Examining Dyadic Developmental Psychotherapy as a Treatment for Adopted and Foster Children

Abstract

Dyadic developmental psychotherapy (DDP) is a mental health intervention intended primarily for children with problematic attachment histories. It has received increased attention in the United Kingdom and the United States in the last few years. DDP has been publicized as a research-supported treatment, but a review of research shows that it does not meet ordinary standards for this category. In addition, DDP appears to be based on a number of questionable metaphors that have been used in attempted explanations of personality development and mental illness. Some unanswered questions about the background assumptions of DDP are presented. Caution about this method of therapy is recommended.

Dyadic Developmental Psychotherapy (DDP): the development of the theory, practice and research base

“…However, we believe that many critics, including Dr Mercer, misunderstand both the theory and practice of DDP as founded and developed by Dan Hughes over the past 20 years and which is now taught in a certification programme through the DDPI. Mercer's (2014) article has provided an opportunity to address her concerns, which others may share. For those who have not undertaken training in DDP, we acknowledge that some of our responses might not be apparent in our writings.…”

“…The final two metaphors cited by Mercer (2014) are the psychoanalytic notions of regression and catharsis/abreaction and the notion of 'attachment cycle'. However, these two points are irrelevant to the discussion as they are nowhere to be found in the training and certification of DDP practitioners as outlined in Hughes (2011) and have never been presented by him as an aspect of DDP.…”

“…As some observations, such as those of Mercer (2014), appear to be based on the recent writings of Becker-Weidman, it is important to note that in 2010 he founded the Attachment-Focused Treatment Institute (AFTI) that certifies individuals as attachment-focused therapists. While the Institute’s certification programme includes some principles and components of DDP, it is not recognised by DDPI as maintaining fidelity to the DDP model.…”

“…To clarify further the aims and methods of DDP, it is helpful to focus on some of the points raised by Mercer (2014). She connects DDP to four conceptual maps of psychological realities that she refers to as ‘metaphors’.…”

“…DDP can help children who have been hurt and/or neglected within their families in their early years by supporting them to recover from previous trauma and to experience attachment security and emotional connection within their current family. As with any developing therapy, questions have been raised about its clinical relevance and effects. One such critique recently appeared in an article by Mercer (2014) and this will be used to demonstrate how misunderstandings, misinterpretations and the selective use of case studies can lead to misguided views of this important innovation. This article particularly addresses inaccuracies in accounts of the development of DDP as an intervention for looked after and adoptive children and their families, how DDP is practised around the world and how theory underpins the model.…”