Dyadic Developmental Psychotherapy (DDP): the development of the theory, practice and research base

Abstract

Dyadic Developmental Psychotherapy (DDP) is a relationship-focused therapy characterised by a strong therapeutic alliance, empathy and unconditional positive regard. It seeks to treat the complex psychological problems of looked after and adopted children as they struggle to develop a greater measure of stable functioning in their homes. It was developed by Dan Hughes based on his extensive clinical experience of working with children and families together and is rooted in a close study of relevant theory. DDP can help children who have been hurt and/or neglected within their families in their early years by supporting them to recover from previous trauma and to experience attachment security and emotional connection within their current family. As with any developing therapy, questions have been raised about its clinical relevance and effects. One such critique recently appeared in an article by Mercer (2014) and this will be used to demonstrate how misunderstandings, misinterpretations and the selective use of case studies can lead to misguided views of this important innovation. This article particularly addresses inaccuracies in accounts of the development of DDP as an intervention for looked after and adoptive children and their families, how DDP is practised around the world and how theory underpins the model. Although a lack of evidence derived from robust evaluations is acknowledged, the authors discuss the evidence base that is currently available and plans that are in place to strengthen this.