Abstract
BackgroundMaltreated children have significant and complex problems which clinicians find difficult to diagnose and treat. Previous US pilot work suggests that Dyadic Developmental Psychotherapy (DDP) may be effective; however, rigorous evidence from a randomised controlled trial (RCT) is lacking. The purpose of this study is to establish the feasibility of an RCT of DDP by exploring the ways that DDP is operating across different UK sites and the impacts of current practice on the potential set-up of an RCT.MethodsQualitative methods (interviews, focus groups and teleconferences) were used to explore trial feasibility with therapists and service managers from teams implementing both DDP and possible control interventions. Data were analysed thematically and related to various aspects of trial design.ResultsDDP was commonly regarded as having a particular congruence with the complexity of maltreatment-associated problems and a common operating model of DDP was evident across sites. A single control therapy was harder to establish, however, and it is likely to be a non-specific and context-dependent intervention/s offered within mainstream Child and Adolescent Mental Health Services (CAMHS). Because a ‘gold standard’ Treatment as Usual (TAU) does not currently exist, randomisation between DDP and TAU (CAMHS) therefore looks feasible and ethical.The nature of family change during DDP was regarded as multi-faceted, non-linear and relationship-based. Assessment tools need to be carefully considered in terms of their ability to capture change that covers both individual child and family-based functioning.ConclusionsAn RCT of DDP is feasible and timely. This study has demonstrated widespread interest, support and engagement regarding an RCT and permissions have been gained from sites that have shown readiness to participate. As maltreated children are among the most vulnerable in society, and as there are currently no treatments with RCT evidence, such a trial would be a major advance in the field.
Highlights
Maltreated children have significant and complex problems which clinicians find difficult to diagnose and treat
This study has demonstrated widespread interest, support and effective engagement regarding an randomised controlled trial (RCT) to explore the efficacy of Dyadic Developmental Psychotherapy (DDP)
The data suggests that there are a sufficient number of sites practicing DDP with the resources, managerial support and agreement from stakeholders to be involved in an exploratory trial
Summary
Maltreated children have significant and complex problems which clinicians find difficult to diagnose and treat. Whilst the US studies are reasonably robust, they are not definitive; they are based on the results of comparing children having DDP with a matched control group of similar children having a range of other psychotherapeutic interventions, but the DDP was conducted by a single therapist and was not randomised. This means that, despite these promising findings to date, randomised controlled trial (RCT) evidence, which is regarded as the highest level of evidence in terms of quality [16], is currently lacking for DDP
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
