It only took a day to realize that the experience of riding in a police car and two days in the ER did nothing to help Sunshine's behaviors.

She was still in crisis.

There was nothing anyone could do to make this madness stop.

It was time to return to the ER.

After our experience in the first ER, several therapists and specialists recommended taking her to an ER over the mountain nearest our home, only 45 minutes away.

That's what we decided to do.

So the arrangements began.

This time we experienced what should happen when your child is in the ER for mental health reasons.

Our intensive in-home therapist drove Sunshine and I to the ER while my husband stayed home with the other three kiddos, packing lunches and getting them ready to be shipped off to friends' homes for the day until he could pick them up after his shift around midnight.

I had already packed everything I knew I would need before Sunshine woke up.  It was all ready to go.

Admittance

At the ER, we were immediately taken back to check in.  During that check-in process Sunshine made it clear she was not happy to be there.

No one questioned what we were telling them.

We were escorted back to a room designed for someone who is a danger to herself or others.

They were taking us seriously.

To be believed was such a incredible feeling.

The Room

The room had one chair, a hospital bed, a sink and a TV encased in a protective shell high up on one wall close the ceiling.

One wall was metal, as if it was a pull down door.  The main door to the room had a second smaller door inside it with a lock, in case it was needed.

All of my things were locked in a set of drawers right outside her room.  I was permitted to have my cell phone so long as I could prevent her from reaching it.

Care

Nurses immediately came in to get vitals, obtain information about behaviors and help us settle.

They were compassionate. They were caring.  They were respectful.

Seeing Sunshine's agitation, the head nurse, who happened to be male, immediately set up a plan of incentives and reinforcers to prevent any unsafe behaviors.

A security guard came in with a metal detector to make sure Sunshine wasn't hiding anything under her clothes. Having traveled by airplane, Sunshine was familiar with this process.  We called the wand a "magic wand" so she was a bit more excited when it happened.

In less than an hour a medical doctor with a nurse was in Sunshine's room to do a full exam and once again ask about behaviors.

A psychiatrist came to the room shortly thereafter to speak to me.

There was no question that Sunshine needed help.

Everyone believed me.

Behavior Protocol

In between people coming in and out of the room Sunshine was extremely agitated.  She tried to elope several times.  When I would block the door she would become aggressive.

I was unaware that there was a camera in the room when this first started.  It took only seconds after her aggression started that nurses were in the room trying to calm and redirect her.  They had been watching at the nurses station.

All of use knew that Sunshine was not herself. She was in crisis.

The nurses were kind and loving towards her, knowing she needed help and that this was not her normal.

There was no judgment towards Sunshine or me as her parent.

I broke into tears of relief for the immediate help and support.  No longer would I have to do this by myself like we had in the other hospital.  These people really cared and wanted to help Sunshine receive the help she so desperately needed.

These episodes of aggression happened several times with multiple interventions.

Realizing that it was not safe to leave Sunshine in the room with me or by herself, the nurses made a plan to have a third person join us in the room to try to distract her, with a security guard outside the door.

Our helper was an EMT. She brought in crayons, coloring books, stickers, and fun activities to do with Sunshine.

No restraints were permitted in this hospital.

A request for a sedative was put in to the doctor.

The approved request took a couple of hours.  Our helper stayed with us the entire time.

The oral medication was given with applesauce.

There was no trauma.

There were no needles.

As far as Sunshine was concerned, she just needed medicine to help her feel better and was having a yummy snack.

A security guard and helper remained with us until everyone was sure the sedative took affect.  They would not leave until they knew Sunshine could be safe.

I thought I would be more upset with my child being sedated, but after so many days of continued aggression I had nothing left in me to give and knew this was the only way to calm her down until we could get help.

The sedation was a tremendous help when it came time to get blood work later on.  It took three of us to hold her down even with the sedation, but we were able to make it through it.

Blood work was the most traumatic experience of our stay at this ER.

The Waiting Game

Once all of the doctors and nurses had finished their jobs, the waiting game began.  There were still no beds available.

The head nurse placed an order for Sunshine's dinner when it was time.  Her food allergy diet was followed to the T.

After dinner Sunshine quickly fell asleep.

