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By: Steven Lecce, LMHC  Introduction
Reactive Attachment Disorder (RAD) is a complex condition that affects children who have experienced early trauma, neglect, or disrupted attachment. These children struggle with forming healthy emotional bonds and often exhibit challenging behaviors. Play-guided Eye Movement Desensitization and Reprocessing (EMDR) therapy offers a promising approach to addressing RAD symptoms effectively.
Understanding EMDR and RAD
EMDR is an evidence-based therapeutic approach primarily used for treating symptoms of trauma. The use of EMDR has been adapted for treating trauma symptoms in children, especially those with RAD, and has gained attention in recent years. RAD disrupts a child’s ability to trust and connect with caregivers, leading to emotional dysregulation, aggression, and difficulty forming secure attachments.
The Benefits of Play-Guided EMDR Therapy
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Engagement and Trust Building: Children with RAD often struggle to engage in traditional talk therapy. Play provides a natural avenue for connection. Integrating EMDR with play therapy allows therapists to establish rapport and build trust. Through play, children feel safe and more willing to explore their emotions.
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Child-Centered Approach: Play-guided EMDR therapy focuses on the child’s perspective. Therapists collaborate with the child to identify targets for treatment. By allowing the child to choose the areas they want to address, therapy becomes more relevant and engaging.
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Emotional Regulation: RAD children often experience intense emotions. Play therapy helps them express and regulate these emotions. EMDR enhances emotional processing by integrating bilateral stimulation (such as eye movements) during play activities. This dual focus helps children process traumatic memories more effectively.
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Resource Development: Before trauma reprocessing, therapists use the Preparation Phase to teach self-soothing and emotional regulation skills. These resources empower children to manage distressing emotions during EMDR sessions. Play-based techniques enhance resource development.
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Trauma Reprocessing: Play-guided EMDR allows children to revisit traumatic memories in a controlled manner. Therapists use play activities (such as drawing, storytelling, or sand tray work) to target specific memories. The bilateral stimulation facilitates memory integration and reduces emotional charge.
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Attachment Repair: EMDR can help children refocus on the strengths of their relationships within the family unit. By processing attachment-related traumas, children develop more adaptive thoughts like “I can have someone to play with” and “my parents will always love me too.”
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Parent Involvement: Involving parents in the treatment process is crucial. Play-guided EMDR encourages joint parent-child sessions. Parents learn how to support their child’s emotional regulation and reinforce positive attachment experiences.
Clinical Considerations
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Present-Oriented Targets: Children may focus on present symptoms rather than core negative cognitions. Therapists adapt by starting with the child’s presenting problem and gradually moving toward deeper cognitive targets.
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Avoiding Resistance: Instead of labeling it as resistance, therapists actively engage children. When children choose their targets, they become more invested in therapy.
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Developmental Factors: Children’s age and functioning impact treatment. Therapists adjust the pace and complexity of EMDR based on individual needs.
Conclusion
Play-guided EMDR therapy offers a holistic approach to treating RAD in children. By combining playfulness, bilateral stimulation, and trauma reprocessing, therapists empower children to heal, form secure attachments, and thrive emotionally. As we continue to explore the intersection of EMDR and play therapy, we unlock new possibilities for supporting children who are impacted by trauma.
References:
- EMDR and Children with Reactive Attachment Disorders (Dr. Robbie Adler-Tapia, 2019)
- EMDR and Play Therapy (Connect EMDR, 2021)
- Top 10 Treatments for Reactive Attachment Disorder (Child Residential Treatment, 2021)
- Benefits of EMDR Therapy for Children (Anchor Light Therapy Collective)
About the Author...
Steven Lecce's therapeutic approach is grounded in evidence-based, trauma-informed therapies, with a special emphasis on EMDR. He is a trained and experienced child-centered play therapist who integrates tools such as art, play and gaming into his therapeutic work. Steven specializes in treating PTSD, RAD, anxiety, depression, ODD, and personality disorders.
Click here to contact or learn more about Steven Lecce Last Update: 4/2/2024
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