Dyadic Devel­op­men­tal Psy­chother­a­py

About DDP

Devel­oped in the con­text of the recog­nised effects of mal­treat­ment on chil­dren, Dyadic Devel­op­men­tal Psy­chother­a­py (Hugh­es, 2011)[1] is a rela­tion­al ther­a­py devel­oped to facil­i­tate attach­ment secu­ri­ty between the child and their par­ents or care­givers.  This mod­el applies the frame­works of attach­ment the­o­ry, inter­sub­jec­tiv­i­ty and the neu­ro­bi­ol­o­gy of mal­treat­ment.  This is achieved by using ‘here and now’ inter­sub­jec­tive expe­ri­ences (the process by which one per­son com­mu­ni­cates their under­stand­ing of the oth­er) in the ther­a­py room to dis­cov­er pos­i­tive qual­i­ties in the child, pro­vide emo­tion­al reg­u­la­tion, and facil­i­tate a new under­stand­ing of why the child has need­ed to use dis­trust­ful, defen­sive and con­trol­ling behav­iours in order to keep safe (Hugh­es, 2011, Hugh­es, Gold­ing & Hud­son, 2015)[2] .  The mod­el active­ly involves the par­tic­i­pa­tion of the care­giv­er as an attach­ment fig­ure to increase safe­ty and secu­ri­ty on which the young per­son can revis­it their unre­solved yet for­ma­tive expe­ri­ences in rela­tion­ships.  For more infor­ma­tion on DDP see DDPnetwork.org.

This mod­el is flex­i­ble and can be deliv­ered as a direct inter­ven­tion or through informed prac­tice. The lat­ter has been termed “Dyadic Devel­op­men­tal Prac­tice” and both ele­ments of DDP, psy­chother­a­py and prac­tice, are deliv­ered at Clover Child­care.  Key ele­ments of the mod­el, con­cep­tu­alised as the Pyra­mid of Need (Gold­ing, 2015) are used to guide assess­ments and mon­i­tor­ing of progress of the young peo­ple dur­ing their time at Clover Child­care Ser­vices.

Fig­ure 8.1. Dyadic Devel­op­men­tal Prac­tice Mod­el 

In the prac­tice mod­el (fig­ure 8.1) we also attend to the impor­tance of under­stand­ing devel­op­men­tal trau­ma with­in con­text.  This means reflect­ing on how devel­op­men­tal trau­ma impacts as it inter­con­nects with the expe­ri­ence, cul­ture and iden­ti­ty of the child, fam­i­ly and with the prac­ti­tion­ers offer­ing the sup­port. A sim­ple dia­gram does not cap­ture the com­plex­i­ty of mean­ing and unique­ness behind the words and labels and is there­fore in dan­ger of being reduc­tion­ist. How­ev­er, we want­ed to high­light the impor­tance of under­stand­ing devel­op­men­tal trau­ma with­in a wider con­text which impacts on all of us. This includes the inter­sec­tion of devel­op­men­tal trau­ma with the expe­ri­ence, some­times trau­mat­ic, of grow­ing up in a mar­gin­al­ized group. This includes dif­fer­ence because of gen­der, sex­u­al­i­ty, class, race, reli­gion, neu­ro­di­ver­si­ty, phys­i­cal and men­tal dis­abil­i­ty.   Know­ing our­selves and those we are sup­port­ing is an impor­tant part of Dyadic Devel­op­men­tal Prac­tice. (4)

About DDP at Clover Child­care Ser­vices Lim­it­ed 

In 2010, DDP was cho­sen by the Direc­tors of Clover Child­care Ser­vices as rep­re­sent­ing a close fit in the guid­ing vision of the homes and the imple­men­ta­tion of these val­ues with­in a coher­ent the­o­ret­i­cal mod­el. The sto­ry of the imple­men­ta­tion of DDP at Clover Child­care has been pre­sent­ed at the 2016 Inter­na­tion­al DDP con­fer­ence in Glas­gow (fol­low: DDP Con­fer­ence 2016).  

