation or radiotherapy is a series of localized use of high-dose radiations given to a Mesothelioma patient either externally (known as external radiotherapy) or internally (known as internal radiotherapy). It destroys the cancer cells in the targeted section of the body by means of x-rays or radioactive materials.

External Radiotherapy:

In external radiotherapy, radiations are passed through a patient’s body using x-rays and/or cobalt irradiation. This type of radiotherapy is a relatively painless procedure, which is divided into several sessions. Although, it reduces the size of the tumor, the external radiotherapy also damages the normal cells. Thus, the idea to have it in sessions results the damage control of normal cells that can be repaired naturally.

Internal Radiotherapy:

Internal radiotherapy is a clinical procedure that delivers higher quantity of radiations to a Mesothelioma patient than the external radiotherapy. This is usually given to those patients whose cancer is on extreme stages. In internal radiotherapy, a radioactive material is placed inside the patient’s tumor or a radioactive fluid is given to a patient through mouth or injection. The radioactive material(s) then circulates throughout the body, with the help of blood, and annihilates the cancer cells.

Radiation therapy can be administered, with or without chemotherapy, after a surgery to avoid the recurrence of Mesothelioma. Doctors may also prescribe a limited amount of radiation therapy to a patient, depending on the nature, position and stage of the cancer. Certain side effects are recorded in patients who underwent radiation therapy, which were minor and diminished once the radiation treatment was over. Consult a professional oncologist for detailed information about the side effects and its treatment(s), before undergoing radiotherapy.

Mesothelioma is a cancerous disease that affects the serous linings of various internal organs in the human body. Among them, the lungs, heart and the stomach are the mostly affected.

It is estimated that each year, 2,000 new cases of Mesothelioma are reported. The patients suffering from this cancerous disease have had prior exposure to asbestos, which is considered to be the only known cause of Mesothelioma.

Mesotheliomic patients are often told of the short survival duration of 6 – 12 months. But doctors specialized in treating malignant Mesothelioma at leading cancer centers expect better survival rates. Though Mesothelioma causes immense pain and suffering to the victim along with short life expectancy, certain treatments have resulted in the successful reduction and removal of the cancerous tumors of Mesothelioma.

Treatment of Mesothelioma depends on many factors, including the stage of the cancer, the circulation of the malignant cells, pathology reports determining the nature of the cancer cells and patient’s age and health. Following is a detail description of the options for Mesothelioma Treatment.

CHEMOTHERAPY:

Chemotherapy is a “systematic treatment” of Mesothelioma that uses drugs, chemicals and medicines in an efficient manner to kill cancer cells. It is given to patients in either pills form or is injected directly into the body. In some cases, the medicines are directly inserted into the chest, known as intrapleural chemotherapy, or into the abdomen, known as intraperitoneal chemotherapy, to destroy the growth of cancerous cells. It is also given to patients before and after a surgery to limit the growth of Mesothelioma cancer.

The widely used pemetrexed, Alimta ®, is given in combination of Cisplatin (a standard platinum compound) to treat pleural Mesothelioma. The drug was approved by the U.S. Food and Drug Administration (FDA) in February, 2004. The working of this drug is simple: it enters the blood stream of a patient and kills the cancer cells throughout the body, while stopping the malignant cell growth. The drug has some side-effects for which vitamin B 12 and folic acid is given to the patients undergoing this treatment.

Mesothelioma is a cancer and like most other types of cancer – it is incurable. Great advances have been made in the diagnosis and treatment of these malignancies, but as yet, there is no complete mesothelioma treatment available that really works. All you can do is perhaps gain some satisfaction and compensation by filing a mesothelioma lawsuit against the employer or whoever exposed you to the chemicals who gave you this cancer.

Almost all cancers are cause by external stimuli and mesothelioma is no different. It is caused when the body is exposed to extremely high amounts of a carcinogen – asbestos. Mesothelioma affects the lining of the internal organs of the body and because of this extremely difficulty location, the infected cells rarely respond to conventional treatments that work for other types of cancer.

Getting mesothelioma treatment is made tougher by the fact that it can seldom be diagnosed on time – there are no blatant symptoms. Because of these factors, the effectiveness of many conventional treatments is limited. Mesothelioma treatment involves multiple treatment options including surgery, radiation and chemotherapy – though these only help slow the growth of the cancerous cells. New treatments like angiogenesis, photodynamic and gene therapy hold new hope for victims of mesothelioma everywhere.

Mesothelioma treatment is an expensive affair and most of the time, afflicted patients find themselves in a financial bind. This disease has long been recognized as a work related disease and very rarely does a patient contract mesothelioma outside of work environs. Companies tend to avoid telling their workers about the risk and hazards faced when being exposed to asbestos contamination in the work place because it takes many, many years before the effect of this exposure – mesothelioma becomes apparent. That’s why many people are now being diagnosed with mesothelioma after being exposed to asbestos thirty, forty, even fifty years ago.

