Dyadic Developmental Psychotherapy (DDP): An Attachment‐focused Family Treatment for Developmental Trauma

Abstract

The impact of intrafamilial, relational trauma on the development of children is severe and pervasive, affecting all aspects of the child's functioning. The psychological treatment of children who have experienced such trauma may well have the greatest impact in facilitating their development when it adopts a relational approach incorporating central features of attachment theory while also including their caregivers when they are able to provide safety. Dyadic developmental psychotherapy (DDP), an attachment‐focused family therapy, has two phases. In the first, the therapist sees the caregivers alone to ensure that they have the motivation and ability to relate with the child in ways that facilitate attachment security. This stage includes a description of the process of the treatment and the caregivers’ central role in the co‐regulation of emotional states, reducing the impact of the trauma on the child, assisting the child in turning to them for comfort and safety, and assisting in the development of new meanings of the trauma itself and its effect on the child's future. During the joint sessions, the therapist, utilising an intersubjective stance, actively facilitates a dialogue between therapist, child, and caregiver that incorporates the goals mentioned above and, within an open‐and‐engaged conversational tone, helps the child to develop a coherent autobiographical narrative that is not fragmented by terror and shame.