What is Dyadic Developmental Psychotherapy (DDP)?

Dyadic Developmental Psychotherapy (DDP) is a new therapeutic approach used in psychology that can help a child to feel safe.

Here, Dr Kerry Ashton-Shaw, renowned consultant clinical psychologist based in Liverpool, provides an expert insight into DDP.

What is DDP?

DDP (dyadic developmental psychotherapy) is a therapy that was originally developed to help children who had been through developmental trauma, such as neglect, abuse, or chronic trauma.

The heart of DDP is to help a child feel safe through relationships. Sometimes, these relationships involve their parents, their adoptive parents, their foster parents or whoever the safe adult is in a child’s life.

How does DDP help patients?

If I am working with a family, the usual reason for their consultation is that their child is struggling because of developmental trauma (long-term, chronic relational trauma).

Typically, the child will not be living with their birth family anymore. Instead, the child might be living with an adoptive family or with staff members, if the child is in residential care.

DDP helps to regulate emotions and to feel safe in relationships. If, for example, the child has lived through chronic stress and trauma, these will have affected the way in which the child’s brain has developed. This means that the child might become distressed more easily, the child might not be able to trust in relationships, or the child might not be able to connect in relationships in the way that humans are evolved to do.

As a result, the child might be very, very overreactive or very over sensitised. This is not the child’s fault; this is the result of the trauma that the child has lived through.

Imagine that a child has been brought up with sharks, and these are dangerous, unkind and have really hurt the child. If, for example, the child is taken away from these sharks and put in a living space with new sharks that look exactly the same, but this time, the child is being told by others that these sharks are very safe, caring and not the same ones as before, the child’s body and brain will not be able to trust the words.

DDP will work with parents first to help them understand the reason for their child’s behaviour, where the child might be extremely rejecting or dissociating, the child might not be able to make relationships, or the child might be going through really difficult behavioural processes. Through a particular way of communication, DDP will then start making the child feel safe. At the same time, the relationship between the child and the child’s parents will also develop as a result of DDP. This safe relationship will start to change the child’s brain for the better, in contrast to abuse and neglect which will cause damage to the brain. With DDP, behavioural and relational changes will also occur.

Sometimes, a child will come to therapy with a diagnosis of ADHD or oppositional defiant disorder. Once the child is regulated and part of the work as DDP is done, the child may no longer meet the diagnostic criteria for a large part of these conditions, so DDP can also help in this way.

What is the process of DDP?

DDP first works with the adults in the child’s life, helping them to feel safe. This is because, sometimes, it is quite traumatic to be on the receiving end of a child who is struggling, and to try and parent that child. Thus, the process of DDP starts with the child’s parents to help them feel safe.

In some cases, the psychologist will then meet with the child individually, before meeting with the parents and the child together in the last part of therapy.

The whole process of DDP can take between six to 12 months, depending on what is needed. In some cases, the psychologist might do a piece of work, then not see the child and/or the child’s parents for a while, and later come back all together. Despite this, the process of DDP usually works with parents first, then with the child, and lastly with the whole family.

How long do people usually continue using DDP?

It is different for different cases.

I use DDP with almost every family that comes to work with me, but this does not necessarily mean that all these children have suffered long-term trauma – that is only what DDP was initially developed for.

As a result, in some cases, it might be only one or two parent sessions that are using some of the principles of DDP for support. However, in other cases, DDP may be used over a number of years, so the duration of DDP really depends on the needs of the patient.

What is DDP parenting, and how beneficial is it?

DDP parenting is using the principles of DDP for parenting support. Again, this could be applied across the board for any parent or child.

I personally use the principles of DDP with my own child, because the therapy does not necessarily need to be used only with children who have suffered long-term abuse and neglect. For this reason, parenting support can help to manage many hardships, such as rifts, complicated relationships, behavioural problems, and academic difficulties at school.

The principles of DDP prioritise relationships, which means setting boundaries and rules. Despite this, the parent-child relationship always comes first, which helps to regulate a child.

As a result, DDP parenting might be useful for:

• Parents during their child’s teenage years
• New parents who are thinking about how they can start building boundaries for their child
• Difficult family situations – for example, bullying at school
• When there are actually no difficulties, because this can cause problems with the parent-child relationship

Dr Kerry Ashton-Shaw is a highly knowledgeable and dedicated consultant clinical psychologist with over 20 years’ experience.

If you are thinking about trying DDP (Dyadic Developmental Psychotherapy) and would like to know more, do not hesitate to book an appointment with Dr Ashton-Shaw via her Top Doctors profile today.