But once diagnosed, the patient has every right to file a mesothelioma lawsuit against the company for passing this kind of a death sentence against him/her. Mesothelioma lawsuits have shot up in numbers in the US and across the world over the last few years with increased awareness and there have been several multi-million dollar settlements. It is wise for anyone diagnosed with mesothelioma to file a lawsuit because while the disease can’t be cured, compensation can ensure a good life for the family of the patient.

However, it is very important that the mesothelioma lawsuit be filed immediately upon diagnosis.

When I was looking for a reliable mesothelioma treatment center that can provide me all the legal information on mesothelioma, one of my friends has suggested me to go for New Mesothelioma Treatments. After visiting the website I really found the required information about mesothelioma treatment that I was looking for. In this article I am going to discuss why I was appreciated by this informative website.

As all we know that mesothelioma is a rare cancer cause of asbestos to exposure. Mesothelioma is such a disease that can spread out in quick manner if you don’t take any treatment in the time. As per as precaution is concerned you need to have basic knowledge about mesothelioma disease that can help you to prevent from some unexpected incidents. To get legal information or to get some ideas about mesothelioma disease and about its symptoms you need to research on Internet. You will find lots websites are on the Internet that are providing mesothelioma information. Make sure before taking any step or any medicine on the basis of these websites you need to consult with your doctor. Because these web sites are not often reliable as per as mesothelioma treatment is concerned.

Like me if you are also interested in getting knowledge about mesothelioma diseases and the way to get rid of this serious disease you need to go through a reliable website that can provide all the information about new mesothelioma treatment. While I found difficulties in finding out a good website, one of my friends has just suggested me to get for New Mesothelioma Treatments website. After visiting this appreciating website I really satisfied with the information they provided on the website – thanks New Mesothelioma Treatments for providing such needful information for the mesothelioma patients. I think these information would be useful to all the patients who are suffering from mesothelioma diseases.

So if you are looking for the mesothelioma information and also want to visit mesothelioma treatment center I would recommend you to go through this website in order to know about new mesothelioma treatment

.

New mesothelioma treatment is being popular as the number of mesothelioma patients is increasing tremendously. New mesothelioma treatment is important for both the patients and the doctors. If you have been suffering from mesothelioma disease for a long time and not getting any positive results that you are expecting then you should go for the new mesothelioma treatment methods.

There are lots of methods involved with the new mesothelioma treatment including surgery, radiation, chemotherapy etc. Doctors often use these conventional methods of treatment to provide fastest and most accurate treatment for mesothelioma. Before taking any of these options you should consult with the doctor as they are very much aware of this dangerous disease than you. Doctors will decide what treatment you should take. Experienced doctors or surgeons into this new mesothelioma treatment add the chemotherapy before surgery and radiation usually reduce the possibility of the cancer spreading to another area away from the original site.

Types of new mesothelioma treatment:

There are some good mesothelioma treatment methods are available nowadays.

Immunotherapy
Immunotherapy is one of such new mesothelioma treatments that is being tested properly. Immunotherapy uses the patients own immune system to fight the mesothelioma, which consists of using substances found in the immune system to counteract the growth of the tumor.

Heat Therapy
Heat Therapy is another type of new mesothelioma treatment. Heat therapy works in the way that it heats the chemotherapy agents before they are injected. When these chemicals are heated before injection it seems to kill more of the tumor cells. This new mesothelioma treatment is also known as chemo hyperthermia and has shown good results in those with malignant mesothelioma.

Gene Therapy
The third type of new mesothelioma treatment is Gene therapy. Gene therapy involves manipulating the genes involved in the tumor into a virus, such as the common cold, and then using antiviral drugs or your own immune system to destroy the cells. The improvement of this mesothelioma treatment is still being conducted.

Photodynamic Therapy
Photodynamic Therapy is one of the most important new mesothelioma treatment methods. It consists of injecting light sensitive molecules in the pleural space before surgery. When the surgery is done light is put directly on the molecules, thus killing the tumor cells.

If you are looking for more information about new mesothelioma treatment, then I can assure you to visit at New Mesothelioma Treatments that specializes in providing latest information about new mesothelioma treatment.

If you are a victim of Mesothelioma cancer, how will you get into Mesothelioma treatment?

The best way is to find reliable Mesothelioma cancer information and learn first everything that is relevant to Mesothelioma.

Do you think that Mesothelioma treatments are effective in one or two applications only? It depends to the patient’s body on how we react to the Mesothelioma treatment.

The doctor is the first one who is being aware for applying Mesothelioma treatment. We already know the advantage and disadvantage in taking them.

And most of the time Mesothelioma treatments are being useless in some reason.

Mesothelioma treatments are broken down into two categories:

1.Traditional treatments

Traditional mesothelioma treatments are similar to other standard cancer treatment modalities.

Two or more traditional mesothelioma treatments are often used together to better combat cancerous cells.

Traditional mesothelioma treatments are often used in combination with one-another to best target cancer cells.

2.New treatments.

New mesothelioma treatments are in the process of ongoing research, development and testing.