My husband arranged for a friend to bring me dinner and visit.  It was so nice to have someone to talk to.  Otherwise I was just watching TV alone.

While at the hospital I couldn't charge my phone except for at the nurses station, so I had to stay off it as much as possible.  No outlets were in Sunshine's room.  Cords were not permitted.

Sunshine woke up briefly. The sedative made her extremely agitated.  We laid in her hospital bed together. I rubbed her back until she was down for the night.

Staff did bring in a reclining chair, but the hospital bed was far more comfortable so we slept together all night long.

Night staff were great.  They would watch Sunshine if I had to run to the bathroom.  If I needed my drawers unlocked, they would do so.

During the night they did not wake Sunshine for vitals.  And in the morning, they let me know they had ordered both Sunshine and I breakfast trays.

By morning the sedation had warn off.  Once again we went through the same series of attempts at elopement and aggression.  A security guard was brought into the room to help until the sedative arrived and took effect.

Once again there was no trauma related to the experience. The security guards and helpers were so wonderful bringing in activities to do with Sunshine.  Everyone was so kind.

Sunshine and I then spent the day watching TV, walking back and forth to the water cooler and to the bathroom still waiting for a bed.

At lunch time, once again trays were ordered for both Sunshine and myself.

And then it happened...

Transport to a Children's Inpatient Psychiatric Hospital 

At about 1 PM, a nurse came in.  She had come to announce that a bed had opened up at the child psych ward closest to the hospital where we had prayed Sunshine would be admitted.  (It was the closest one to our home and so many had raved about it.)

The psych ward had initially wanted to take another child waiting but the nurse pushed them to take Sunshine.  I cried tears of joy and gave her a big hug.

Sunshine was sleeping again at that point.

I was in shock and so relieved we didn't have to spend another night at the hospital.

More paperwork had to be filled out.  More vitals needed to be taken.  Another physical exam was given.  A security guard swiped her again with the metal detector.

By 4 PM, paramedics arrived for transport to the inpatient facility.

Sunshine was quite anxious about this process.  One of the paramedics was amazing with her, walking her through the process of being strapped into the stretcher, helping her adjust to the movement of the stretcher while walking her through the halls to the ambulance.

I never would have thought that the ambulance ride would have bothered me so much, but even as I write this I tear up.  The emotions I felt in that moment as she was loaded into the ambulance...  It was so hard to hold back tears.

I was unable to sit in the back of the ambulance with Sunshine, but her favorite paramedic was with her.  My spot was in the front.

The paramedic driving could sense my emotions.  He spoke with me the entire way to the inpatient facility.

Never have I been so thankful for the kind and gentle voice of a stranger who could not imagine what I was feeling, but could keep me calm in the moment.  He had a special needs child at home too.

The ride was short.  We were met at the door by nurses who took me one way and Sunshine another.  And that was it.  My daughter was officially being admitted into an inpatient psych ward after four days waiting in two different ERs.

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What You Don't Want to Have Happen When Your Child is in the ER for Mental Health Reasons (Chapter 2)

The police had already arrived with Sunshine when my husband and I made it to the hospital. I was taken back to see her as my husband filled out admissions paperwork.

When I was brought back to be with Sunshine I thanked the police officer for his help and asked how she was on the way.

He quickly replied that she was great and walked away shaking his head.

Next came the nurse, bringing Sunshine something to eat.

“She has food allergies.” I said as quickly and as kindly as possible.

“I know. She told me.” That was all the nurse said and walked away shaking her head.

This.

This was exactly what I feared most.

No one believed me.

Sunshine was acting like a perfect angel. And I was the crazy parent. I was already being judged harshly for seeking help for our family.

My husband came in at that moment. I asked where Sunshine’s therapist was as she had also followed us to the hospital.

They weren’t letting her come back.

“Go get her now! Do whatever you need to do. I NEED her back here with me.”

There was a cross between panic and anger in my voice. I couldn’t do this alone.

Already the story of what you don’t want to happen when your child is in the ER for mental health reasons was unfolding.

Sunshine’s therapist did join me shortly thereafter. My husband had to go to work and we knew it was going to be a long night.

