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		<title>Dyadic Developmental Psychotherapy: an Evidence-based Treatment for Disorders of Attachment; the Empirical Support</title>
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		<pubDate>Mon, 31 Aug 2009 16:10:48 +0000</pubDate>
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		<description><![CDATA[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 &#38; Lee (2006) determined that DDP is a supported and acceptable treatment (category 3 in a six level [...]]]></description>
			<content:encoded><![CDATA[<div align="left"><img src="http://i.ytimg.com/vi/7M3XrZVtt4I/1.jpg" width="250" height="250" alt="Dyadic Developmental Psychotherapy: an Evidence-based Treatment for Disorders of Attachment; the Empirical Support"></div>
<p>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 &amp; Lee (2006) determ<span id="more-81"></span>ined 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, &#8216;usual care&#8217;, 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 &amp; 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, &#8216;Supported and probably efficacious&#8217;. 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:</p>
<p>* 1. The treatment has a sound theoretical basis in generally accepted psychological principles.</p>
<p>Dyadic Developmental Psychotherapy is based in Attachment Theory (see texts cited below</p>
<p>* 2. A substantial clinical, anecdotal literature exists indicating the treatment&#8217;s efficacy with at-risk children and foster children.</p>
<p>See reference list.</p>
<p>* 3. The treatment is generally accepted in clinical practice for at risk children and foster children.</p>
<p>As demonstrated by the large number of practitioners of Dyadic Developmental Psychotherapy and it&#8217;s presentation as numerous international and national conferences over the last ten or fifteen years.</p>
<p>* 4. There is no clinical or empirical evidence or theoretical basis indicating &#8211; that the treatment constitutes a substantial risk of harm to those receiving it, compared to its likely benefits.</p>
<p>* 5. The treatment has a manual that clearly specifies the components and administration characteristics of the treatment that allows for implementation.</p>
<p>Creating Capacity for Attachment, Building the Bonds of Attachment, and Attachment Focused Family Therapy constitute such material.</p>
<p>* 6. At least two studies utilizing some form of control without randomization (e.g., wait list, untreated group, placebo group) have established the treatment&#8217;s efficacy over the passage of time, efficacy over placebo, or found it to be comparable to or better than an already established treatment.</p>
<p>See ref. list</p>
<p>* 7. If multiple treatment outcome studies have been conducted, the overall weight of evidence supported the efficacy of the treatment.</p>
<p>These studies support several of O&#8217;Connor &amp; Zeanah&#8217;s[2] conclusions and recommendations concerning treatment. They state (p. 241), &#8220;treatments for children with attachment disorders should be promoted only when they are evidence-based.&#8221;</p>
<p>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].</p>
<p>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.</p>
<p>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&#8217;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:</p>
<p>Ø Adults are experienced as inconsistent or hurtful.</p>
<p>Ø The world is viewed as chaotic.</p>
<p>Ø The child experiences no effective influence on the world.</p>
<p>Ø The child attempts to rely only on him/her self.</p>
<p>Ø The child feels an overwhelming sense of shame, the child feels defective, bad, unlovable, and evil.</p>
<p>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].</p>
<p>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, &amp; Warren, 1992).</p>
<p>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].</p>
<p><b>FIRST PRINCIPAL</b>. 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 &#8220;active ingredient&#8221; in the healing process.</p>
<p>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 &amp; Deborah Shell):</p>
<p>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.</p>
<p>Dr. Steve taught me how to play and have fun with my Mom. But I still didn&#8217;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.</p>
<p>Stuff Dr. Art Taught Me
<p>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&#8217;t overflow because I let some of the feelings out.</p>
