Because disinhibited social engagement disorder (DSED) can put a child at risk of development delays and predatory adults, it’s crucial to seek treatment.

Disinhibited social engagement disorder (DSED) is an attachment disorder seen in children and teens characterized by overly friendly behavior with unknown adults and lack of fear of strangers. Risk factors for DSED stem from neglect, inadequate care environments (such as orphanages), frequent changes in caregivers (such as foster care) and childhood trauma.

Many times, even when conditions improve and a stable environment and caregiver are present, a child with DSED will continue to display signs of the disorder. Once a stable caregiver and home environment is established, specific care must be given for such a child, including a DSED treatment plan. DSED treatment varies based on the individual and recommendations from a pediatrician or therapist, but it often involves play therapy, art therapy, medications for co-occurring conditions and behavioral management techniques for both child and parent.

Play Therapy

Play is an important part of a child’s healthy development. Play therapy allows a therapist or a caregiver to come to the level of the child and better understand problem areas the child is struggling with through play.

The goal of this therapeutic method is to build a nurturing and safe environment where the child can take the lead in playing with different toys and materials. Play therapy for children can allow adults to better understand the interactions and relationships of a child, including their concerns, likes and dislikes.

Art Therapy

Many mental health professionals praise art therapy as an often underutilized treatment option. Studies have shown art and creativity to be an important factor in a child’s emotional development. According to one study, the relationship between a parent and child can be improved using art as a medium. An art therapist can use creative tools to assist both the parent and the child with difficult emotional processes. Because childhood trauma, such as sexual abuse, can be a cause for DSED, art therapy may be a suitable treatment to reduce the symptoms associated with the condition.


No research has been done concerning the direct treatment of DSED with the use of medication. However, if a child has a co-occurring condition, such as anxiety disorderattention-deficit hyperactivity disorder or mood disorder, administering medication for those conditions may improve the outlook for DSED symptoms.

Behavioral Management

Among the treatments available for attachment disorders, behavioral management is thought to be one of the most promising. This form of treatment can help parents or caregivers focus on the quality of their interactions with their child. Behavior modification strategies for parents can help parents communicate appropriate behavioral expectations and consequences and provide adequate support to their children.

Administering behavioral management training to children with DSED can also help the child have appropriate interactions with unfamiliar adults and reduce potentially problematic or dangerous behaviors.

Treating DSED and Co-Occurring Conditions

To effectively treat DSED, a thorough physical and mental health examination must be conducted by a medical professional. If there are any co-occurring conditions present in a child with DSED, those should also be addressed.

Some co-occurring conditions that can be seen with DSED include:

It is important to discuss all treatment options for a child with DSED with a licensed professional. A thorough examination can help identify the presence of co-occurring disorders and effective treatment options for children and their caregivers.

If you or someone you know is struggling with substance use in relation to DSED or another co-occurring disorder, give us a call at The Recovery Village. You can speak with one of our representatives about a treatment plan to get you on the road to recovery. Take the first step to a better future now.

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Editor – Megan Hull
Megan Hull is a content specialist who edits, writes and ideates content to help people find recovery. Read more
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Medically Reviewed By – Dr. Karen Vieira, PhD
Dr. Karen Vieira has a PhD in Biomedical Sciences from the University of Florida College of Medicine Department of Biochemistry and Molecular Biology. Read more

Reddy, R.P., Hirisave, U. “Child’s Play: Therapist’s Narrative.” Indian Journal of Psychological Medicine, April-June 2014. Accessed May 11, 2019.

Zeevi, L.S., Regev, D., Guttmann, J. “The Efficiency of Art-Based Intervention[…]n Parental Training.” Frontiers in Psychology, August 22, 2018. Accessed May 11, 2019.

Bitonte, R.A., De Santo, M. “Art Therapy: An Underutilized, yet Effective Tool.” Mental Illness, March 4, 2014. Accessed May 11, 2019.

Dickman, Cassie. “Parent–Child Interaction Therapy for t[…]order: A Case Report.” Evidence-Based Practice in Child and Adolescent Mental Health, 2017. Accessed May 15, 2019.

Zeanah, C.H., Chesher, T., Boris, N.W., “Practice Parameter for the Assessment and Treatment of Children and Adolescents With Reactive Attachment Disorder and Disinhibited Social Engagement Disorder.” Journal of the American Academy of Child and Adolescent Psychiatry, 2016. Accessed May 11, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.