And it was, but nothing happened as I thought it would

Just the Beginning

We changed rooms three times. The last time being at 10 PM right after Sunshine had finally settled down. Only the first room was set up for those with mental health issues who were a danger to themselves or others. Talk about making a difficult situation worse!

I thought we would at least meet with a doctor or something, but that wasn’t the case. A nurse practitioner spoke with us for less than two minutes and then I was asked to skype with a psychiatric on call nurse.

She looked at Sunshine for less than 30 seconds and then asked me a couple of questions. From there she said she would seek voluntary placement at an inpatient psychiatric facility for children.

After that we were literally left alone, shut up in a corner room as if we didn’t exist.

I asked about dinner for Sunshine.

“Sorry, the cafeteria is already closed.”

I asked if someone could watch Sunshine so I could make a phone call. Sunshine doesn’t let me talk on the phone. I needed to figure out what was going on with my other three children who had been shipped off with friends and neighbors.

With a look of disgust the nurse said she would try to find someone. A security guard eventually came in.

While I was on the phone, Sunshine pushed the code button sending the ER into a frenzy.

Sunshine takes her medications every evening at 8:30 PM. At 6 PM I mentioned this to nurses. It was at 9 PM that they informed me they didn’t have her medications and could not get them. We would have to have them brought in from home.

I wanted to cry.

So this is what it’s like when a parent seeks help for their child with mental health issues.

We remained in the ER for about 36 hours. While there, nurses brought Sunshine food she was allergic to. They showered her with gifts of stuffed animals, bubbles, balloons, and more. That’s on top of the unlimited TV time.

Sunshine thought she was on a vacation where everyone catered to her.

Meanwhile I couldn’t leave her room to go to the bathroom, get food or drink for myself, or do anything. Sunshine was my problem and everyone in the ER made that very clear.

I wasn’t sure if I should keep her as calm as possible or let her loose on hospital staff. As I spoke with other community resources, they said to keep her calm, as it wouldn’t speed up the process of finding a bed for her. None were to be had.

And that’s how it went. My husband switched off with me as he had the next day off. But still we made no progress. He petitioned the magistrate for involuntary placement, in hopes that we could speed up the process of getting help. The magistrate granted the petition, but then it just went downhill again.

More Defeat

Instead of a police officer simply standing outside of the door when the petition was granted, the captain of the police department along with an officer came and spoke to my husband. They were not on board with this.

Their concern being how traumatic it would be for Sunshine to be transported in a police vehicle to whichever hospital was selected for her placement.

As my husband explained behaviors, the police officers just shook their heads.

To be the parent that no one believes is terrifying, especially as you try to protect your other children.

In the end the woman screening Sunshine decided to deny involuntary placement for two reasons.

1. The transport to whichever facility was selected would be too traumatic for such a young child.

2. She was worried about Sunshine being safe in the state facility if that was the only option, as they’re required to take her.

My husband was literally handed discharge papers as Sunshine was beating him up.

We were furious and felt so broken.

What Now?

As we left the hospital Sunshine accelerated again. We had to wait for 30 minutes in the parking lot before leaving because she wasn’t safe.

Other mental health professionals had told us to take her to another ER if things didn’t work here.

My husband and I literally parked at a gas station for another 30 minutes to figure out a plan.

That’s when we decided if nothing else, we needed sleep and we knew Sunshine would sleep through the night with all of her medications.

After a police transport, 36 hours in an ER, and no progress made, we brought Sunshine home.

No one would help us.

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Call the Police! (Chapter 1)

I kept telling myself if we could just make it to the therapy appointment, we’d be okay.

It had been a week full of rages and aggression.

For the first time ever I found myself using the word violence to describe it.

Everyone was hurt. Some even had bruises.

It was the perfect storm of triggers.

No matter what we did, no one could make it stop.

I had cried every day.

We needed help.

But every time I thought to call the police, I knew she’d calm down before they arrived, and no one would believe me. I was just a bad parent who couldn’t control their child.

After all who could imagine that an innocent six-year-old child could be capable of so much.

Call the Police

The Therapy Appointment

The therapist arrived Monday at about 12:15 PM. She listened as my husband and I recounted all that had gone on during the past week. I cried once again.

Dinomite, Bulldozer, and Princess shared all that had happened to them.

