EXPERIENCES OF ATTACHMENT THERAPY: A FOLLOW-UP STUDY OF ADOPTIVE MOTHERS by JANE SHOEMAKER WIMMER (Under the Direction of M. Elizabeth Vonk) ABSTRACT The purpose of this study was to explore mothers’ experiences of attachment therapy as related to their current relationships with their adopted children. The therapy cited in this study was family-focused intervention which engaged the child and parents in resolving attachment difficulties. All of the children were adopted from the Georgia public child welfare system and had been diagnosed with Reactive Attachment Disorder, a serious emotional disorder of childhood that is exhibited by lack of bonding of the child to parental figures. The 16 mothers interviewed in this study had participated in state-sponsored attachment therapy and were part of an evaluation of that therapy in 2003. This research study employed a descriptive qualitative design that used in-depth semi- structured interviews, artifacts, and a reflective research journal for data collection. The population was purposefully chosen, and all mothers who were part of the 2003 study participated. Three research questions guided this study: (1) What was the experience of attachment therapy for the participants? (2) How did the participants view their current relationship with their adopted child? (3) What were the participants’ perceptions of the role attachment therapy played in their current level of functioning? Data analysis guided by the constant comparative method revealed eight major findings. The experience of attachment therapy was (1) consistently supportive, (2) emotionally painful, and (3) physically safe. The mothers’ current relationships with their adopted children were (4) continuously stressful and (5) unquestionably permanent. Attachment therapy had (6) instilled confidence in the mothers, (7) preserved family structure, and (8) offered partial solutions to the children’s problems. Conclusions were that adoptive mothers exhibited extraordinary resilience, that attachment therapy had essential therapeutic components including a sense of the safety of therapy, and that families needed multi-level support from therapists, community resources, and public policy. INDEX WORDS: Reactive attachment disorder, Attachment therapy, Adoption, Special needs adoption, Child welfare EXPERIENCES OF ATTACHMENT THERAPY: A FOLLOW-UP STUDY OF ADOPTIVE MOTHERS by JANE SHOEMAKER WIMMER B.A., Bucknell University, 1967 M.S.W., Rutgers University, 1969 A Dissertation Submitted to the Graduate Faculty of the University of Georgia in Partial Fulfillment of the Requirements for the Degree DOCTOR OF PHILOSOPHY ATHENS, GEORGIA 2007 © 2007 Jane Shoemaker Wimmer All Rights Reserved EXPERIENCES OF ATTACHMENT THERAPY: A FOLLOW-UP STUDY OF ADOPTIVE MOTHERS by JANE SHOEMAKER WIMMER Major Professor: M. Elizabeth. Vonk Committee: Patricia M. Reeves Alberta J. Ellett Electronic Version Approved Maureen Grasso Dean of the Graduate School The University of Georgia May 2007 iv DEDICATION Jack was adopted when he was seven in the mid 1980s. A handsome, blond haired little boy, he was the blessing his adoptive parents had prayed for to complete their family. But Jack had been abused and neglected, and he had Reactive Attachment Disorder, a diagnosis that was unrecognized when he was placed. After 20 years his adoptive mother wrote, Grandchildren are really wonderful. John is 4 and Ricky is 3. They spent the weekend with us, and so we are exhausted but our hearts are filled with so much love that we will be able to exist without them until we get them for the weekend in 2 weeks. They were adopted by their biological mother's parents. The biological mom does not see the kids at all and Jack, now 27, is forbidden to see them by a court order. Fortunately, we have a good relationship with the other grandparents and although we are no longer legally grandparents they treat us as such, so we can have the kids almost as much as we want. Jack is still maintaining his carefree lifestyle, sponging off anyone he can. We have come to terms with our relationship. We understand that he never really bonded with us and I think we finally accepted that it is not his fault nor was it ours. We could not penetrate the shield he built to keep from getting hurt. We see him at least twice a month and he spends the holidays with us. He does not work for longer than 1 to 2 weeks at a job, but he is going to the local tech school to study welding. Hopefully learning a trade will help. He is a handsome young man and now that he is on probation (7 years left) he is not using drugs. Jane, we will never stop hoping that v someday he will be able to make a life for himself that involves some responsibility and in turn provides him true happiness. Our marriage is still strong (amazing as that must seem). God has blessed me with a wonderful man. (Adoptive Mother, personal communication, March 7, 2005) Statistically, this is a successful adoption. Jack did not disrupt from his adoptive family. He never returned to foster care. However, in spite of love, skill, patience, and professional help, Jack’s parents were unable to help him attach to them. He abused drugs, and he abused his children. This dissertation is dedicated to those who seek to find help for children like Jack. vi ACKNOWLEDGMENTS My heartfelt thanks to my friends and colleagues who supported me through the extraordinary journey of doctoral education: Rene Searles McClatchey, who walked with me every step of the way, Penelope Lane, who looked at the world with me, and Pamela Awtrey, who was there from beginning to end. My gratitude also to my committee: Bert Ellett, whose door was open from the first day, Trisha Reeves, who introduced me to qualitative research, and Betsy Vonk, whose dedication to adopted children and their families I admire. vii TABLE OF CONTENTS Page ACKNOWLEDGEMENTS........................................................................................................... vi LIST OF TABLES......................................................................................................................... ix CHAPTER 1 INTRODUCTION .........................................................................................................1 Statement of the Problem ..........................................................................................6 Purpose of the Study..................................................................................................6 Significance of the Study for Social Workers ..........................................................7 Definitions.................................................................................................................9 Assumptions of the Study........................................................................................10 Organization of the Study........................................................................................10 2 REVIEW OF THE LITERATURE .............................................................................12 Prevalence and Description of Attachment Disorders ............................................12 Research on the Post-Adoption Needs of Families and Their Adopted Children...17 Understanding and Treating Attachment Disorders................................................26 Practice Literature on Treatment of Attachment Disorders ....................................33 The Program of Attachment Therapy for Adopted Children in Georgia ................37 Conclusion...............................................................................................................41 3 METHODOLOGY ......................................................................................................44 Description of Methodological Perspective ...........................................................46 viii Methods...................................................................................................................49 Data Analysis ..........................................................................................................54 Presentation of Findings..........................................................................................56 Validity and Reliability ...........................................................................................57 Researcher Biases....................................................................................................61 4 FINDINGS...................................................................................................................65 The Participants.......................................................................................................66 Overview of Categories...........................................................................................84 Chapter Summary..................................................................................................134 5 DISCUSSION AND CONCLUSIONS .....................................................................138 Categories and Literature ......................................................................................139 Conclusions ...........................................................................................................149 Limitations of the Study........................................................................................157 Implications...........................................................................................................159 Concluding Remarks .............................................................................................171