‘Holding Therapy’ Seen By Experts As Controversial

Dr. Foster Cline’s treatment of severely disturbed children was made nationally famous by the 1987 book “High Risk: Children Without A Conscience” by Ken Magid and Carole A. McKelvey. The forward was written by Congresswoman Pat Schroeder, and the book was featured on NBC’s “Today” show, “Hour Magazine,” the New York Times and Woman’s Day.

As a leader in the field of treatment for children with severe attachment disorders, Cline has been widely sought after for speaking engagements around the country and the world.

But his use of an approach called “holding therapy” has become highly controversial.

Last fall the Colorado Board of Medical Examiners admonished Cline and restricted him from using the harsher aspects of this treatment. Earlier last year, a CBS “48 Hours” segment examined the treatment and interviewed critics as well as supporters.

As a child psychiatrist then based at The Attachment Center in Evergreen, Colo., Cline trained and supervised other therapists in “holding therapy.”

Using these techniques, a therapist or parent will often physically restrain a child and stimulate him into a rage which is believed to help him express his underlying rage and anger. The therapist then helps the child cope with these feelings in a way that is bonding and healthy.

These techniques are primarily used with foster children who have not been reached by more conventional treatments, according to Cline.

Cline’s “Success in Parenting” partner, Benjamin Brucker, said recently, “Most professionals are unwilling to take the risk of working with psychopathic, unattached children … children who have killed … attempted to kill or set fires to their parents or siblings … children who are rapists, cult members and Satan worshipers. When everyone else has given up on these kids, Foster was there.”

It was a 1988 case which Cline supervised which led to the Colorado Board of Medical Examiners’ 1995 admonishment of Cline. The case, Cline wrote in a recent e-mail memo, “has been a heart-breaker for me over many years.”

“I never saw the child, but he was seen by two therapists, one under my supervision,” he wrote during an on-line interview.

In that case, an 11-year-old, who had chased a younger crippled brother with a knife and raped a younger sister, was treated with holding therapy.

A video tape of a portion of the treatment was viewed by the medical board. The board restricted Cline from using the “averse physical stimulation or verbal abuse” shown in the video tape.

“I had no trouble accepting this restriction, as in the case of this kid, the therapists WERE extremely pushy. I had not been that pushy for decades,” Cline wrote. “But then, maybe I hadn’t had a kid with that depth of problem for decades.”

Cline agreed that the video-tape segment appeared abusive. But, he wrote, “Much of therapy, taken out of context, can look much more intrusive than the total picture.”

Beverly James is the author of “Treatment of Attachment Trauma in Children” and a clinical social worker in Hawaii. While declining to criticize Cline specifically, James speaks out against coercive techniques in general that are used on foster and adoptive children.

She describes three types of coercive techniques: prolonged physical restraint, prolonged noxious stimulation and interference with bodily functions.

She says therapists teach parents to restrain children for long periods. The parents learn to tickle the children, tap their head or feet or yell in their faces. They may also refuse to let the child go to the bathroom, hold the child’s head and force eye contact, or cover the child’s mouth and scream at the child to breathe through the nose.

“These three practices are terrorizing, abusive, inhumane and have no place in psychotherapy,” she says. “We would not be allowed to do this to prisoners of war or convicted felons. Yet this is being allowed with our children.”

Dr. Michael Manz, head of child and adolescent psychiatry at Sacred Heart Medical Center, criticizes Cline’s “holding therapy.”

“I find it a bit shallow, I don’t find it respectful and I find it too punitive,” Manz says.

In July 1995 a 3-year-old in Salt Lake City died when her adoptive father allegedly used this treatment on her. Prosecutors say he held her down, pressed his fist into her abdomen and his weight against her chest. She died of asphyxiation.

The father had learned the technique from a Salt Lake therapy clinic.

“I heard about the problem in Salt Lake City,” Cline wrote. “I do not know that therapist. However, I do believe that he did have at least some training in Colorado by some of the practitioners there. I did not participate in his training and was not associated with his training as far as I know.”

Cline has ended his connection with The Attachment Center in Evergreen.

“I am no longer associated with The Attachment Center as a consultant or board member, but I do wish them well,” Cline wrote.

Last year Cline decided against fighting the Colorado medical board’s admonition because it would have cost more than $20,000 in legal and court fees. Because he was no longer practicing holding therapy, he didn’t think the expense was worth it.

He now fears he made the wrong decision.

“At any rate, I feel saddened for all the children that may not receive adequate treatment because of my letter of admonition,” he wrote. “It is a cross to bear that will probably follow me all of my professional life. To those who know me, it makes no difference. To those that don’t, it understandably does.”

, DataTimes