<p>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&#8217;t take good care of me. I was a baby and I needed someone to hold me and rock me. But they couldn&#8217;t because there were too many babies. Then I put 16 bricks around my heart. I was protecting my heart so it wouldn&#8217;t get hurt anymore. But the bricks kept the love out too. I wouldn&#8217;t let Mom&#8217;s love in. I had lots of mad in my heart.</p>
<p>My hard work in therapy got rid of all the bricks. Then Mom&#8217;s love got in. The love made the cracks heal. Now I have a bright red heart with no cracks.</p>
<p>I really liked Dr. Art now and am proud that I am strong. I still don&#8217;t need therapy. I still let Mom&#8217;s love into my heart!!!!!! Sometimes I send e-mail&#8217;s to Dr. Art. I tell him how good I&#8217;m doing.</p>
<p>I started missing Dr. Art and told Mom. Mom was confused and thought I wanted more therapy. I told Mom &#8220;I don&#8217;t need therapy. I just want to have lunch with Dr. Art.&#8221; 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.</p>
<p>Sometimes it&#8217;s still hard. I still get mad and sometimes I don&#8217;t express my feelings well. Sometimes when Mom helps me ? I can express my feelings and say &#8220;I don&#8217;t want to pick up my toys. It makes me mad that I have to ? but I will&#8221;. When I say that it doesn&#8217;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</p>
<p>It&#8217;s been a really longtime since I tried to hurt Mom or break things when I&#8217;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&#8217;t feel like I&#8217;m a bad boy anymore.</p>
<p>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.</p>
<p><b>SECOND PRINCIPAL</b>. Therapy must be family-focused. Therapy helps the child address the underlying trauma in a supportive, safe, secure environment in &#8220;titrated&#8221; and manageable doses so that what the parents have to offer can get in and heal the child. It is the parents&#8217; 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 &#8220;attitude[15]&#8221; that heals. Parents are actively involved in treatment.</p>
<p><b>THIRD PRINCIPAL</b>. 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&#8217;s trauma. Revisiting the trauma is essential if the child is to begin to revise the child&#8217;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.</p>
<p><b>FOURTH PRINCIPAL</b>. 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. &#8220;Compression-wraps,&#8221; invasive and intrusive stimulation designed to evoke rage, &#8220;re-birthing,&#8221; 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.</p>
<p><b>Fifth Principal</b>. Therapy is consensual and not coercive. At our center we are very clear that physical restraint is <i>not</i> 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&#8217;s White Paper on Coercion in treatment.</p>
<p>DETAILED DESCRIPTION OF TREATMENT</p>
<p>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:</p>
<ol>
<li>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.</li>
<li>Therapist and caregiver are attuned to the child&#8217;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.</li>
<li>Sharing of subjective experiences.</li>
<li>Use of PACE and PLACE are essential to healing.</li>
<li>Directly address the inevitable misattunements and conflicts that arise in interpersonal relationships.</li>
<li>Caregivers use attachment-facilitating interventions.</li>
<li>Use of a variety of interventions, including cognitive-behavioral strategies.</li>
</ol>
<p>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&#8217;Connor &amp; Zeanah (2003, p. 235) have stated, &#8220;A more puzzling case is that of an adoptive/foster caregiver who is &#8216;adequately&#8217; 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.&#8221; Treatment is necessary to directly address the rigid and dysfunctional internalized working models that traumatized children with attachment disorders have developed.</p>
<p>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.</p>
<p>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.</p>
<p>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 &amp; Shell (2005) Hughes, 2006). The caregiver&#8217;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.</p>
<p>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&#8217; attunement results in co-regulation of the child&#8217;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.</p>
<p>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&#8217;s sense of shame and increase the child&#8217;s sense of being accepted and understood. Forth, the child&#8217;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:</p>