I had taken video of one of the most mild incidents, explaining that I had replayed it over and over trying to find the magic word or action that would make it stop.

I showed it to the therapist.

If I could just figure out what I was doing wrong… Surely there was something I could do differently, even though I felt like I had exhausted all of my options.

But that’s when she said it.

“This is not okay. Sunshine is in crisis. Your family is in crisis. You need help.”

And just like that she started making phone calls.

My husband and I looked at each other. At that point I can’t recall if we were more devastated, feeling as if we had failed, or if we felt relieved and validated that what we were experiencing was as horrible as we thought it was.

The bottom line was the therapist knew Sunshine wasn’t okay and we needed help.

Phone calls seemed to lead no where as we’re just barely established here and supports are minimal.

But then it happened.

Make the Call

We were all outside enjoying the weather. The kids were playing. Sunshine had just left the porch after speaking with her therapist.

As she passed Bulldozer she punched him.

The adults intervened.

Sunshine just accelerated.

I had to go get her.

That’s when she started hitting and kicking me.

I was trying to calm her. I was trying to comfort her. But nothing worked.

She just kept punching and kicking me.

That’s when the therapist spoke up.

“Call the police!”

She led my husband inside with Sunshine, observing how the rage and aggression continued to escalate while I stayed outside with the other kids and made the call.

Even now I can’t put into words what it felt like to call 911 on my baby girl.

I was shaking, stumbling on my words, and pacing back and forth in the yard.

My other kids were frightened and emotional.

We all knew that at some point this would happen, but we didn’t expect it now.

The kids wondered if one or more police officers would show up. They wondered if they would come sirens blazing. And of course the big question was how long it would take for them to get to us as we live out in the middle of nowhere.

I couldn’t answer their questions. We just had to wait.

I took turns hugging each of them as they cried and expressed their feelings about the situation.

Princess’ words still echo in my mind.

“I didn’t believe this could really happen. I can’t believe this is happening.”

Help Arrives

It took over 10 minutes for the police officer to arrive. He came in a disguised car with no sirens.

I directed him upstairs.

By that time Sunshine had calmed down. One would say she was even excited to see him. My husband and I cringed. This was the whole reason we hadn’t called before. No one would believe us.

But here’s the thing. The therapist had seen the episode. She had seen the recording of Sunshine’s behaviors from earlier in the week. It wasn’t just coming from us.

It was the therapist that asked that the police officer take Sunshine to the nearest emergency room so we could seek voluntary placement in a psychiatric hospital for children.

Sunshine needed help.

Thankfully I was able to find someone to take my other three children before Sunshine was brought downstairs.

We weren’t sure if she would go willingly or not. We were warned she put up a fight she would be handcuffed and taken away screaming.

I didn’t want my other children to see that.

It turned out Sunshine didn’t mind going with the police officer. The two walked hand in hand to the police vehicle. He strapped her in the back and I watched as they pulled out of the driveway.

Just the Beginning

My husband and I grabbed essentials and then headed to the emergency room. I cried all the way there. Neither one of us could express how we were feeling in words.

Ultimately though we both felt validated.

This was devastating.

It was a nightmare.

But it needed to happen.

We needed help and the only way to get that was to call the police.

This was just the beginning though.

There’s no turning back after you call the police.

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How to Discipline a Child with Reactive Attachment Disorder

My husband and I are eight years into our journey parenting our oldest adopted daughter with Reactive Attachment Disorder.

We’re six years into the journey of parenting our youngest adopted daughter with Reactive Attachment Disorder.

How we respond to behaviors with the first has the opposite effect on the second.

One child leans towards passive aggression and manipulation paired with destruction of property and self-harming behaviors.

The other is loud, in your face, physically aggressive, and at times violent with rage.

In these cases, anything can become a weapon and anyone can become a victim.

How to discipline a child with Reactive Attachment Disorder (RAD) is a very complicated subject.

As complicated as it is though, there are some things all parents and caregivers can do.

First let us address two points that are very important to understand.

1. Trusting a child with Reactive Attachment Disorder is a bad idea.
2. Consequences for behaviors usually don’t work with children who have RAD but still must be given.

You may now be wondering...