New mesothelioma treatments are being evaluated in mesothelioma clinical trials in hopes of a mesothelioma cure.

While mesothelioma treatments are slowly inhibiting the victim from being able to enjoy the life they have left, big business is slowly killing the rights of mesothelioma symptoms victims all over the country.

Most of the Mesothelioma treatment options are too high in price that ordinary victims cannot afford to have such treatment.

Various Mesothelioma Treatments

* Bronchoscopy

* Biopsy

* CT scans

* Laparocoscopy

* Mediastinoscopy

* Thorocoscopy

* Peritoneoscopy

* Radiotherapy

* X-ray

* Fluid drainage

* MRI scan

Usually, some medicines and necessary materials are used to function well. With this kind of Mesothelioma treatment, a victim will recover faster.

Having a treatment is necessary because it gives life to the patient or victim in order to survive. Put hope mostly on the family and relative of the patient, and the most important role is to cure everyone with a disease like Mesothelioma cancer.

To be better familiarized with Mesothelioma cancer, join some group or programs relative and concerned with epidemic cancer for the purpose on how to prevent cancer by applying new health technology, healthy lifestyle, diet and nutrition counseling, and alternatives.

Mesothelioma treatments are constantly being developed through clinical trials and research. Mesothelioma treatments are advancing, but the disease still claims far too many lives each year.

Mesothelioma treatments are themselves very aggressive, and invasive, and in many cases not recommended. Treatments are very expensive and usually range -between four hundred thousand and eight hundred thousand dollars.

As the time is passing many treatment programs are getting added into the drug and alcohol treatment programs in Alaska. Each of these programs has their unique working styles and the principles followed by them are also different. There are treatment programs that are designed for particular treatment; some are designed for particular age group, etc. But all these treatment programs have become successful in bringing their patients out of the addictions.

The treatment programs in Alaska offer the addict to choose whichever treatment program they find suitable for them. If the addict wants he or she can first take a mild treatment program and if that doesn’t work then can try a higher form of treatment program. In all the states of America there is so much flexibility when it comes to deciding a treatment program. The main motto of all these drug and alcohol treatment programs in Alaska is to get the person completely out of their addiction.

In America all the drug and alcohol treatment programs are made very elaborate and lengthy, as the treatment has to bring the patient out of their addiction and that to 100% out of their addiction. That is the reason that all the treatment programs in Alaska are a bit longer and planned neatly. Depending upon the level of addiction and the kind of addiction the treatment program will follow a different pattern of working.

Here is a list of the treatment programs in Alaska that you can choose from:

1. Inpatient Treatment Program: The inpatient treatment program is carried out in an inpatient treatment center in Alaska. Here the patient will need to stay in the center till the time there treatment gets over. The patient will be given 24 hours medical help and there will be various experts who will give counseling and any other guidance to the patients.

The detox treatment is main part of this treatment program and in this the patient will be asked not to consume the addictive substance. The detox will remove all the earlier accumulated addictive substance from the body of the addict and thus make the future life of the addict safe. After the detox gets completed the patient will be given various maintenance therapies and the family of the patient will also be given some counseling. After all this, the patient will be referred for an outpatient treatment program.

2. Outpatient Treatment Program: The outpatient treatment program is best for those who are into mild form of addiction and don’t need to have an extensive treatment program. The outpatient treatment program in Alaska is a mild form of treatment program. The detox treatment is not the main part of this treatment program. But if the patient needs there are some provisions to give the detox treatment.

The patient will need to visit the treatment center in Alaska at least three to four times in a week. The main condition for qualifying for getting admission to an outpatient treatment program that is the patient should be physically and mentally fit and should have mild addiction. The patients who take inpatient program may also join an outpatient program after their aftercare program gets over.

3. Day Treatment Program: The people who are in moderate kind of addiction can think about joining a day treatment program in Alaska. The advantage of this treatment program is that the patient can take the treatment without going away from the family. The patient will need to visit the treatment center three to four hours in a day. This way the patient can also complete their work and home responsibilities while taking the treatment.

The main focus here will be given on the counseling sessions but the detox treatment will also be included in the treatment program. The patient can stay with the family and attend the treatment center daily for taking the treatment. For all those who are into moderate forms of addiction this treatment is the best option till date.

4. Residential Treatment Program: For all those who are into sever addiction the residential treatment program is the best. In the residential treatment program the patient will get everything from detox to counseling to aftercare program. These programs are very lengthy and the patient might need to stay for more than a year in the rehabilitation center in Alaska.

There are various addiction treatment programs in Kansas and the format of each of them is also unique. There are simple as well as complicated rehabilitation treatment programs. Out of all these treatment programs, the dual diagnosis treatment program is quite popular in Kansas. The dual diagnosis addiction treatment program is also an old program but people have started a liking towards this treatment recently. The counselors also suggest their patient to go for this treatment, and that is the reason why this program is so popular. Though, the format of this program is unknown to most of the people.

Here you will learn a brief summary about the dual diagnosis addiction treatment program in Kansas and its format. You will also come to know how effective this treatment can be.

