WHAT IS DYADIC DEVELOPMENTAL ATTACHMENT THERAPY?
Dyadic Developmental Psychotherapy is a highly regarded treatment for Attachment Disorder, developed by Dr. Dan Hughes, PhD., a leading attachment therapist and educator. I have completed extensive training with Dr. Hughes.
There are two vital components to this parent-child treatment. First it is important to note, the work is dyadic, meaning it takes place in the dyad between parent(s) and child. Since early attachment problems first were created in a problematic relationship to a birth parent or primary caregiver, healing must take place in in the primary relationship between child and adoptive parents or care givers. In sessions I work with parents and child to create active emotional connection.
Second, the treatment is developmental, meaning that parent and therapist are growing the child through the first developmental phase of “Trust vs. Mistrust.” Often children with early life trauma have missed this important developmental stage. Building Trust is accomplished first through educating parents about the unique needs of their child and teaching them a set of emotional attunement and limit setting skills to help the child form a more secure attachment. The work relies on key therapeutic principles including empathy, emotional attunement, playfulness, curiosity and acceptance.
This description has been taken from the UK DDP network site
Is DDP right for your family?
Here you’ll find some questions and answers about the therapy to help you decide if Dyadic Developmental Psychotherapy & Practice (DDP) could be right for you and your family.
Once you have made the decision to try to find someone to help you and your family, it can be hard to know what the best next step might be.
Different countries have a wide range of ways that organisations or individuals provide help. Countries vary in the extent to which they have a national health service as well as in the way social care services are provided.
It can also be difficult to decide what kind of therapy might be best for you and your family. Some are family and relationship-based; others take a more individual approach.
What we have provided here are some questions that parents and foster carers have asked us in the past with some answers. We have given general answers and there may be some differences in practice between countries and also between different practitioners. We hope that this will be helpful, and give you a general guide, regardless of how services are organised where you live.
What do the words mean?
‘Dyadic’ means ‘something about two people’. This word was used because this therapy helps people with their relationships with other people.
DDP specifically aims to help parents or caregivers and their child make deeper emotional connections with each other. This can be one of the hardest things for children to do who have given up on trusting, or relying on adults, because they have been let down by adults in the past who have cared for them.
It can be just as hard for children who have had good care and then had to leave the adults who provided this good care. Often they move many times until they lose trust that their current caregivers will be lasting. For this reason, DDP is a type of therapy where you will be seen with your child.
‘Developmental’ is used because the children and adolescents who have experienced developmental trauma may have had their emotional, social or cognitive development affected. This can happen in a wide range of ways that are individual to your child’s circumstances and are sometimes hard to make sense of.
This therapy aims to work out whether and how your child’s development might have been affected and how you might be able to help your child’s development progress.
Who is it for?
DDP is a way of helping children and young people who have been adopted or fostered or live in kinship care, or residential homes. It can also help children who live with their biological parents if the home and parenting provided is now safe and nurturing, both emotionally and physically.
Biological parents will also need to be able to understand and accept responsibility for any of their past behaviours that may have harmed their child or left him or her unprotected from harm.
What does DDP aim to do?
It aims to:
- Help your child to have a better relationship with you
- Help you to have a better relationship with your child
- Help you make more sense of what might be the reasons behind or underneath your child’s more concerning, confusing or worrying behaviour
- Help your child, with you alongside, make sense of their current day to day feelings, thoughts and behaviours as well as the things that have happened in the past
- Help you, together with your child, make sense of how these may be linked
- Help your child to understand how your motives are different form the motives of past caregivers who provided them with inadequate care.
How this happens will depend on the ways your child learned to cope with his or her earlier experiences. For example, if he or she finds it hard to trust you or ask for help, the therapist will focus on this. If your child seems to need to always feel in control of everything, this will be focused on.
One way of looking at this is that it aims to increase your child’s attachment security.
What’s involved in this therapy?
Getting to know you as parents or caregivers
First of all, your therapist will want to get to know you, and find out about your child from you, before meeting you with your child. How long this takes depends on your situation. Sometimes the therapist will ask people who know you and your family well, like social workers, for information, or ask for reports, always with your permission. These first meetings will also prepare you for the meetings with your child so you can be fully and actively involved.
You will also hear about ways of parenting children with developmental trauma. This will include learning about Parenting with PACE
Your therapist may also talk with you about any of your own life experiences that might be relevant. This is because caring for a child who has experienced developmental trauma can bring up, or trigger forgotten feelings or memories from your own past, often in unexpected ways.
Finally, your therapist will try to understand how it has affected you if you have often been unsuccessful in helping your child’s development or in forming an enjoyable relationship with your child. When caregiving becomes hard – when your commitment to your child keeps you going but your satisfaction in parenting is low – your therapist will want to provide you with the same understanding and support that is being asked of you to give to your child.
