Dyadic Developmental Psychotherapy (DDP)
Dyadic Developmental Therapy (DDP) is a form of family and relationship focused psychotherapy for children that have been neglected or hurt by their families in their early years, often for children in foster care or adoptive families with trauma-attachment disorders. These children may have been traumatised by their early experiences, causing them to find it difficult to feel safe in their new families. DDP’s main purpose is to help these kids develop the ability to form healthy attachment-based connections with their parents and caregivers, where ordinary parenting may not be able to.
How Does DDP Help?
The experience of being parented presently may remind the children of the way these children are being parented in the past, even though there is no present danger. These children may be afraid of a parental figure and struggle with normal healthy parenting, and develop different ways to adapt to the fears.
These developed ways to cope may be maladaptive and parents may find it difficult to manage the child’s behaviour, and form a healthy emotional connection.
Specifically, these difficulties may include difficulties in attachment; where children find it difficult to feel safe and secure with their parents, and difficulties in intersubjectivity; where children find it hard to give and take in relationships.
The parent-child bond is held in high regard by DDP, and this “dyad” is used as a healing platform. Parents acquire a trauma-informed parenting approach during treatment, and children gain emotional regulation and interpersonal relationship skills as they learn to trust. As a result, the child is able to construct an autobiographical story that is essential for a healthy attachment. This approach can also assist them in developing strong protective shields against mental health disorders in the future.
DDP rests on a simple but profound idea: healing happens within safe, attuned relationships. When early experiences have taught a child that adults are unpredictable or unsafe, the child’s nervous system adapts for survival—hypervigilance, controlling behaviours, avoidance, or explosive protest may once have kept them safe. In a nurturing but structured therapeutic space, DDP invites the child and caregiver to experience something different: consistent care, emotional attunement, clear boundaries, and a shared narrative that makes sense of past pain. Over time, this new pattern allows the child to internalise trust and move toward secure attachment.
A hallmark of DDP is the PACE stance—Playfulness, Acceptance, Curiosity, Empathy. Playfulness adds lightness and connection, signalling that the relationship can carry difficult feelings. Acceptance communicates that the child’s inner world—feelings, wishes, fears—is welcomed without judgment, even when certain behaviours still require limits. Curiosity sounds like “I wonder…” and helps uncover meaning beneath behaviour. Empathy validates the child’s experience, meeting shame and fear with warmth. This stance is modelled by the therapist and coached with parents so it becomes the default tone at home.
DDP also emphasises intersubjectivity, the shared understanding that develops when two people hold each other’s minds in mind. Many traumatised children have missed thousands of micro-moments of attuned gaze, contingent response, and soothing repair. DDP sessions deliberately create these moments in the here-and-now: slowing down, noticing cues, reflecting feelings, and repairing quickly when misattunements occur. These experiences build the child’s capacity for co-regulation (calming with an adult), then self-regulation (calming independently).
How Does DDP Work?
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The therapist will start by working with the parents.
Early sessions involve hearing the family’s story, identifying hopes and stressors, and offering psychoeducation on attachment, trauma, and the brain. Parents learn why behaviours that look defiant may actually be protective adaptations. The therapist introduces the PACE stance and practices it in-session so it becomes embodied rather than just “technique.” Safety, predictability, and collaboration are established from the start.
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Parents would be starting to get prepared for their role in the therapeutic process as the therapist gets to know them and explains their role in the DDP sessions.
Parents are coached to lead with connection before correction. They learn to notice triggers (e.g., transitions, food, bedtime), to offer structured choices, and to set limits without escalating shame. Practical tools include connection rituals, repair scripts after conflicts, and routines that make the day feel safe. This foundation is crucial; children risk vulnerability only when caregivers feel confident and regulated.
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The child joins the session and the therapist would try to understand the child better.
With the child present, the dyad practises short, attuned interactions—shared storytelling, playful eye contact, noticing and naming feelings, and brief co-regulation exercises. The therapist guides both to slow down, reflect, and wonder together about what behaviour might be communicating. The goal is not to extract confessions or force disclosure but to foster felt safety and curiosity about inner experience.
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The therapist will help the child to talk to his/her parents and collectively try to understand the child’s experiences, and find ways for parents to use appropriate discipline and boundaries.
Conversations weave past and present: “When Mum says it’s time to stop, it can feel bossy and scary—maybe like before. I wonder if your tummy gets tight then? What could we try together when that feeling shows up?” The therapist models reflective language, validates the child’s logic for surviving difficult times, and supports parents to keep warmth while holding boundaries. Discipline becomes teaching within connection, not punishment from disconnection.
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Therapy ends when there are some signs that the child is developing some attachment security.
Markers of progress include increased trust, quicker repair after conflict, more flexible behaviour, and a richer autobiographical story that includes past pain and present safety. Families also report more joy in ordinary moments. The endpoint is not “perfect behaviour” but a resilient bond where struggles can be faced together.
What a Typical DDP Session Looks Like
Sessions are active, relational, and paced to maintain safety. A therapist might begin by checking each person’s emotional temperature and inviting a brief connection ritual (a shared memory, a playful game, or a calming breath). The dyad then explores a recent challenging moment, reconstructing it with curiosity: what the child felt, what the parent perceived, and what needs were unmet. The therapist highlights successes, reframes behaviour through an attachment lens, and coaches a small experiment for next time. Sessions end with appreciation and a concrete plan so the home environment reinforces gains.
