dyadic therapy

Dyadic Developmental Psychotherapy is a treatment approach for families that helps children with symptoms of emotional disorders, including Complex Trauma and disorders of attachment.

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.

Dyadic developmental psychotherapy is based on the theory that maltreated infants not only frequently have disorganized attachments but also, as they mature, are likely to develop rigid self-reliance that becomes a compulsive need to control all aspects of their environment.

Caregivers are seen as a source of fear with the result that children endeavor to control their caregivers through manipulation, over-compliance, intimidation or role reversal in order to keep themselves safe. Such children may also suffer intrusive memories secondary to trauma and as a result may be reluctant or unwilling to participate in treatment. It is anticipated that such children will try to actively avoid the exposure involved in developing a therapeutic relationship and will resist being directed into areas of shame and trauma.

It is proposed that an attachment based treatment may be more effective for such foster and adoptive children than traditional treatment and parenting interventions.

"To be effective, the child must be engaged by the therapist at the level of pre-verbal attunement rather than in a setting of rational discussions. The therapy must also involve a great deal of physical contact between the child and the therapist and parent. During much of the most intense therapeutic work, the child is being touched or held by the therapist or parent. The intense emotions are received, accepted, and integrated into the self. Within a therapeutic atmosphere based on attunement, a child is able to begin to explore aspects of his/herself and the relationships with their parents that have previously not been accessible. The development of both the child's attachment to their parents and his/her integrated self is the primary goal of the therapist; all else is secondary."  Daniel Hughesax