Meeting with you and your child
Once your child joins you in the therapy, often arranged as weekly sessions, your therapist may want to talk with you about how the week has gone before the session. This also enables plans to be made about what is important to discuss during the meeting. This helps to make the best use of the time you all have together. This might happen by telephone or in a meeting.
In sessions, you and your therapist work together to help your child feel as emotionally safe as is possible. PACE is central in this process, just as it is central in day-to-day parenting. For children who find it hard to trust adults, this is really important to help with building relationships, making sense of what has happened in the week and thinking about how your child coped with and adapted to his or her past experiences.
Your therapist will explore with your child events of your child’s life – both past and present – in a way that is intended to help your child remain open and engaged in the conversation, rather than become defensive.
How does the therapy work?
Your therapist will:
- Help you and your child talk about things that happen now
- Help you and your child make sense of his or her past experiences and how these might be linked to things that happen now
- Help your child understand and reduce the shame that may be underneath current behaviours, which originated in his or her traumatic past.
- Help your child to discover qualities of self that might elicit pride, not shame, and joy, not despair. This is done as your therapist helps you to discover these same qualities in your child that lie underneath his or her traumas and challenging, shame-based behaviours.
- Work with you to help your child be more aware of his or her thoughts, emotions and wishes as well as his or her possibly traumatic memories. This will be done slowly and only when the time is right
- Help you all work out the most helpful ways of you parenting your child
- Help you and your child build a narrative together that makes sense to all your family
What if my child won’t talk about things?
Sometimes it will be too hard for your child to talk about what he or she has done or about tough feelings or memories. This is always OK. When this happens you and your therapist will let your child know that this is fine and totally understandable. It doesn’t mean though that difficult things will be avoided or ignored.
Often, it means that your therapist will slow down the conversation, focusing longer on lighter, positive, and successful events first and more gradually introducing more difficult themes.
Your therapist for example may talk about things with you, while your child listens.
Your therapist might also talk for your child, helping him to find the words that describe his inner life of thoughts, feelings, and wishes. Many children begin talking in DDP in ways and about events that they had rarely spoken about in the past.
Your therapist may ask you to try other ways of wondering about things during meetings. These might include:
- Reading books together
- Telling or listening to stories
- Nurturing activities
- Using creative activities, such as puppets or plasticine
- Using toys or puppets
When activities like these are included, the aims are the same. Your therapist will be trying to help you and your child to add words to their experiences.
Will the therapist always want to involve my child?
Sometimes, you may all decide that the most helpful way to work with your family is to see you for a number of parental consultations and not to see your child. One aim of these consultations will be to think about family relationships. Another will be to discuss ways to parent your child, taking into account all we know about the impact of trauma, neglect and multiple loss on a child and just how hard this can make parenting. This is called Dyadic Developmental Parenting.
Following your child’s response to the therapist’s consultations with you, you and your therapist will decide together if there is need for further sessions that directly involve your child with you or if they do not seem to be needed.
Why doesn’t the therapist see my child on his or her own?
One straightforward answer is that when a child has been deeply affected or troubled by something that happened within a past parenting relationship, the therapeutic approach that will help the child most will focus directly on their current relationships with parents or caregivers. This means having parents and their child together in the room.
When a child is exploring a past stressful event while receiving the comfort and support of their parent or caregiver, that child is likely to be engaged in the therapeutic exploration more quickly, safely, and with greater benefit than if it is being done with only the therapist being present.
In summary, DDP sessions:
- Create a safe and emotionally containing environment that helps positive relationships develop between parents or caregivers and their child
- Provide a safe space for a child to explore thoughts, feelings and memories, including scary and unpleasant ones
- Build trust
- Help the parent or caregiver share the child’s emotional experiences and make sense of them together
- Help the child to feel that his or her emotional experiences, thoughts, wishes, feelings, perceptions and motives are accepted and not made light of, or judged, by their parents or caregivers
- This is done alongside helping parents with effective ways to respond to their child when his or her behaviour requires this
When a child’s early attachment history consists of abuse, neglect, and/or multiple placements, they fail to experience the interaction that are necessary for normal development and often have a reduced readiness and ability to participate in such experiences.
Many children, when placed in a foster or adoptive home that provides appropriate parenting, are able to learn, day by day, how to engage in and benefit from the dyadic experiences provided by the new parent. Other children, have been much more traumatized and compromised in those aspects of their development that require these dyadic experiences, have much greater difficulty responding to their new parents. For these children, specialized parenting and treatment is often required
See what Dr Dan Hughes has to say about DDP