As I've been reading up on trauma therapies, I've been delighted at how attachment research and theory is permeating the new therapies. A few years ago I was delighted with videos of Dan Hughes working with distressed kidsusing his DDP technique. Last week, Arthur Becker-Weidman sent me an article that he and Hughes published in Child & Family Social Work (2008, 13 pp 329-337): Dyadic Developmental Psychotherapy: an evidence-based treatment for children with complex trauma and disorders of attachment. Here's the abstract and then I'll tell you more about it.
Dyadic Developmental Psychotherapy (DDP) is a family therapy treatment based on Attachment Theory. It is an integration of several approaches, methods and techniques that have a strong evidence base. The approach was originally developed to treat children with disorders of attachment and has been shown to be effective. It has since been more broadly used to help families with a variety of difficulties, including complex trauma. This paper outlines the primary principles and components of DDP and the evidence to support the effectiveness of the components and, therefore, of DDP."
From the article: "Dyadic Developmental Psychotherapy (DDP) has as its core, or central therapeutic mechanism for treatment success, the maintenance of a contingent, collaborative, sensitive, reflective and affectively attuned relationship between therapist and child, between caregiver and child, and between therapist and caregiver. DDP focuses on and relies upon the intersubjective sharing and joint development and organization of emotional experience." They speak about intersubjectivity, one of my favorite concepts, where the parent and child experience themselves as having an impact on the experience of the other. "For example, children experience themselves as being delightful, loveable and clever whenever their parents experience them as manifesting those characteristics. In a similar way, the parents experience themselves as being capable and caring whenever their children experience them as manifesting those traits."
DDP basic principles include the importance of parents' and therapists' good attachment capacity and ability to provide good intersubjective experiences for the children. It's all about attunement. It includes good acronyms: PACE, that the therapist sets a healing pace to tx by being playful, accepting, curious, empathetic; and PLACE, that the parent creates a healing environment by being playful, loving, accepting, curious and empathetic. DDP emphasizes repair of misattunements and conflicts, which helps with affect regulation and teaches that conflict doesn't lead to abandonment, or abuse.
Both kids and parents are involved with the process. Both learn to attune, to make repair, to giggle together, and hold the sadness and pain of life. It looks informal with lots of back and forth, co-relating of stories, cocreation of right-now reality. Resistance is handled with curiousity. Trauma is handled together, with the therapist giving words to the old experience. Parents are taught how to touch their kids to provide solace, engagement, and containment. And parents are assessed for attachability.
It's a great therapy for Reactive Attachment, for trauma, and for kids with any attachment disruptions. I think the principles work with adults, too. It's how I try to work, with a mix of other treatment strategies thrown in.
If you'd like to read the whole article, contact Arthur Becker-Weidman at email@example.com and he'll send you a PDF file of it. It's a good, clear, easy-to-read nine pages. His website is www.Center4FamilyDevelop.com