<p>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&#8217;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.</p>
<p>Fifth, the child communicates this understanding to the caregiver.</p>
<p>Sixth, finally, a new meaning for the behavior is found and the child&#8217;s actions are integrated into a coherent autobiographical narrative by communicating the new experience and meaning to the caregiver.</p>
<p>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&#8217;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.</p>
<p>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&#8217;s emerging affective states and developing secondary representations of thoughts and feelings, the child&#8217;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.</p>
<p>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:</p>
<p>Ø Self-regulation</p>
<p>Ø Interpersonal relating including the capacity to trust and secure comfort</p>
<p>Ø Attachment</p>
<p>Ø Biology, resulting in somatization</p>
<p>Ø Affect regulation</p>
<p>Ø Increased use of defensive mechanisms, such as dissociation</p>
<p>Ø Behavioral control</p>
<p>Ø Cognitive functions, including the regulation of attention, interests, and other executive functions.</p>
<p>Ø Self-concept.</p>
<p>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&#8217;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</p>
<p>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.</p>
<p>[1] Becker-Weidman, A., (2006) &#8220;Treatment for Children with Trauma-Attachment Disorders: Dyadic Developmental Psychotherapy,&#8221; Child <i>and Adolescent Social Work Journal.</i> Vol. 23 #2, April 2006, 147-171.</p>
<p>Becker-Weidman, A., (2006). &#8220;Dyadic Developmental Psychotherapy: A multi-year Follow-up,&#8221; in, New Developments In Child Abuse Research, Stanley M. Sturt, Ph.D. (Ed.) Nova Science Publishers, NY, pp. 43 &#8212; 61.</p>
<p>Becker-Weidman, A., (2007) &#8220;Treatment For Children with Reactive Attachment Disorder: Dyadic Developmental Psychotherapy,&#8221; <i><a rel="external nofollow" target="_blank" href="http://www.center4familydevelop.com%2Fresearch.pdf&amp;_gwt_noimg=1&amp;gsessionid=cHwa12Y-Ao9_pRhUd_8BcQ">research</a><a rel="external nofollow" target="_blank" href="http://www.center4familydevelop.com%2Fresearch.pdf&amp;_gwt_noimg=1&amp;gsessionid=cHwa12Y-Ao9_pRhUd_8BcQ">http://www.center4familydevelop.com/research.pdf</a></i></p>
<p>Becker-Weidman, A., &amp; Hughes, D., (2008) &#8220;Dyadic Developmental Psychotherapy: An evidence-based treatment for children with complex trauma and disorders of attachment,&#8221; Child &amp; Adolescent Social Work, 13, pp.329-337.</p>
<p>Craven, P. &amp; Lee, R. (2006) Therapeutic interventions for foster children: a systematic research synthesis. <i>Research on Social Work Practice</i>, <b>16,</b> 287-304.</p>
<p>[2] O&#8217;Connor, T., &amp; Zeanah, C., (2003) Attachment Disorders: Assessment strategies and treatment approaches. <i>Attachment &amp; Human Development,</i> 5, 223-245.</p>
<p>[3] Hughes, D., (2008) Attachment-focused Family Therapy. NY: Norton.</p>
<p>[4] Lyons-Ruth, K., &amp; Jacobvitz, D., Attachment disorganization: unresolved loss, relational violence and lapses in behavioral and attentional strategies. In Cassidy, J. &amp; Shaver, P., (Eds.) Handbook of Attachment. pp 520-554, NY: Guilford Press, 1999.</p>
<p>Solomon, J. &amp; George, C. (Eds.). Attachment Disorganization. NY: Guilford Press, 1999.</p>
<p>Main, M. &amp; Hesse, E. Parents&#8217; Unresolved Traumatic Experiences are related to infant disorganized attachment status. In Greenberg, M.T., Ciccehetti, D., &amp; Cummings, E.M. (Eds.) Attachment in the Preschool Years: Theory, Research, and Intervention, pp.161-182, Chicago: University of Chicago Press, 1990.</p>
<p>Carlson, E.A. (1988). A prospective longitudinal study of disorganized/disoriented attachment. Child Development 69, 1107-1128.</p>
<p>[5] Carlson, V., Cicchetti, D., Barnett, D., &amp; Braunwald, K. (1995). Finding order in disorganization: Lessons from research on maltreated infants&#8217; attachments to their caregivers. In D. Cicchetti &amp; V. Carlson (Eds), Child Maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 135-157). NY: Cambridge University Press.</p>
<p>Cicchetti, D., Cummings, E.M., Greenberg, M.T., &amp; Marvin, R.S. (1990). An organizational perspective on attachment beyond infancy. In M. Greenberg, D. Cicchetti, &amp; M. Cummings (Eds), Attachment in the Preschool Years (pp. 3-50). Chicago: University of Chicago Press.</p>
<p>[6] Robins, L.N. (1978) Longitudinal studies: Sturdy childhood predictors of adult antisocial behavior. <i>Psychological Medicine,</i>. 8, 611-622.</p>
