Children and Young People’s Experiences of Dyadic Developmental Psychotherapy

Abstract

Aims: Dyadic Developmental Psychotherapy (DDP) is a family-based psychotherapeutic intervention designed to help children and young people with the psychological difficulties that may result from early experiences of interpersonal familial abuse, neglect, and adversity. The study aim was to understand the experience of DDP through the lens of the child, with a view to informing an understanding of any perceived changes that may have come about through the therapeutic process in relation to attachment security and increased caregiver closeness. Method: Six children aged between 8 and 12 years old accessing ongoing DDP interventions participated. Participants were adopted or living with extended family under Special Guardianship Orders. Narrative story stem methodologies were utilised to elicit projective responses through figurine enactments, alongside additional creative visual methodologies. Data was analysed using Interpretative Phenomenological Analysis, and triangulated through a DDP therapist focus group, which was interrogated using template analysis. Results: Two master themes and eight subthemes were identified from the data. Together these themes described a dynamic process where the qualities of the therapeutic interactions were the active ingredient, generating potential for increased caregiver closeness and connection. A cycle of interactive repair was important to maintain the process of developing trust. Most participants were able to express benefits of the therapy, depicting increased connection and closeness with caregivers. Implications: Findings indicate that attuned emotional interactions in DDP may drive positive change, generating the relational conditions through which to blend affective states with reflective functioning, leading to increased attachment security through the active involvement of caregivers. Outcomes are likely to be moderated through therapist effects, supporting robust practitioner training with regular DDP specific supervision and development through the practicum process as relevant to ensure therapist proficiency. Play and activity-based research techniques were helpful in promoting meaningful inclusion for this group of children.