So if you can’t trust a child with Reactive Attachment Disorder and consequences for good and bad behaviors don’t work, what do you do?  Here are our best tips.

8 Tips When Disciplining a Child with Reactive Attachment Disorder

1. Focus on Safety

Your main priority is to keep everyone and everything safe. Take as many preventative measures as possible to avoid dangerous behaviors that jeopardize the safety of others.

With safety measures in place, there will be fewer opportunities for behaviors, and less of a need for discipline as we understand it. The discipline is the safety protocol in place.

Consider the safety of all in your family. It is your responsibility as a parent to keep everyone safe.

If you fail to do so there can be significant legal ramifications that can destroy your family permanently. When deciding consequences and forms of discipline, make safety your focus. How can I help everyone be safe?

2. Remember Your Other Children

It is so easy to waste all your energy and effort disciplining your child with Reactive Attachment Disorder, whether you do it intentionally or not.

Your other children are very aware of this.

They watch how you respond to behaviors on your best days and on your worst.

Try to remember your other children.

What are you trying to teach them?

As you discipline your child with Reactive Attachment Disorder, are you helping to strengthen relationships with your other children?

How do they feel about the parent you’ve become?

Consequences most often do not work when disciplining a child with Reactive Attachment Disorder, but consequences do work with your other children.

Are you giving appropriate consequences that you would also give to your other children if they did the same things?

Is your emotional response appropriate?

What lessons are you teaching your other children as you discipline your child with Reactive Attachment Disorder?

If they follow your example with their own children, will you be pleased with the result?

Are you teaching them that any form of abuse is okay, whether it’s abuse you’re permitting from your child with Reactive Attachment Disorder, or abuse you are unintentionally showing towards your child with Reactive Attachment Disorder?

When responding to behaviors, are you responding with fear, anger or other negative emotions in the heat of the moment, or are you modeling appropriate coping mechanisms?

Discipline and consequences may not have any affect on your child with Reactive Attachment Disorder, but everything you do, everything you say, and how you respond in the heat of the moment will affect your other children for the rest of their lives.

When you’re able to think about your response to behaviors as a teaching moment, advocating for others in your home, your ability to handle the situation appropriately will increase significantly.

You are also teaching your other children the importance of mercy and justice.

Evaluate your actions to determine if you are advocating for everyone in your home.  Sibling relations when Reactive Attachment Disorder are so important to keep an eye on.

3. Set Clear Boundaries for Yourself

Typical parenting approaches have little to no effect on a child with Reactive Attachment Disorder.

You will get desperate and try anything and everything to help your child with RAD and bring peace to your home.

In these acts of desperation, it’s important to have clear boundaries that are set ahead of time regarding what you will and will not do in regards to discipline.

These boundaries are to protect YOU.

You may have the best of intentions, and think you are helping, when in fact you have turned into an abuser yourself.

You may be faced with a situation in which you are the target of rage, violence, or worse.

What is your instinctive response?

Do you fight back?

Or are you one who flees the scene?

Prepare for this when setting boundaries for yourself and deciding on forms of discipline, because this situation WILL occur at one time or another.

Talk to your team of specialists. Create a safety plan. You can NOT do this alone.

4. Everyone Has a Breaking Point

As a parent of a child with Reactive Attachment Disorder, you must always have your guard up. It’s as if you’re on the front lines of the battlefield ALL the time.

This takes a heavy toll.

No one, and I mean NO ONE can do what you’re being asked to do 24/7 for years on end without taking care of yourself. This includes constant self-care, respite, and an unwavering support system.

Let’s be clear!

Self-care, respite and support are not forms of weakness.

They are the opposite.

It’s only through them that you will become strong enough to endure the battle.

Everyone has a breaking point.

Take care of yourself.

Don’t let Reactive Attachment Disorder transform you into the monster you fear most, especially as you attempt to discipline your child.

5. Eliminate Battles

I used to think that confronting behaviors head on would lead to progress. If I could only understand the “why” behind the behavior, we could fix it and rewire the brain, or come up with coping mechanisms.

Yeah… Not so much.

This approach only led to rages and screaming fits that lasted hours, followed by more negative behaviors, a headache, and emotional exhaustion for all parties.

And still there were no answers.