<p>[7] Prino, C.T. &amp; Peyrot, M. (1994) The effect of child physical abuse and neglect on aggressive withdrawn, and prosocial behavior. <i>Child Abuse and Neglect,</i> 18, 871-884.</p>
<p>[8] Schreiber, R. &amp; Lyddon, W. J. (1998) Parental bonding and Current Psychological Functioning Among Childhood Sexual Abuse Survivors<i>. Journal of Counseling Psychology,</i> 45, 358-362.</p>
<p>[9] Finzi, R., Cohen, O., Sapir, Y., &amp; Weizman, A. (2000). Attachment Styles in Maltreated Children: A Comparative Study. <i>Child Development and Human Development,</i> 31, 113-128.</p>
<p>[10] Dozier, M., Stovall, K.C., &amp; Albus, K. (1999) Attachment and Psychopathology in Adulthood. In J. Cassidy &amp; P. Shaver (Eds.). <i>Handbook of Attachment</i> (pp. 497-519). NY: Guilford Press.</p>
<p>[11] Finzi, R., Cohen, O., Sapir, Y., &amp; Weizman, A. (2000). Attachment Styles in Maltreated Children: A Comparative Study. <i>Child Development and Human Development,</i> 31, 113-128.</p>
<p>[12] Allan, J. (2001). Traumatic Relationships and Serious Mental Disorders. NY: John Wiley.</p>
<p>Andrews, B., Varewin, C.R., Rose, S., &amp; Kirk (2000). Predicting PTSD symptoms in Victims of Violent Crime. <i>Journal of Abnormal Psychology,</i> 109, 69-73.</p>
<p>[13] MacMillian, H.L. (2001). Childhood Abuse and Lifetime Psychopathology in a Community Sample. <i>American Journal of Psychiatry,</i> 158, 1878-1883.</p>
<p>[14] Allan, J. Traumatic Relationships and Serious Mental Disorders, NY: Wiley, 2001.</p>
<p>Andrews, B., Varewin, C.R., Rose, S. &amp; Kirk. Predicting PTSD symptoms in Victims of Violent Crime. Journal of Abnormal Psychology, vol. 109, 69-73, 2000.</p>
<p>[15] Hughes, D., (2007) Building the Bonds of Attachment, 2nd. Edition, NY: Guilford Press.</p>
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<h3>Watch the video related to  treatment </h3>
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<h3>Help answer the question about  treatment</h3>
<p>What is the treatment for symptomatic rabies?<br />When I read about rabies, the only treatment mentioned is immunization. I never find much about how to treat the symptoms of rabies. I know that once the disease is symptomatic there is no chance for survival, but I&#039;m mainly interested in treatment that improves the quality of life. For example, treament that makes the patient more lucid, treatment to lower the temperature, treatment to prevent muscle spasms etc. Thank you in advance.</p>
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		<title>Using A Qualified Treatment Program For Addiction Treatment In Wisconsin</title>
		<link>http://cdcwrt.org/using-a-qualified-treatment-program-for-addiction-treatment-in-wisconsin/</link>
		<comments>http://cdcwrt.org/using-a-qualified-treatment-program-for-addiction-treatment-in-wisconsin/#comments</comments>
		<pubDate>Sun, 16 Aug 2009 06:12:55 +0000</pubDate>
		<dc:creator></dc:creator>
				<category><![CDATA[Uncategorized]]></category>
		<category><![CDATA[Addiction Treatment In Wisconsin]]></category>
		<category><![CDATA[anti-aging]]></category>
		<category><![CDATA[cellulite]]></category>
		<category><![CDATA[Treatment]]></category>

		<guid isPermaLink="false">http://cdcwrt.org/using-a-qualified-treatment-program-for-addiction-treatment-in-wisconsin/</guid>
		<description><![CDATA[Addiction is a very serious and a progressive disease. It needs to be attended to as soon as detected, or else it can become very dangerous. If someone in your family is detected of addiction of any substance, getting him the best available treatment is the most important. You will find a number of different [...]]]></description>
			<content:encoded><![CDATA[<div align="left"><img src="http://i.ytimg.com/vi/5sGCxPFzfDQ/2.jpg" width="250" height="250" alt="Using A Qualified Treatment Program For Addiction Treatment In Wisconsin"></div>
<p>Addiction is a very serious and a progressive disease. It needs to be attended to as soon as detected, or else it can become very dangerous. If someone in your family is detected of addiction of any substance, getting him the best available treatment is the most important. You will find a number of <span id="more-18"></span>different programs for addiction treatment in Wisconsin, some specializing in drug treatment, some in alcohol treatment.<br/><br/>
<p>Depending upon the level of the patient&#8217;s addiction and the type of his addiction, you must choose the correct treatment program. But choosing a qualified program from the many available options for addiction treatment in Wisconsin is very important. Choosing an unqualified program is as bad as giving no addiction treatment to your loved one. Let us study in brief why it is necessary to choose a program which is qualified over others.<br/><br/>
