Dyadic Developmental Psychotherapy

Dyadic Developmental Psychotherapy is a psychotherapeutic treatment method for families that have children with symptoms of emotional disorders, including Complex Trauma and disorders of attachment. It is based on Attachment theory. It was originally developed by psychologist Daniel Hughes as an intervention for children whose emotional distress resulted from earlier separation from familiar caregivers. Hughes cites attachment theory and particularly the work of John Bowlby as theoretical motivations for dyadic developmental psychotherapy. However, other sources for this approach may include the work of Stern, who referred to the attunement of parents to infants' communication of emotion and needs, and of Tronick, who discussed the process of communicative mismatch and repair, in which parent and infant make repeated efforts until communication is successful.

Dyadic developmental therapy principally involves creating a "playful, accepting, curious, and empathic" environment in which the therapist attunes to the child's "subjective experiences" and reflects this back to the child by means of eye contact, facial expressions, gestures and movements, voice tone, timing and touch, "co-regulates" emotional affect and "co-constructs" an alternative autobiographical narrative with the child. Dyadic developmental psychotherapy also makes use of cognitive-behavioral strategies. The "dyad" referred to must eventually be the parent-child dyad. The active presence of the primary caregiver is preferred but not required.

Two studies by Arthur Becker-Weidman concluded that dyadic developmental therapy is more effective than the "usual treatment methods" for reactive attachment disorder and complex trauma. This conclusion has been criticised. According to the APSAC Taskforce Report and Reply, (Chaffin et al. 2006), dyadic developmental psychotherapy does not meet the criteria for designation as "evidence based" nor provide a basis for conclusions about "usual treatment methods". The approach has been described as a "supported and acceptable" treatment approach in a systematic research synthesis evaluating treatment for foster children, but this conclusion has also proved controversial.(Craven & Lee 2006). Becker-Weidman and Hughes state that dyadic developmental psychotherapy meets the standards for non-coerciveness of the American Professional Society on the Abuse of Children, The American Academy of Child Psychiatry, American Psychological Association, American Psychiatric Association, National Association of Social Workers, and various other groups concerned with treatment of children and adolescents. Daniel Hughes, described by the APSAC Taskforce as a 'leading attachment therapist' cites a list of attachment therapy techniques specifically forsworn by him on his website.