I then moved on, giving consequences that required time, energy, and supervision. This led to more negative behaviors, even more headaches, and even more emotional exhaustion, not to mention a LOT of wasted time focused on negative behaviors, that could have been spent having positive experiences with my other children.

It so wasn’t worth it. In fact it made things worse.

Do your best to eliminate battles. They will not benefit anyone involved. You’re left feeling miserable and the child with Reactive Attachment Disorder just caused more chaos, which is the opposite of what you want to have happen.

6. Accuse with Confidence

I’m not sure what happened that influenced my change in approach. Perhaps it was surrender or exhaustion, or the fact that I didn’t have a voice left.

But one day, Princess did something that I discovered while getting ready for church. She was with my husband getting her shoes and coat on. I had a couple of minutes to myself to think clearly.

I was the last to hop in the van. Princess was already buckled and ready to go. I turned around and looked her straight in the eyes and in the calmest voice stated with confidence,

“I know you did this (fill in behavior), and this is what’s going to happen as a result (fill in consequence).”.

She looked down, didn’t say a word, and the day went on.

Now in some cases, things don’t go as well, and I need to add this phrase,

“If you are unsafe in your response to what I’ve said, I will call the police or take you to the hospital and you can talk to them about what you’ve done, and how you’ve responded to the consequence I’ve given.”

This phrase works, only because my children with Reactive Attachment Disorder know I will not hesitate to call the police or take them to the hospital.

Accuse with confidence and give a consequence that does not require effort on your part when possible.

You will want to save your energy for those times when consequences without effort aren't a choice.

In the rare occurrence that you may be wrong, you can go back and apologize later.

7. Give Behaviors a Rating and Choose the Most Appropriate Response

It’s no secret that if you give a child with Reactive Attachment Disorder an inch, she will take a mile. Because of this, there is such a tendency to micromanage every single behavior.

And once you start micromanaging, your child with Reactive Attachment Disorder picks up on it and has the time of her life driving you insane.

This in turn provokes you, which then leads to poor choices on your part.

Yet, you can’t give the kid an inch, because it’s too dangerous. AHHHHH!

So, incorporating all that you’ve read, come up with a rating for behaviors specific to your child.

Every child is different. No two rating systems are likely to be the same. Even with my two RADlings, there’s a difference.

Once you’ve rated behaviors into groups, choose a consequence for each group.

Memorize it.

In the moment, ask yourself which group the behavior you’re seeing belongs to, and give out the appropriate consequence.

To read more details about this approach and how to create your own, be sure to read 4 Steps to Managing Aggressive Behavior.

8. Document. Document. Document.

No matter how severe the behavior, it's extremely important to document all that's going on in your home regarding your child with Reactive Attachment Disorder.

This documentation can be so beneficial later on when behaviors become more severe and you need a paper trail.

They can be a lifesaver when you are falsely accused of doing something you have not in regards to discipline.

Worst case scenario, documentation can save you in those moments when you didn't do your best and something unexpected happened that you reacted to in the moment.

I can't say it enough. Document. Document. Document.

If you need help, be sure to check How to Document Behaviors for Professionals and Specialists.

My favorite way of documenting is recording all information related to The ABCs of Behavioral Analysis.  This is something that is used with children who have autism, but can very easily be adapted to children who have Reactive Attachment Disorder.

What It's All About

Disciplining a child with Reactive Attachment Disorder may have absolutely no affect on the child, but it does affect you as the parent, and all other children you have in your home.

This is why, when disciplining, it’s important to take the focus off of the child with RAD.

It’s not about them.

It’s about doing your job as a parent.

It’s about teaching your other children what is and what is NOT okay.

It’s about showing your child with Reactive Attachment Disorder how the real world works.

Good choices have good consequences.

Bad choices have bad consequences.

It's about not feeling guilty when having to deal out real world consequences for insane behaviors that you know you would never be okay with in any other circumstance.

It’s about not showing fear and following through when you need help and know behaviors aren’t okay.

It's about not becoming a victim of abuse.

And in the end, it’s about showing that a parent’s love will always be there with appropriate and healthy boundaries for all parties.

For those who would like to follow our story and receive more resources about Reactive Attachment Disorder, be sure to subscribe to our newsletter by clicking the link below.

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