The current study explores reactive attachment disorder which has been linked to the severe and chronic maltreatment and neglect which is very prevalent in youths residing in residential treatment center. Current literature is reviewed and summarized, and discrepancies in diagnostic criteria, associated behavioral symptoms and treatment modalities is reviewed. A needs assessment survey of past and present workers in level 12 and 14 residential treatment centers for severely emotionally disturbed youths in the San Francisco Bay area was conducted to evaluate the knowledge base of new staff, staff education during tenure and desire for information about attachment related difficulties. Then a manual was created to briefly explain attachment theory, Reactive Attachment Disorder and it's behavioral implications and the importance of self care for staff working with children with attachment disruptions. Finally, this manual was peer reviewed by 5 staff. The results suggest that residential staff strongly desire additional training about attachment related disorders. This has important implications for service development for this vulnerable group of children.