What is Dual Diagnosis Program?

Dual diagnosis treatment program is a treatment program where more than one condition can be treated at the same time. This is not the case with other addiction treatment programs. Thus in short, any two or more than two coexisting conditions, can be treated simultaneously only in dual diagnosis treatment program. Out of these conditions, one will be the addiction of the patient and the second can be the physical or mental disorder that is making the treatment difficult and complicated.

What does the Dual Diagnosis treatment program in Kansas offer?

As mentioned earlier, the second condition that gets treated along with the addiction is the physical and mental disorder of the patient. This second condition can be anything like eating disorder, various phobias or sleep disorders. All these conditions make it difficult for the person to come of their addiction. Thus these conditions also need treatment. In dual diagnosis treatment in Kansas, all these conditions also get treated at the same time when the patient gets treated for their addictions.

Most of the patients, who get admitted for getting the treatment for their addiction, are also suffering from some or the other psychiatric condition. Some conditions like depression and schizophrenia can create major blocks in the treatment procedure and make the entire treatment process complicated. Other conditions that need treatment are anxiety disorder, bipolar disorder, panic disorder, and hallucinations. In dual diagnosis treatment program in Kansas, all these conditions get proper treatment along with the treatment for the addiction.

If these conditions not treated while giving the addiction treatment to the patient, the patient will find it difficult to come out of their addiction easily. The patient, undergoing addiction treatment has to be physically as well as mentally prepared in order to show positive results to the treatment given to them.

How does the Dual Diagnosis Treatment Program get implemented in Kansas?

Dual diagnosis treatment program in Kansas are carried out with lot of care and proper attention is given to all the conditions of the patients. This type of treatment program is given only in registered treatment centers in Kansas. All the staff at such treatment centers is also qualified and well-experienced.

When any patient comes to taking dual diagnosis treatment program in Kansas, they are given preliminary opinion based on the patient’s condition. After this the patient will need to undergo detox treatment. During the detox treatment, if the patient has some mental conditions their withdrawal symptoms will be more drastic. Such patient will be given extra care and affection. That is the reason; the detox treatment in dual diagnosis treatment in Kansas is lengthier than the detox treatment in other treatment programs.

After the detox treatment program, the patient will be made to undergo psychiatric analysis program. The psychiatrist will observe the patient and give proper treatment if the patient shows any mental conditions. Depending on this the proper treatment will be given to the patient. The treatment center will look after the addiction and also the condition of the patient at the same time and will try to make these both treatments don’t stress out the patient.

The dual diagnosis treatment program in Kansas has the same pattern of treating the patients. The patient will be given the treatment for their addiction and also for any mental or physical illness that the patient has. Almost all the treatment centers where the dual diagnosis treatment is given the pattern are the same. Dual diagnosis treatment program can be of more duration due to the fact that it also treats the patients for their mental illnesses.

There are two main types of programs for addiction treatment in Alabama. The inpatient treatment program and the outpatient treatment program are the two options, which an addict can select to get treatment for his or her addiction. The addicts and their families get really very confused when it comes to selecting the correct options out of these two. There are few differences in the way both the forms of addiction treatment in Alabama are carried out.

Before seeing the differences between the inpatient and outpatient treatment program in Alabama, it will better to see what similarities between these two are. Both these treatment program give proper counseling to the addicts and their family to guide them about the various aspects of the addiction. Both these programs also educate the addict and their families through individual and group therapies.

The major difference between inpatient and outpatient treatment program in Alabama is about the location where the treatment program gets carried out. The addicts who choose an inpatient treatment program have to stay in the treatment center in Alabama and he or she will have to stay there till they come out of their addiction. In outpatient treatment program the addict will have to attend the treatment center whenever they will be called. Once the inpatient treatment program gets over (it may last three to six weeks) the patient will be also asked to take an outpatient treatment program.

The patients will be allowed to stay at their home if they choose to take an outpatient treatment program. It is helpful for those patients who cannot take leave from work and has to attend work while taking the treatment. This is the reason more than 80% of the people go for outpatient treatment program in Alabama. There are other several advantages of taking outpatient treatment program.

1. The patient can do their work without taking a break from work.

2. The patient can take treatment by paying less money, as the inpatient treatment programs are quite expensive.

3. The patients can see their family and hence feels comfortable while undergoing the treatment.

4. The family of the patient can also be helpful by seeing that the patient attends the treatment programs whenever called by the treatment center.

There are some people who think that the addiction can be control only if the addict stays in the center. That is why the number of people going for inpatient addiction treatment in Alabama is also quite a lot. There are some advantages of taking the treatment from an inpatient treatment program.

1. The patient gets immediate medical facilities in case he or she faces any minor or major health troubles.

2. The patient gets professional care and guidance, as there are qualified people in the treatment center to look after him or her.

3. The severe addiction problems will not be treated by outpatient treatment program. Hence all such addicts who are deeply into addiction take treatment in inpatient treatment program.