<p>But first let us see what a qualified treatment program is. Here is a look at what a program on addiction treatment in Wisconsin entails.<br/><br/>
<p>A qualified treatment program is the program which is affiliated with the state authorities and that the program meets the criteria provided by the state health authorities Substance Abuse and Mental Health Services Administration, the National Institute of Drug Abuse and the National Clearinghouse. These are the common criteria used all over the United Nations. The different states have the right to add certain criteria depending on the different situations in their state but the basic criteria remains the same nationally. A list of the qualified treatment programs for addiction treatment is available on the federal substance abuse websites.<br/><br/>
<p>One finds a lot of other treatments programs which are based on spirituality and faith based healing and even religious programs for abuse treatment in Wisconsin which are not recognized by the state as a qualified treatment. And hence a person cannot enjoy the benefits the state provides to all the qualified treatment programs in Wisconsin.<br/><br/>
<p>The Benefits of a Qualified Treatment Program in Wisconsin:<br/><br/>
<p>1. Low affordable cost:<br/><br/>
<p>The qualified treatment programs are mostly conducted in the treatment centers which are affiliated by the state. Hence most of the treatment centers receive funding from the state. Thus a qualified treatment program will be very cost effective here and would be much more affordable.<br/><br/>
<p>2. Sense of security:<br/><br/>
<p>A qualification by the state for a treatment program for addiction treatment means more value. This means the people of Wisconsin or any nation are able to trust the treatment and bring their loved ones who are addicted to a substance without worrying about the quality of the treatment centers. An addiction treatment in Wisconsin is recognized as a qualified program after it has been approved by medical experts and professionals.<br/><br/>
<p>3. Benefits from Insurance companies:<br/><br/>
<p>The insurance companies also cover treatments only for a qualified addiction treatment in Wisconsin. As the programs are affiliated to the state, the insurance companies trust them and are assured that the treatment centers are will be strict in their admission procedures. Thus if you choose a qualified treatment program in this state, you can be sure of your claims being settled by the insurance company. However, the same cannot be said for the unqualified treatment programs.<br/><br/>
<p>The major difficulty:<br/><br/>
<p>With the number of advantages, there is also a disadvantage with choosing a qualified treatment program. As the addiction treatments are gaining more awareness and benefits from the state authorities, the number of families wanting to put their loved ones into a qualified treatment program are also on a high. Thus one may find it difficult to admit an addicted person in the desired treatment centers as they will have a long waiting list for patients. These waiting lists can go on from several weeks to several months, differing in each treatment centers. This can be frustrating.<br/><br/>
<p>On the other hand, with the amount of increasing patient, the professionals may find it a bit taxing to keep individual tabs on everyone. With the long waiting list, the treatment centers may also reduce the individual time given to relax after the detoxification treatment. There is always a possibility of the quality of the doctor&#8217;s input going down with the increasing work load.<br/><br/>
<p>Here, those people who sort external help, that is the help of an interventionist for the smooth sailing of their entire treatment programs, have a little advantage. These intervention professionals have a partnership deals amongst them. Due to this, the treatment centre reserves some quota of seats for patients who come to the centre through the interventionists.</p>
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<h3>Watch the video related to  treatment </h3>
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<h3>Help answer the question about  treatment</h3>
<p>Does facial treatment really help in getting rid of pimples and acne?<br />I have some acne and pimples as well as scars on my face. My friends were suggesting me to go for facial treatment but I&#039;m not sure whether it will really help me in clearing the acne, pimples and the scars.</p>
