Dyadic Developmental Psychotherapy

Dyadic developmental psychotherapy is a psychotherapeutic treatment method for families with children showing symptoms of emotional disorders, including complex trauma and attachment disorders, originally developed by Arthur Becker-Weidman and 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 a theoretical basis. It principally involves creating a playful, accepting, curious and empathic environment in which the therapist attunes to a child's subjective experience and reflects it back through eye contact, facial expression, gesture, movement, voice tone, timing and touch, co-regulating emotional affect and co-constructing an alternative autobiographical narrative with the child, and also draws on cognitive-behavioral strategies; the dyad it ultimately concerns is the parent-child dyad, though the active presence of the primary caregiver is preferred rather than required. A 2006 study by Becker-Weidman suggesting the approach outperforms usual treatment methods for reactive attachment disorder and complex trauma was criticized by the American Professional Society on the Abuse of Children, whose task force found the method does not meet criteria for designation as evidence-based and provides no basis for conclusions about usual treatment methods; a separate 2006 research synthesis described it as a supported and acceptable treatment, a conclusion that has itself proved controversial, and a 2013 review recommended caution, arguing it has no support for claims of effectiveness at any level of evidence and rests on a questionable theoretical basis.