The outpatient treatment program in Alabama is a best option for those who are in mild forms of addiction. The outpatient addiction treatment in Alabama is a mild kind of treatment. There will be no need for the addict to stay away from the family and friends while taking the treatment. The patients of outpatient treatment program will need to visit the treatment center in Alabama about three to four times in a week.

The outpatient treatment program focuses on counseling treatment and while for those who are into severe addiction urgent medical treatment is needed. Hence for all those who are into major kind of addiction, inpatient treatment program is the only option. Also all those who have some physical and mental conditions cannot do well with outpatient treatment program. It is better all such addicts choose inpatient treatment program and takes proper medical help without any further delay.

In any case taking a treatment for the addiction is a must. If the addict and his or her family will keep on denying the addiction then they will have to see major consequences in latter life. It is very important to take proper counseling before choosing the right kind of treatment program. If the addict is not agreeing to take a treatment program then the family can take help of the intervention program given by the treatment center in Alabama. Intervention program will also help you in deciding the proper kind of treatment option and will also help you to get admission to the desired treatment program.

Dyadic Developmental Psychotherapy (DDP) is an evidence-based and effective form of treatment for children with trauma and disorders of attachment[1]. It is an evidence-based treatment, meaning that there has been empirical research published in peer-reviewed journals. Craven & Lee (2006) determined that DDP is a supported and acceptable treatment (category 3 in a six level system). However, their review only included results from a partial preliminary presentation of an ongoing follow-up study, which was subsequently completed and published in 2006. This initial study compared the results of Dyadic Developmental Psychotherapy with other forms of treatment, ‘usual care’, 1 year after treatment ended. It is important to note that over 80% of the children in the study had had over three prior episodes of treatment, but without any improvement in their symptoms and behavior. Episodes of treatment mean a course of therapy with other mental health providers at other clinics, consisting of at least five sessions. A second study extended these results out to 4 years after treatment ended. Based on the Craven & Lee classifications (Saunders et al. 2004), inclusion of those studies would have resulted in Dyadic Developmental Psychotherapy being classified as an evidence-based category 2, ‘Supported and probably efficacious’. There have been two related empirical studies comparing treatment outcomes of Dyadic Developmental Psychotherapy with a control group. This is the basis for the rating of category two. The criteria are:

* 1. The treatment has a sound theoretical basis in generally accepted psychological principles.

Dyadic Developmental Psychotherapy is based in Attachment Theory (see texts cited below

* 2. A substantial clinical, anecdotal literature exists indicating the treatment’s efficacy with at-risk children and foster children.

See reference list.

* 3. The treatment is generally accepted in clinical practice for at risk children and foster children.

As demonstrated by the large number of practitioners of Dyadic Developmental Psychotherapy and it’s presentation as numerous international and national conferences over the last ten or fifteen years.

* 4. There is no clinical or empirical evidence or theoretical basis indicating – that the treatment constitutes a substantial risk of harm to those receiving it, compared to its likely benefits.

* 5. The treatment has a manual that clearly specifies the components and administration characteristics of the treatment that allows for implementation.

Creating Capacity for Attachment, Building the Bonds of Attachment, and Attachment Focused Family Therapy constitute such material.

* 6. At least two studies utilizing some form of control without randomization (e.g., wait list, untreated group, placebo group) have established the treatment’s efficacy over the passage of time, efficacy over placebo, or found it to be comparable to or better than an already established treatment.

See ref. list

* 7. If multiple treatment outcome studies have been conducted, the overall weight of evidence supported the efficacy of the treatment.

These studies support several of O’Connor & Zeanah’s[2] conclusions and recommendations concerning treatment. They state (p. 241), “treatments for children with attachment disorders should be promoted only when they are evidence-based.”

Dyadic Developmental Psychotherapy, as with any specialized treatment, must be provided by a competent, well-trained, licensed professional. Dyadic Developmental Psychotherapy is a family-focused treatment[3].

Dyadic Developmental Psychotherapy is the name for an approach and a set of principals that have proven to be effective in helping children with trauma and attachment disorders heal; that is, develop healthy, trusting, and secure relationships with caregivers. Treatment is based on five central principals.

At the core of Reactive Attachment Disorder is trauma caused by significant and substantial experiences of neglect, abuse, or prolonged and unresolved pain in the first few years of life. These experiences disrupt the normal attachment process so that the child’s capacity to form a healthy and secure attachment with a caregiver is distorted or absent. The child lacks a sense trust, safety, and security. The child develops a negative working model of the world in which:

Ø Adults are experienced as inconsistent or hurtful.

Ø The world is viewed as chaotic.

Ø The child experiences no effective influence on the world.

Ø The child attempts to rely only on him/her self.

Ø The child feels an overwhelming sense of shame, the child feels defective, bad, unlovable, and evil.