Why PACE Matters at Home
Children learn most from repeated micro-interactions at home. A parent’s steady PACE response—“I can see this is hard; I’m here; let’s figure it out together”—gradually disconfirms the expectation that adults are rejecting or dangerous. Over time, the child internalises the parent’s calm voice and begins to self-soothe. Moments of playfulness (shared humour, gentle teasing that stays kind) signal safety to the nervous system and increase openness to guidance.
Trauma, Shame, and the Autobiographical Story
Many children hold fragmented, shame-laden narratives: “I’m bad,” “I make trouble,” “Adults leave.” DDP helps weave a coherent autobiographical story that honours survival while locating responsibility with the grown-ups who failed to protect. Parents learn to say, “What happened to you should not have happened. You did what you needed to stay safe. Now it’s our job to keep you safe, and your job is to let us help.” As this story is repeated in words and actions, shame softens and identity shifts from “bad kid” to “valued child with a hard past.”
Skills Parents Practise
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Co-regulation strategies (grounding, paced breathing, sensory tools) that parents can lead during distress.
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Repair scripts for after conflict (“I’m sorry I raised my voice; I care more about us than being right. Let’s try again.”).
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Playful connection rituals (five minutes of child-led play, secret handshakes, shared songs) that build joy banks.
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Curiosity phrases that reduce power struggles (“I wonder what your worry is telling you right now?”).
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Clear, consistent boundaries paired with warmth (“I won’t let you hurt yourself; I’m going to sit close so we can calm together.”).
DDP and Other Approaches
DDP integrates well with occupational therapy, speech and language work, and school supports. Some families also use skills from CBT, mindfulness, or parenting programmes; the key is to keep attachment at the centre. For children with high arousal, brief sensorimotor regulation may precede deeper relational work. When medication is part of care, therapists and physicians coordinate so the child can engage fully in sessions.
Culture, Identity, and Adoption
DDP honours the child’s cultural, racial, and familial identity. For adoptive families, sessions may include conversations about origin stories, loss, contact with birth relatives where appropriate, and building pride in multiple identities. For kinship and foster carers, the work may focus on balancing advocacy with system demands, managing transitions, and preserving the child’s connections in safe ways. The therapist’s stance remains one of humility and curiosity about each family’s lived context.
Safety and Readiness
DDP is carefully paced. If there is ongoing danger (e.g., violence, unstable housing), practical safety steps come first. Parents’ own histories may be activated by the child’s behaviours; reflective space for caregivers—whether within DDP sessions or in parallel support—is often essential. The aim is not perfection, but good-enough consistency: showing up, repairing, and trying again.
Progress and Outcomes
Families often notice progress in everyday life: fewer battles around routines, quicker calming after upsets, more spontaneous affection, and better tolerance of limits. Teachers may report improved engagement and peer relationships. Parents describe feeling less helpless and more confident. Importantly, growth is uneven; slips are opportunities to practise repair. The long-term aim is attachment security—trust in caregivers, an integrated sense of self, and the capacity to seek help when distressed.
Trauma-Informed Parenting at a Glance
Trauma-informed parenting means interpreting behaviour through the question, “What happened to you?” rather than “What’s wrong with you?” It pairs predictable structure with emotional attunement, uses natural and logical consequences instead of harsh punishment, and prioritises connection before correction. In DDP, trauma-informed parenting is not a checklist but a way of being: warm, curious, firm, and hopeful.
Common Challenges—and How DDP Addresses Them
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Control battles: Children who once had to be in charge to survive may test limits. DDP helps parents hold boundaries kindly, reduce power struggles, and offer meaningful choices.
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Shame storms: Small mistakes can trigger huge reactions. PACE responses name and soothe shame, separating the child’s worth from the behaviour.
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Testing trust: As security grows, children may test whether care is conditional. Consistent follow-through and quick repairs build faith that love endures.
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School difficulties: The team collaborates with educators to provide predictable routines, regulation breaks, and relational support.
Measuring Progress
Therapists and families may use simple trackers—rating scales for stress, logs of conflicts and repairs, and notes on connection moments. Qualitative signs matter too: shared laughter, eye contact that lasts longer, or a child seeking comfort instead of withdrawing. These everyday markers often tell the most truthful story of change.
Telehealth and Accessibility
DDP can be delivered in person or via telehealth. Remote sessions may include virtual home tours to plan routines, coaching during mealtime or bedtime, and secure messaging for quick check-ins. Many families appreciate the flexibility and the chance to practise new skills where they matter most—at home.
Getting Started
If you are considering DDP, begin with a conversation about goals and hopes for your family. A therapist trained in DDP will outline the approach, answer questions, and collaborate on a plan that fits your child’s age, strengths, culture, and needs. Early wins are small and relational: a calmer morning, a quicker repair, a moment of shared delight. Over time, these moments accumulate into attachments that feel sturdy and safe.
Key Takeaways for Caregivers
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You did not cause the trauma, and you are central to the healing. Your presence—not perfection—is the main tool of change.
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PACE every day: a little playfulness, steady acceptance, gentle curiosity, and real empathy.
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Structure helps safety. Predictable routines and clear limits reduce anxiety and invite cooperation.
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Repair early and often. “Let’s try that again together” teaches hope.
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Celebrate progress, however small. Joy is not a luxury; it is a treatment ingredient.
For many families, DDP becomes more than a therapy—it becomes a language of connection. With practice, home feels different: voices soften, bodies relax, and problems become shared puzzles rather than lonely battles. This is the essence of attachment security: knowing you are held in mind, even when you are struggling.
We recommend This Video to those who wants to learn more about Dyadic Developmental Therapy.
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