Dyadic Developmental Psychotherapy (DDP)
Dyadic Developmental Psychotherapy (DDP) is a treatment approach for families of traumatized children or those with disorders of attachment. It was originally developed by Daniel Hughes, an expert in attachment and trauma. DDP principally involves creating a PLACE (playful, loving, accepting, curious, and empathic) environment in which the therapist and the parent attune to the child’s emotions and reflects this back to the child by means of eye contact, facial expressions, gestures and movements, voice tone, timing and touch, “co-regulates” emotional affect and “co-constructs” an alternative autobiographical narrative with the child.
The therapy is family-focused and parents are actively involved in the treatment. Parents’ own emotional and relationship problems are addressed during the treatment process. Parents are coached in the model and taught parenting strategies that promote safe and appropriate management of behaviors and a healthy attachment. Being able to have empathy for the child, accept the child and be curious and playful are all parts of the “attitude” that heals.
Attunement is a cornerstone of this therapy. Attunement simply means to bring yourself into a receptive or harmonious relationship. In DDP, the therapist (and the parents as they are coached by the therapist) will seek to attune themselves with the child, to better create a safe environment for healthy attachment.
DDP is an experiential therapy, meaning that it involves continuous reciprocal experiences between the therapist and child and the parent and child, with the adult reading non-verbal cues and providing a response to the child, adjusting his interactions to meet the child’s needs. The approach recognizes that the roots of attachment disorder are pre-verbal, so experiences not talk therapy are necessary for healing.
Trauma is directly addressed, in a safe and secure environment, with the goal being to resolve the child’s painful and shameful emotions. Holding is one of the experiential methods used as a way to cradle the child, providing a multi-sensory experience to facilitate attunement. Restrictive, invasive and constricting holds are not used.
The child’s avoidance, resistance and controlling behaviors are viewed as survival skills that were developed when the child was under overwhelming trauma. These behaviors are met with empathy and adults who remain emotional regulated themselves to model self-regulation for the child.
Research has been done on DDP that show statistically significant improvements.