Since then there has been a strong invest­ment in the approach and in the staff deliv­er­ing this mod­el with the aim that all staff in time will com­plete  DDP Lev­el one and Lev­el two train­ing.

Before any for­mal DDP train­ing takes place, all new staff com­plete a 15 hour train­ing, over 3 weeks, in the basic prin­ci­ples of DDP, the role of blocked care, the impact of mal­treat­ment on attach­ment secu­ri­ty and apply the prin­ci­ples of par­ent­ing with PACE.  

This course is deliv­ered and designed by the Con­sul­tant Clin­i­cal Psy­chol­o­gist and aside from high rat­ings of sat­is­fac­tion, the course has shown pos­i­tive, sta­tis­ti­cal­ly sig­nif­i­cant ben­e­fits for the par­tic­i­pants in their lev­el of con­fi­dence in apply­ing attach­ment the­o­ry into prac­tice in man­ag­ing both rela­tion­al and behav­iour­al dif­fi­cul­ties.

Please see below our train­ing num­bers. 

 How is DDP prac­tice applied at Clover?

In the moment, where inter­ac­tions between staff and chil­dren are con­cerned, this mod­el is imple­ment­ed in a process mod­el called ‘Par­ent­ing in the Moment’ This mod­el was devel­oped (co-cre­at­ed) by Clover Child­care Ser­vices with Dr Kim Gold­ing, the DDPI and Con­sul­tant and Train­er in DDP and is includ­ed in the Foun­da­tions for attach­ment train­ing course (Gold­ing, 2017)[3].  This mod­el is embed­ded through­out DDP Lev­el one and two train­ings and the Nav­i­gate train­ing course ensur­ing the approach is con­sis­tent for all staff.

The DDP approach is also informed through the facil­i­ta­tion of team super­vi­sions on a month­ly basis led by a Con­sul­tant Child and Ado­les­cent Psy­chi­a­trist, who in addi­tion to exten­sive expe­ri­ence of work­ing and with and lead­ing a ser­vice for chil­dren looked after, has Lev­el two train­ing in DDP.  

Clover Child­care Ser­vices employs a Char­tered Con­sul­tant Clin­i­cal Psy­chol­o­gist who is an accred­it­ed Expe­ri­enced Prac­ti­tion­er in DDP. (Please fol­low the link for more infor­ma­tion on Clover’s Char­tered Con­sul­tant Clin­i­cal Psy­chol­o­gist — Dr Ben Gur­ney-Smith). DDP ther­a­py can be direct­ly pro­vid­ed to chil­dren and young peo­ple with their pri­ma­ry attach­ment fig­ure with­in the home.  Inter­ven­tions are mea­sured pre and post for effec­tive­ness.  Inter­ven­tions are also used in inter­ven­tions, where appro­pri­ate, with birth par­ents.  The Con­sul­tant can also pro­vide super­vi­sion to those prac­tic­ing the appli­ca­tion of DDP from Lev­el one and two train­ings.  The Con­sul­tant also pro­vides addi­tion­al assess­ments along­side this role in terms of neu­rode­vel­op­ment and psy­cho­log­i­cal well-being and over­sight of annu­al assess­ments guid­ed by the Pyra­mid of Need (Gold­ing 2015).  

[1] Hugh­es D (2011) Attach­ment-focused Fam­i­ly Ther­a­py Work­book. New York: WW Nor­ton & Co.

[2] Hugh­es, D., Gold­ing, K. S., & Hud­son, J. (2015). Dyadic Devel­op­men­tal Psy­chother­a­py (DDP): the devel­op­ment of the the­o­ry, prac­tice and research base. Adop­tion & Fos­ter­ing, 39(4), 356–365.

[3] Gold­ing, K. (2017). Foun­da­tions for Attach­ment Train­ing Resource: The Six-Ses­sion Pro­gramme for Par­ents of Trau­ma­tized Chil­dren. Jes­si­ca Kings­ley Pub­lish­ers.

(4) Gold­ing, K and Hugh­es, D. (2023) Heal­ing Rela­tion­al Trau­ma Work­book : DDP in Prac­tice. Nor­ton Pub­lish­er.