Reactive attachment disorder (RAD) is a psychiatric condition affecting children that is characterized by inappropriate and sometimes disturbing ways of relating socially to others, including parents. Relatively rare, RAD is thought to arise from a failure to form close attachments to primary caregivers in early childhood due to abrupt or prolonged separation, neglect, or abuse. In the United States, the incidence of RAD increased in the 1990s as Americans began to adopt an unprecedented number of formerly institutionalized children from orphanages abroad and from within American child welfare systems. To help resolve the extreme behavioral problems exhibited by their children, many adoptive parents are now turning to a controversial but popular treatment: attachment therapy.
In The Road to Evergreen, Rachael Stryker provides an in-depth exploration of the theory, implementation, and culture of attachment therapy as it is practiced in Evergreen, Colorado, the center of RAD treatment in the United States. To understand RAD and the Evergreen model, Stryker conducted interviews with client families at an attachment clinic in Evergreen, other American adoptive families, participants in the Denver foster care system, and personnel at international adoption agencies and orphanages. At the center of Stryker's analysis is the disjuncture between the ideal of family life and the reality of caring for formerly institutionalized children. American parents who have pledged to offer unconditional love are at a loss when children offer indifference, hostility, destructiveness, or outright violence in return.
Stryker demonstrates that the Evergreen model, with its goal of emotionally rehabilitating adoptees to prevent their eventual exile from families, is an important component of a cultural logic for preserving adoptive family in the United States. However, the therapy does not always deliver the promised happy ending. Stryker's clear and balanced account of attachment therapy will be useful in informing and reforming both adoption practice and pediatric psychology.