<p>Should I go for facial treatment?</p>
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		<title>Disastrous Effects of Drug Addiction Call for Rapid Family Intervention</title>
		<link>http://cdcwrt.org/disastrous-effects-of-drug-addiction-call-for-rapid-family-intervention/</link>
		<comments>http://cdcwrt.org/disastrous-effects-of-drug-addiction-call-for-rapid-family-intervention/#comments</comments>
		<pubDate>Sun, 16 Aug 2009 06:12:12 +0000</pubDate>
		<dc:creator></dc:creator>
				<category><![CDATA[Uncategorized]]></category>
		<category><![CDATA[Drug Addiction]]></category>
		<category><![CDATA[Drugs]]></category>
		<category><![CDATA[Rehab]]></category>
		<category><![CDATA[Treatment]]></category>

		<guid isPermaLink="false">http://cdcwrt.org/disastrous-effects-of-drug-addiction-call-for-rapid-family-intervention/</guid>
		<description><![CDATA[Every day of every year, families in every state grapple with the drug problems of one or more of their members. Distraught parents, children or siblings appeal to the drug or alcohol user to please cease their excessive substance abuse without understanding that when substance abuse has progressed to addiction, most addicts need rehabilitation before [...]]]></description>
			<content:encoded><![CDATA[<div align="left"><img src="http://i.ytimg.com/vi/FEIg1as2ppc/1.jpg" width="250" height="250" alt="Disastrous Effects of Drug Addiction Call for Rapid Family Intervention"></div>
<p>Every day of every year, families in every state grapple with the drug problems of one or more of their members. Distraught parents, children or siblings appeal to the drug or alcohol user to please cease their excessive substance abuse without understanding that when substance abuse has progressed <span id="more-15"></span>to addiction, most addicts need rehabilitation before they can quit. That is true no matter how much they promise they will end their drug or alcohol use. When a person is addicted, the addiction controls them rather than their controlling the addiction.</p>
<p>The slide into addiction very often has a consistent pattern, person to person. Problems at work, problems paying bills, unexplained loss of money; if the person has taken to dealing drugs to support their habit, unexplained cash. Missed family events, falling grades in school, secretive or accusative behavior are all common symptoms of the descent into addiction.</p>
<p>But these events are mild in comparison to what lies ahead when a person completes his or her full descent into addiction.</p>
<p>Drug or alcohol addiction commonly results in manipulative, abusive or criminal behavior; suicide; homelessness; overdoses leading to hospitalization or death. Addiction is frequently accompanied by serious or incurable health conditions: HIV, Hepatitis C, herpes, heart disorders, loss of teeth, abscesses, staph infections, liver disease and much more. Then there&#8217;s the constant threat of incarceration. The average sentence for drug felonies in 2004 was 51 months.</p>
<p>&#8220;Families often call or email us wondering what they should do to help someone they love who is addicted,&#8221; stated said Derry Hallmark, Director of Admissions and Certified Chemical Dependency Counselor at Narconon Arrowhead. Narconon Arrowhead is one of the country&#8217;s leading drug and alcohol rehabilitation centers, located in Canadian, Oklahoma. &#8220;Unfortunately, many families try to help the addict by bailing them out of jail, helping them pay their bills or find a new job. The right thing to do is to help the addict learn to live completely drug-free by getting them into an effective rehabilitation program.&#8221;</p>
<p>Rather than substitute an addictive medication for an illicit drug problem, the Narconon drug and alcohol rehabilitation program uses nutrition, one-on-one counseling and life skills training to help a person resolve the real reasons they started using drugs in the first place. The result is that 70 percent of Narconon graduates remain drug-free after graduation.</p>
<p>&#8220;Not every drug addict is ready to ask for help with the family wants them to,&#8221; added Mr. Hallmark. &#8220;That&#8217;s why Narconon works with experienced interventionists around the country. These people are experienced at helping addicted people make their own decision to stop the pain and loss by getting help. That decision is really the first step in rehabilitation.&#8221;</p>
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<h3>Help answer the question about addiction</h3>
