What is DYADIC DEVELOPMENTAL PSYCHOTHERAPY? What does DYADIC DEVELOPMENTAL PSYCHOTHERAPY mean?



What is DYADIC DEVELOPMENTAL PSYCHOTHERAPY? What does DYADIC DEVELOPMENTAL PSYCHOTHERAPY mean? DYADIC DEVELOPMENTAL PSYCHOTHERAPY meaning – DYADIC DEVELOPMENTAL PSYCHOTHERAPY definition – DYADIC DEVELOPMENTAL PSYCHOTHERAPY explanation.

Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/by-sa/3.0/ license.

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 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 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.

A study by Arthur Becker-Weidman in 2006, which suggested that dyadic developmental therapy is more effective than the “usual treatment methods” for reactive attachment disorder and complex trauma, has been criticised by the American Professional Society on the Abuse of Children (APSAC). According to the APSAC Taskforce Report and Reply, dyadic developmental psychotherapy does not meet the criteria for designation as “evidence based” nor provide a basis for conclusions about “usual treatment methods”. A 2006 research synthesis described the approach as a “supported and acceptable” treatment, but this conclusion has also proved controversial. A 2013 review of research recommended caution about this method of therapy, arguing that it has “no support for claims of effectiveness at any level of evidence” and a questionable theoretical basis.

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. Hughes cites Lyons-Ruth & Jacobvitz (1999) in support of this theory. Caregivers are seen as a source of fear with the result that children endeavour to control their caregivers through manipulation, overcompliance, 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. Hughes proposes that an attachment based treatment may be more effective for such foster and adoptive children than traditional treatment and parenting interventions.

It is stated that once an infant’s safety needs are met (by attachment) they become more able to focus on learning and responding to the social and emotional needs of caregivers. (Schore, 2003ab). Hughes posits that this ‘affective attunement’, described by Stern (1985) is crucial in the development of both a secure attachment as well as a positive, integrated sense of self. Attunement is a primarily a non-verbal mode of communication between infant and carer, and synchrony in the degree of arousal being expressed, as well as empathy for the child’s internal experience. Hughes states “Whether it is a motivational system separate from attachment as is suggested by Stern (2004), or a central aspect of a secure attachment dyad, it remains vital in the child’s overall development.”

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