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Dyadic Developmental Psychotherapy (DDP)
DDP is a parent and child attachment therapy that helps children process and resolve difficult feelings that stem from experiences of neglect and/or trauma in their birth home. The adoptive parents participate fully and are assisted by the therapist to provide empathic support to the child as s/he is helped to talk about past difficult experiences. When past trauma is acknowledged and talked about with the support of the new parents, the process helps the child form a secure attachment with the adoptive parents.
What is the basis for DDP?
The basis for DDP, which was developed by Dr. Daniel Hughes (Philadelphia), is attachment theory. In healthy, nurturing families, children grow up feeling lovable, emotionally safe and secure. This is because most parents are attuned to the child's needs for food, comfort and soothing, and physical touch, and they interact with the child in a way that is playful, accepting, and clearly lets the child know s/he is someone who is worthwhile and loved. The parents' positive, minute-by-minute interactions with the child not only help him or her feel safe and secure but foster healthy neurological, emotional and cognitive development. Children who have been repeatedly traumatized and neglected by parents often have great difficulty responding positively to new foster or adoptive parents. Their development has been compromised by the trauma and neglect and their behaviour may be extremely challenging and exhausting for parents. Instead of feeling worthwhile, they carry a core sense of shame and fear that drives their oppositional behaviour. They need specialized therapy and parenting in order to heal from their experiences, to develop a positive sense of themselves and for their behaviour to change.
What happens in therapy?
The attachment therapist sees parent(s) and child together. The therapist and parent provide opportunities for enjoyment and laughter and communicate at all times an attitude of acceptance, playfulness, curiosity (especially about the child's feelings) and empathy. The child is shown that his symptoms and problems reflect his history and he is helped by the therapist to tell about his experiences at a pace that is tolerable for him. As she tells her story, therapist and parent empathize with the fear she must have felt when the trauma happened. The therapist also helps the child link his traumatic past with his reactions to current situations so that he can make sense of them. For example, a child who froze in fear when his father got angry with him for his behaviour, appeared to the father to be defying his authority. The therapist helped the child understand his "freezing" as a normal response to fear and that his father's anger had triggered the terror he once felt when he was abused by his birth parents. Once the father understood, he was able to say to his son that he felt badly that the boy had had to go through the abuse. He let his son know how terrified he must have felt and understood how that now, when he, the father, got angry with him, he felt very scared all over again. The father assured the boy of his love for him, that he would respond differently when he felt angry and that he would not hurt him.
In this example, both father and son began to make sense of the child's reaction and the child was assisted in telling his story about the abuse he had suffered. Most importantly, the response of the parent to the child helped the child begin to feel safe with the father and was a step towards a more secure attachment relationship.
The therapist can also be of help and support to parents. She can offer practical parenting suggestions and help parents become aware of how their own attachment histories may influence their beliefs and parenting practices. Often, a child's behaviour triggers powerful feelings in the parent. Once these are uncovered and resolved it becomes easier for the parent to respond to the child in a supportive, empathic manner.
How long does DDP take?
Therapy can last up to one to two years or more, depending on the severity of the child's problems.
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