Reactive Attachment Disorder is a severe developmental disorder caused by a chronic history of maltreatment during the first couple of years of life. Reactive Attachment Disorder is frequently misdiagnosed by mental health professionals who do not have the appropriate training and experience evaluating and treating such children and adults. Often, children in the child welfare system have a variety of previous diagnoses. The behaviors and symptoms that are the basis for these previous diagnoses are better conceptualized as resulting from disordered attachment. Oppositional Defiant Disorder behaviors are subsumed under Reactive Attachment Disorder. Post Traumatic Stress Disorder symptoms are the result of a significant history of abuse and neglect and are another dimension of attachment disorder. Attention problems and even Psychotic Disorder symptoms are often seen in children with disorganized attachment[4].

Approximately 2% of the population is adopted, and between 50% and 80% of such children have attachment disorder symptoms[5]. Many of these children are violent[6] and aggressive[7] and as adults are at risk of developing a variety of psychological problems[8] and personality disorders, including antisocial personality disorder[9], narcissistic personality disorder, borderline personality disorder, and psychopathic personality disorder[10]. Neglected children are at risk of social withdrawal, social rejection, and pervasive feelings of incompetence[11]. Children who have histories of abuse and neglect are at significant risk of developing Post Traumatic Stress Disorder as adults[12]. Children who have been sexually abused are at significant risk of developing anxiety disorders (2.0 times the average), major depressive disorders (3.4 times average), alcohol abuse (2.5 times average), drug abuse (3.8 times average), and antisocial behavior (4.3 times average)[13] (MacMillian, 2001). The effective treatment of such children is a public health concern (Walker, Goodwin, & Warren, 1992).

Left untreated, children who have been abused and neglected and who have an attachment disorder become adults whose ability to develop and maintain healthy relationships is deeply damaged. Without placement in an appropriate permanent home and effective treatment, the condition will worsen. Many children with attachment disorders develop borderline personality disorder or anti-social personality disorder as adults[14].

FIRST PRINCIPAL. Therapy must be experiential. Since the roots of disorders of attachment occur pre-verbally, therapy must create experiences that are healing. Experiences, not words, are one “active ingredient” in the healing process.

For example, one eight year old boy who had Reactive Attachment Disorder, Bipolar Disorder, and a variety of sensory-integration disorders wrote about his past therapy and attachment therapy this way (More details of this story can be found in the book Creating Capacity for Attachment, edited by Arthur Becker-Weidman & Deborah Shell):

My first therapy was with Dr.Steve. The therapy was FUN!!!! We ate lots of snacks. I had a bottle. We played lots of cool games like thumb wrestling, pillow rides, giant walk, Superman rides, guess the goodies, eye blinking contests, hide and go seek goodies. I had to follow the rules and play the games just like Dr. Steve said.

Dr. Steve taught me how to play and have fun with my Mom. But I still didn’t know how to love. I would still get real mad and try to hurt Mom and break things. Inside I still thought I was a bad boy. I was still afraid Mom and Dad would get rid of me. I had lots of tantrums at home. Sometimes I would still get out of control and break things and try to hurt Mom. I was getting even worse when I got mad.

Stuff Dr. Art Taught Me

I learned about my feeling well. Sometimes I stuff too many feelings like mad, scared and sad into my feeling well. Then the well will overflow and I could explode with behaviors. But I can stop that by expressing my feelings. Then the well can’t overflow because I let some of the feelings out.

I also made pictures of my heart. I was born with a nice heart but then when I went into the orphanage I got cracks in my heart. My heart cracked because they couldn’t take good care of me. I was a baby and I needed someone to hold me and rock me. But they couldn’t because there were too many babies. Then I put 16 bricks around my heart. I was protecting my heart so it wouldn’t get hurt anymore. But the bricks kept the love out too. I wouldn’t let Mom’s love in. I had lots of mad in my heart.

My hard work in therapy got rid of all the bricks. Then Mom’s love got in. The love made the cracks heal. Now I have a bright red heart with no cracks.

I really liked Dr. Art now and am proud that I am strong. I still don’t need therapy. I still let Mom’s love into my heart!!!!!! Sometimes I send e-mail’s to Dr. Art. I tell him how good I’m doing.

I started missing Dr. Art and told Mom. Mom was confused and thought I wanted more therapy. I told Mom “I don’t need therapy. I just want to have lunch with Dr. Art.” So I sent Dr. Art an email to let him know that I wanted to have lunch with him. Then one day we had lunch together.

Sometimes it’s still hard. I still get mad and sometimes I don’t express my feelings well. Sometimes when Mom helps me ? I can express my feelings and say “I don’t want to pick up my toys. It makes me mad that I have to ? but I will”. When I say that it doesn’t make me feel mad anymore. It helps me to listen to Mom. But sometimes when I get mad I pout and stomp my feet and run to my room if I forget to express my feelings. But now I let Mom help me so that I can talk about my feelings and do what she says

It’s been a really longtime since I tried to hurt Mom or break things when I’m mad. I feel good about love now. I know that my Mom and Dad love me. I know that I love Mom and Dad. I don’t feel like I’m a bad boy anymore.

Effective therapy uses experiences to help a child experience safety, security, acceptance, empathy, and emotional attunement within the family. A number of techniques and methods are used including psychodrama, interventions congruent with Theraplay, and other exercises.

