Dyadic Developmental Psychotherapy (DDP) has been developed by Daniel A. Hughes over
the last two decades and is derived from Attachment theory and research.
DDP is a treatment approach for young people effective in helping with the impact
of trauma, neglect and loss experiences.
It is called DDP as the treatment approach is based on the importance of the parent-child
relationship and in particular the interactions between parent / carer and child
to facilitate attachment security.
Attachment security refers to the quality of the bond between the primary carer and
the child. It refers to the process of children seeking comfort or avoiding danger.
Such that the child feels worthwhile, safe and effective and perceives others as
available, trustworthy and responsive.
This is developed through repeated experiences of attuned responding where the parent
/ carer is able to respond to the child by matching their emotional state to help
them manage their own feelings. This is known as co-regulation of affect.
DDP focuses on enabling children to think about memories and emotions as well as
their current situation within a safe context with the support of the parent / carer
to help them through the associated feelings of shame and fear.
This process will enable the child to integrate their memories and feelings and develop
a coherent life story enabling attachment security.
Secure attachments are recognised as protecting against future mental health problems
as well as facilitating social and educational progress.
The therapist models the parenting principles which incorporate the attitude of Playfulness,
Love, Acceptance, Curiosity, and Empathy (PLACE).
Treatment usually involves the therapist working with the parent / carer together
with the young person.
The approach uses a number of parenting principles, as defined by Dan Hughes:
More information about DDP can be found at www.danielhughes.org
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1
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Eye contact, voice tone, touch (including nurturing-holding), movement, and gestures
are all used to communicate safety, acceptance, love, curiosity, playfulness, and
empathy. These interactions are reciprocal, not coerced.
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2
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Opportunities for enjoyment and laughter, play and fun, are provided unconditionally
throughout every day with the child.
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3
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Decisions are made for the purpose of providing success, not failure.
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4
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Successes become the basis for the development of age-appropriate skills.
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5
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The child's symptoms or problems are accepted and contained. The child is shown how
these simply reflect their history. They are often associated with shame which must
be reduced by the adult's response to the behaviour.
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6
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The child's resistance to parenting and treatment is responded to with acceptance,
curiosity, and empathy.
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7
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Skills are developed in a patient manner, accepting and celebrating "baby-steps"
as well as developmental plateaus.
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8
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The adult's emotional self-regulation abilities must serve as a model for the child.
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9
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The child needs to be able to make sense of their own history and current functioning.
The understood reasons are not excuses, but rather they are realities necessary to
understand the developing self and current struggles.
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10
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The adults must constantly strive to have empathy for the child and to never forget
that, given their history, they are doing the best they can.
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11
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The child's avoidance and controlling behaviours are survival skills developed under
conditions of overwhelming trauma. They will decrease as a sense of safety increases,
and while they may need to be addressed, this is not done with anger, withdrawal
of love, or shame.
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The child may be held at home or in therapy for the purpose of containment and safety
when the child is in a dysregulated, out-of-control state only when less active means
of containment are not successful in helping them regain control, and only as long
as the child remains in that state. The therapist or carer’s primary goal is to ensure
that the child is safe and feels safe. The goal is never to provoke a negative emotional
response or to scold or discipline the child but rather to help them to become safe
and regulate their distress through the parents accepting and confident manner.
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