The ABC program 20/20 did the public no service in its recent myopic support of pseudoscience. Aired in late November, 2008, the presentation "The Toughest Call" emphasized common "alternative" approaches to adoption issues, rather than citing excellent empirical research from investigators such as Sir Michael Rutter. "The Toughest Call" (Nov. 28, 2008, Parts 1-5; http://abcnews.go.com/2020) encouraged the public to accept myths about adoption, including the idea that adopted children have many unpredictable mental health risks. The program suggested that the children they discussed were cases of Reactive Attachment Disorder, a legitimate diagnosis-- but in fact the symptoms described were not those conventionally considered for diagnosis of this disorder, but another, more frightening set of behaviors advertised by the cult-like "Attachment Therapy" community.
Like "Attachment Therapists", "The Toughest Call" put forward the unsubstantiated claim that adopted children need to be treated with systematic harsh, humiliating, and potentially dangerous disciplinary practices, a view contrary to a report of a task force of the American Professional Society on the Abuse of Children. Critics of "Attachment Therapy" have noted a wide range of professional ethical violations by proponents of these practices; in the case of "The Toughest Call", an egregious ethical error involved ABC's payment for transportation of children and their parents to a treatment facility which received valuable publicity through the program. In presenting "The Toughest Call", 20/20 did a serious disservice to adoptive families, and a valuable service to practitioners who base their treatments on pseudoscientific evidentiary claims. In addition, ABC staff responded to complaints by a weak attempt at rebuttal rather than by serious reconsideration.
It is by no means unusual for journalists to seek "pop" information on the Internet and to reinforce public misconceptions by repeating inaccurate statements. This seems to especially true with respect to adoption and children's mental health issues. For example, the reporter Mark Puente, writing in the Cleveland Plain Dealer about an abusive adoptive family, referred to Reactive Attachment Disorder as involving "defiant, rageful behavior", a description found among proponents of pseudoscientific mental health treatments, but not in the Diagnostic and Statistical Manual of the American Psychiatric Association. Because print journalists work under time pressure and do not always have access to excellent sources, this is not surprising.
However, the 20/20 program was in development for many months and apparently involved discussion with a number of sources, suggesting that the producers should have been able to provide reliable information. Regrettably, as well as failing on this point, ABC staff replied defensively to post-program complaints from the non-profit group Advocates for Children in Therapy. Indeed, a critical thinking analysis of the ABC response suggests that most if not all of the "responses" are simply irrelevant to the complaints made, while others are clearly red herrings.
ABC's News Practices Director, Nicole Gallagher, replied at length to the ACT concerns, listing in a general way the sources used. For example, she referred to "numerous families with children who were adopted... [and] who provided similar stories of RAD... [which were] supported and diagnosed by trained licensed physicians." This information is of little use unless we are also told how many of these numerous families there were and, above all, how they were selected from among other families. Because there is no simple method for the diagnosis of Reactive Attachment Disorder, it would have been useful to know what methods were used by the physicians and exactly what their training was.
Ms Gallagher stated that ABC had consulted with "dozens" of experts on Reactive Attachment Disorder, but she named only one such person, referring to "respected research on the subject from authorities such as Psychologist Gregory Keck at the Attachment and Bonding Center... of Ohio." This is an interesting claim, as Keck (whose doctorate is in criminology) has never done any systematic empirical research on RAD-related issues nor published any such work done with colleagues. It is difficult to imagine what research might have been found and respected under these circumstances; however, it is possible that Ms. Gallagher, like many people, conflates "research" with "published statements". Certainly, Ms. Gallagher seems to have missed the important point that Keck until very recently displayed on his web site material derived from a pseudoscientific-and potentially harmful-view of adoption and emotional attachment (quotations from Keck's Internet material can be seen at childrenintherapy.org/keck.html).
According to the ABC response, the "experts concluded that it was reasonable to consider that children separated from their primary parents, put into institutions and adopted, would be at risk for developing attachment issues." Setting aside the considerable and much-discussed differences between having Reactive Attachment Disorder and "being at risk... for attachment issues", it is notable that systematic empirical research, such as that of Sir Michael Rutter, indicates that the great majority of institution-adopted children do very well developmentally. If the word "would" were replaced by "might", the ABC comment would be more in line with the statistical reality.
One final point: Ms. Gallagher commented that the director of the "Ranch for Kids", highlighted in the 20/20 program, had "agreed to evaluate the... family pro bono this past summer... we are comfortable with our ethics as nothing was hidden or misrepresented." However, the general use of the term pro bono means that the service is performed without payment in kind or otherwise to the professional; surely, no one would argue that an hour's worth of free advertising is not payment of a valuable nature.
The necessary conclusion seems to be that ABC prepared "The Toughest Call" either carelessly or with deliberate bias. When attention was called to the program's problems, rather than attempting to correct the misinformation they had provided to the public, ABC staff circled the wagons and prepared a response that employed propagandistic arguments. It is regrettably that the 20/20 program, so highly esteemed among skeptics for the work of reporter John Stossel, was used by other staff to support unsubstantiated mental health approaches, especially those involving a potential for harm to a highly vulnerable child and adolescent population.
By Jean Mercer, Ph.D., author of "Understanding Attachment" and the soon-to-be-released book "Child Development: Myths and Misunderstandings."