SECOND PRINCIPAL. Therapy must be family-focused. Therapy helps the child address the underlying trauma in a supportive, safe, secure environment in “titrated” and manageable doses so that what the parents have to offer can get in and heal the child. It is the parents’ capacity to create a safe and nurturing home that provides a healing environment. Being able to have empathy for the child, accept the child, love the child, be curious about the child, and be playful are all part of the “attitude[15]” that heals. Parents are actively involved in treatment.

THIRD PRINCIPAL. The trauma must be directly addressed. Therapy helps healing by providing the safety and security so that the child can re-experience the painful and shameful emotions that surround the child’s trauma. Revisiting the trauma is essential if the child is to begin to revise the child’s personal narrative and world-view. It is by revisiting the trauma and sharing the anger and shame with an accepting, empathetic person that the child can integrate the trauma into a coherent self.

FOURTH PRINCIPAL. A comprehensive milieu of safety and security must be created. Traumatized children are often hyper-vigilant, insecure, and deeply distrusting. A consistent environment that is safe and secure is essential to creating the experiences necessary for the child to heal. This milieu must be present at home and in therapy. Good communication and coordination among home, school, and therapy is another important element of effective treatment. “Compression-wraps,” invasive and intrusive stimulation designed to evoke rage, “re-birthing,” and other provocative techniques are not part of Dyadic Developmental Psychotherapy. These intrusive and invasive techniques are not therapy, not therapeutic, and have no place in a reputable treatment program.

Fifth Principal. Therapy is consensual and not coercive. At our center we are very clear that physical restraint is not treatment and is not used in treatment in any manner. Treatment is provided in a manner consisted with the Association for the treatment and Training of Children’s White Paper on Coercion in treatment.

DETAILED DESCRIPTION OF TREATMENT

Dyadic Developmental Psychotherapy is a treatment developed by Daniel Hughes, Ph.D., (Hughes, 2008, Hughes, 2006, Hughes, 2003,). Its basic principals are described by Hughes and summarized as follows:

1. A focus on both the caregivers and therapists own attachment strategies. Previous research (Dozier, 2001, Tyrell 1999) has shown the importance of the caregivers and therapists state of mind for the success of interventions.
2. Therapist and caregiver are attuned to the child’s subjective experience and reflect this back to the child. In the process of maintaining an intersubjective attuned connection with the child, the therapist and caregiver help the child regulate affect and construct a coherent autobiographical narrative.
3. Sharing of subjective experiences.
4. Use of PACE and PLACE are essential to healing.
5. Directly address the inevitable misattunements and conflicts that arise in interpersonal relationships.
6. Caregivers use attachment-facilitating interventions.
7. Use of a variety of interventions, including cognitive-behavioral strategies.

Dyadic Developmental Psychotherapy interventions flow from several theoretical and empirical lines. Attachment theory (Bowlby, 1980, Bowlby, 1988) provides the theoretical foundation for Dyadic Developmental Psychotherapy. Early trauma disrupts the normally developing attachment system by creating distorted internal working models of self, others, and caregivers. This is one rationale for treatment in addition to the necessity for sensitive care-giving. As O’Connor & Zeanah (2003, p. 235) have stated, “A more puzzling case is that of an adoptive/foster caregiver who is ‘adequately’ sensitive but the child exhibits attachment disorder behavior; it would seem unlikely that improving parental sensitive responsiveness (in already sensitive parent) would yield positive changes in the parent-child relationship.” Treatment is necessary to directly address the rigid and dysfunctional internalized working models that traumatized children with attachment disorders have developed.

Current thinking and research on the neurobiology of interpersonal behavior (Siegel, 1999, Siegel, 2000, Siegel, 2002, Schore, 2001) is another part of the foundation on which Dyadic Developmental Psychotherapy rests.

The primary approach is to create a secure base in treatment (using techniques that fit with maintaining a healing PACE (Playful, Accepting, Curious, and Empathic) and at home using principals that provide safe structure and a healing PLACE (Playful, Loving, Acceptance, Curious, and Empathic). Developing and sustaining an attuned relationship within which contingent collaborative communication occurs helps the child heal. Coercive interventions such as rib-stimulation, holding-restraining a child in anger or to provoke an emotional response, shaming a child, using fear to elicit compliance, and interventions based on power/control and submission, etc., are never used and are inconsistent with a treatment rooted in attachment theory and current knowledge about the neurobiology of interpersonal behavior.