<p>What are 4 reasons addiction to druga and alcohol can change your personality?<br />-<br />
-<br />
-<br />
-</p>
<p>reasons that addiction can change your personality(please just list and not copy and paste) thank you SO MUCH!</p>
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		<title>Widespread Effects of Addiction Demand Effective Rehabilitation</title>
		<link>http://cdcwrt.org/widespread-effects-of-addiction-demand-effective-rehabilitation/</link>
		<comments>http://cdcwrt.org/widespread-effects-of-addiction-demand-effective-rehabilitation/#comments</comments>
		<pubDate>Sun, 16 Aug 2009 06:12:07 +0000</pubDate>
		<dc:creator></dc:creator>
				<category><![CDATA[Uncategorized]]></category>
		<category><![CDATA[Addiction]]></category>
		<category><![CDATA[Drugs]]></category>
		<category><![CDATA[Rehab Center]]></category>
		<category><![CDATA[Treatment]]></category>

		<guid isPermaLink="false">http://cdcwrt.org/widespread-effects-of-addiction-demand-effective-rehabilitation/</guid>
		<description><![CDATA[If you pay attention to government surveys, you&#8217;ll learn that more than 20 million people suffer from addiction to alcohol or street drugs, or they are dependent on prescription drugs that they have been abusing. But a recent survey of American adults shows that the effects of addiction stretch much farther than this. In 2004, [...]]]></description>
			<content:encoded><![CDATA[<div align="left"><img src="http://i.ytimg.com/vi/CRzqvWF_AeE/1.jpg" width="250" height="250" alt="Widespread Effects of Addiction Demand Effective Rehabilitation"></div>
<p>If you pay attention to government surveys, you&#8217;ll learn that more than 20 million people suffer from addiction to alcohol or street drugs, or they are dependent on prescription drugs that they have been abusing. But a recent survey of American adults shows that the effects of addiction stretch much<span id="more-13"></span> farther than this.<br/><br/>
<p>In 2004, 63 percent of adults surveyed said that addiction had impacted their lives, most of them because of a family member&#8217;s battle with drugs or alcohol. That means that more than 135 million people struggle either with their own addiction or that of a family member or someone close to them.<br/><br/>
<p>This doesn&#8217;t measure the number of children who are without a father or mother because they are in jail, in rehabilitation or simply gone. Or the numbers of children who have parents at home but suffer neglect or abuse because of the drug use. It doesn&#8217;t measure the lost productivity or the number of businesses that have had to close because an owner lost everything to substance abuse or an employee embezzled enough to close the doors.<br/><br/>
<p>Substance abuse and addiction exacts a terrible toll on America. And successful rehabilitation programs can be few and far between. Many rehabilitation programs state success rates between 5 and 20 percent.<br/><br/>
<p>&#8220;The Narconon Program is very proud of its 70% success rate,&#8221; stated Derry Hallmark, stated Derry Hallmark, Director of Admissions and Certified Chemical Dependency Counselor at Narconon Arrowhead. Narconon Arrowhead is one of the country&#8217;s leading drug and alcohol rehabilitation centers, located in Canadian, Oklahoma.<br/><br/>
<p>&#8220;In our forty years of delivering rehabilitation services and in our 120 centers around the world,&#8221; Mr. Hallmark added, &#8220;we have been able to return many thousands of people to drug-free lifestyles. Our drug-free program addresses the three primary barriers to addiction rehabilitation: cravings, guilt and depression. We employ a thorough detoxification that uses a dry-heat sauna plus exercise, vitamins and minerals to break through the cravings. Educational and counseling phases of this rehabilitation program enable those in our program to leave guilt and depression far behind and develop new life skills for a drug-free life.&#8221;</p>
<p>If you know anyone who needs help to overcome a drug addiction, please contact<br/><br/>
<p><a rel="external nofollow" target="_blank" href="http://www.stopaddiction.com&amp;_gwt_noimg=1&amp;gsessionid=jynZzqUTa6ha5_sjSbnDSw"><br/><br/>
<p>Narconon Arrowhead</a></p>
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<h3>Watch the video related to addiction </h3>
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<h3>Help answer the question about addiction</h3>
<p>How does one become an addiction counselor?<br />Looking to become an addiction counselor, or some in the area of addiction, any ideas?</p>
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