Multiple Diagnoses

Categories of Children Well Served by Reflective Network Therapy and Other Considerations

Regarding the diagnostic categories of children who can usually be well served by Reflective Network Therapy, over the past four decades the method’s combination of education and therapy has resulted in substantial clinical and cognitive progress among children suffering from:

Adjustment reaction disorders, such as reactions to sexual molestation, foster care placements, and domestic violence

Asperger’s Syndrome, including Asperger’s children with overly aggressive behavior

Attention deficit disorders, with and without hyperactivity

Autism spectrum disorders (ASD)

Behavior disorders

Combinations of developmental and emotional disorders

Combinations of overanxious and aggressive behaviors

Conduct disorders

Depressive disorders

Early childhood depression

Early childhood psychoses

Elective and selective mutism

Emotional effects of life-threatening illnesses in the child or close relative

Oppositional defiant disorders

Overanxious disorders of childhood

Parent-child relationship problems

Pathological bereavement reactions

Pervasive developmental disorder (PDD)

Physical disorders that are worsened by emotional stress, such as psychogenic aggravation of asthma

Posttraumatic stress disorder (PTSD)

Reactive attachment disorders

Serious Emotional Disorders (SED)

School phobia

Social phobia

Traumatized children

Children with multiple diagnoses

Although Reflective Network Therapy clearly helps children in many diagnostic categories, our studies to date are statistically weighted for two categories: preschoolers who are either autistic or traumatized. Detections of these same two categories of early childhood disorders (autism and posttraumatic disorders) are probably on the increase in the general population as well as among children referred to RNT services. Current estimates of the general population incidence of autism are 1 in 150. This number may even be low due to underreporting and inconsistencies in screening practices. Reported cases of early childhood forms of autism have risen at a startling rate in the US, Europe and Asia (Cunningham, 2006). No one is sure yet whether autistic children are being more effectively identified or whether little-understood genetic and environmental factors are at fault for their reported numbers increasing.

There is no clear and persuasive scientific understanding or consensus of investigators about causal factors in this increase, although certainly, autism is a disorder with a basis in brain and genetic abnormalities. Functional MRI studies (Just et al., 2004, 2007) show many well-functioning parts of autistic children’s brains but a lack of their connections via white matter. Children with autism can be rehabilitated through cognitive, or emotional and social exercises (Sallows, 2005; Hope, 1999) which from our point of view may have their good effects by exercising and enhancing networks of neurons and neuronal connections.

IQ rise is greatest among those children who would be ordinarily be the hardest to treat, those with multiple psychiatric disorders, such as combinations of pervasive developmental disorder with a major depressive or post-traumatic disorder.  (Zelman 1996). The method is clinically effective compared to control and comparison groups when measured by standardized global mental health scores  (The Children's Global Assessment Score) Reflective Network Therapy can regularly produce cognitive improvements for seriously ill children and at the same time raise objectively measured intelligence of the treated children.  The data which comes from testing this hypothesis shows that IQ rise is very substantial and does not occur among controls and comparison children. (Zelman 1996, Diaz- Hope 1999, Kliman 2006) Among foster children treated with Reflective Network Therapy. one can objectively test a psychoanalytic concept called the “repetition compulsion” −a tendency to actively repeat traumas.  We demonstrated that Reflective Network Therapy in-classroom treatment reduces the repetition compulsion as measured by transfer rates among foster homes.