The usual structure of a session involves three components. First, the therapist meets with the caregivers in one office while the child is seated in the treatment room. During this part of treatment, the caregiver is instructed in attachment parenting methods (Becker-Weidman & Shell (2005) Hughes, 2006). The caregiver’s own issues that may create difficulties with developing affective attunement with their child may also be explored and resolved. Effective parenting methods for children with trauma-attachment disorders require a high degree of structure and consistency, along with an affective milieu that demonstrates playfulness, love, acceptance, curiosity, and empathy (PLACE). During this part of the treatment, caregivers receive support and are given the same level of attuned responsiveness that we wish the child to experience. Quite often caregivers feel blamed, devalued, incompetent, depleted, and angry. Parent-support is an important dimension of treatment to help caregivers be more able to maintain an attuned connecting relationship with their child. Second, the therapist with the caregivers meets with the child in the treatment room. This generally takes one to one and a half hours. Third, the therapist meets with the caregivers without the child. Broadly speaking, the treatment with the child uses three categories of interventions: affective attunement, cognitive restructuring, and psychodramatic reenactments. Treatment with the caregivers uses two categories of interventions: first, teaching effective parenting methods and helping the caregivers avoid power struggles and, second, maintaining the proper PLACE or attitude.

Treatment of the child has a significant non-verbal dimension since much of the trauma took place at a pre-verbal stage and is often dissociated from explicit memory. As a result, childhood maltreatment and resultant trauma create barriers to successful engagement and treatment of these children. Treatment interventions are designed to create experiences of safety and affective attunement so that the child is affectively engaged and can explore and resolve past trauma. This affective attunement is the same process used for non-verbal communication between a caregiver and child during attachment facilitating interactions (Hughes, 2003, Siegel, 2001). The therapist and caregivers’ attunement results in co-regulation of the child’s affect so that is it manageable. Cognitive restructuring interventions are designed to help the child develop secondary mental representations of traumatic events, which allow the child to integrate these events and develop a coherent autobiographical narrative. Treatment involves multiple repetitions of the fundamental caregiver-child attachment cycle. The cycle begins with shared affective experiences, is followed by a breach in the relationship (a separation or discontinuity), and ends with a reattunement of affective states. Non-verbal communication, involving eye contact, tone of voice, touch, and movement, are essential elements to creating affective attunement.

The treatment provided often adhered to a structure with several dimensions. It is pictured in Figure 1, below. First, behavior is identified and explored. The behavior may have occurred in the immediate interaction or have occurred at some time in the past. Using curiosity and acceptance the behavior is explored. Second, using curiosity and acceptance the behavior is explore and the meaning to the child begins to emerge. Third, empathy is used to reduce the child’s sense of shame and increase the child’s sense of being accepted and understood. Forth, the child’s behavior is then normalized. In other words, once the meaning of the behavior and its basis in past trauma is identified, it becomes understandable that the symptom is present. An example of such an interaction is the following:

Wow, I see how you got so angry when your Mom asked you to pick up your toys. You thought she was being mean and didn’t want you to have fun or love you. You thought she was going to take everything away and leave you like your first Mom did, like when your first Mom took your toys and then left you alone in the apartment that time. Oh, I can really understand now how hard that must be for you when Mom said to clean up. You really felt mad and scared. That must be so hard for you.

Fifth, the child communicates this understanding to the caregiver.

Sixth, finally, a new meaning for the behavior is found and the child’s actions are integrated into a coherent autobiographical narrative by communicating the new experience and meaning to the caregiver.

Past traumas are revisited by reading documents and through psychodramatic reenactments. These interventions, which occur within a safe attuned relationship, allow the child to integrate the past traumas and to understand the past and present experiences that create the feelings and thoughts associated with the child’s behavioral disturbances. The child develops secondary representations of these events, feelings and thoughts that result in greater affect regulation and a more integrated autobiographical narrative.

As described by Hughes (2006, 2003), the therapy is an active, affect modulated experience that involves acceptance, curiosity, empathy, and playfulness. By co-regulating the child’s emerging affective states and developing secondary representations of thoughts and feelings, the child’s capacity to affectively engage in a trusting relationship is enhanced. The caregivers enact these same principals. If the caregivers have difficulty engaging with their child in this manner, then treatment of the caregiver is indicated.

Children who have experienced chronic maltreatment and resulting complex trauma are at significant risk for a variety of other behavioral, neuropsychological, cognitive, emotional, interpersonal, and psychobiological disorders (Cook, A., et. al., 2005; van der Kolk, B., 2005). Children and adolescents with complex trauma require an approach to treatment that focuses on several dimensions of impairment (Cook, et. al., 2005). Chronic maltreatment and the resulting complex trauma cause impairment in a variety of vital domains including the following:

Ø Self-regulation

Ø Interpersonal relating including the capacity to trust and secure comfort

Ø Attachment

Ø Biology, resulting in somatization

Ø Affect regulation

Ø Increased use of defensive mechanisms, such as dissociation

Ø Behavioral control

Ø Cognitive functions, including the regulation of attention, interests, and other executive functions.

Ø Self-concept.

Dyadic Developmental Psychotherapy addresses these domains of impairment. Dyadic Developmental Psychotherapy shares many important elements with optimal, sound social casework and clinical practice. For example, attention to the dignity of the client, respect for the client’s experiences, and starting where the client is, are all time-honored principles of clinical practice and all are also central elements of Dyadic Developmental Psychotherapy

In summary, therapy for traumatized children who have disordered attachments must be experiential, consensual, and provide an environment of security, acceptance, safety, empathy, and playfulness.

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