Arthur Becker-Weidman

Dyadic Developmental Psychotherapy: An evidence-baesd treatment

Part Two

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Dyadic Developmental Psychotherapy, as with any specialized treatment, must be provided by a competent, well-trained, licensed professional. Dyadic Developmental Psychotherapy is a family-focused treatment[3].

Dyadic Developmental Psychotherapy is the name for an approach and a set of principals that have proven to be effective in helping children with trauma and attachment disorders heal; that is, develop healthy, trusting, and secure relationships with caregivers. Treatment is based on five central principals.

At the core of Reactive Attachment Disorder is trauma caused by significant and substantial experiences of neglect, abuse, or prolonged and unresolved pain in the first few years of life. These experiences disrupt the normal attachment process so that the child’s capacity to form a healthy and secure attachment with a caregiver is distorted or absent. The child lacks a sense trust, safety, and security. The child develops a negative working model of the world in which:

Ø Adults are experienced as inconsistent or hurtful.

Ø The world is viewed as chaotic.

Ø The child experiences no effective influence on the world.

Ø The child attempts to rely only on him/her self.

Ø The child feels an overwhelming sense of shame, the child feels defective, bad, unlovable, and evil.

Reactive Attachment Disorder is a severe developmental disorder caused by a chronic history of maltreatment during the first couple of years of life. Reactive Attachment Disorder is frequently misdiagnosed by mental health professionals who do not have the appropriate training and experience evaluating and treating such children and adults. Often, children in the child welfare system have a variety of previous diagnoses. The behaviors and symptoms that are the basis for these previous diagnoses are better conceptualized as resulting from disordered attachment. Oppositional Defiant Disorder behaviors are subsumed under Reactive Attachment Disorder. Post Traumatic Stress Disorder symptoms are the result of a significant history of abuse and neglect and are another dimension of attachment disorder. Attention problems and even Psychotic Disorder symptoms are often seen in children with disorganized attachment[4].

Approximately 2% of the population is adopted, and between 50% and 80% of such children have attachment disorder symptoms[5]. Many of these children are violent[6] and aggressive[7] and as adults are at risk of developing a variety of psychological problems[8] and personality disorders, including antisocial personality disorder[9], narcissistic personality disorder, borderline personality disorder, and psychopathic personality disorder[10]. Neglected children are at risk of social withdrawal, social rejection, and pervasive feelings of incompetence[11]. Children who have histories of abuse and neglect are at significant risk of developing Post Traumatic Stress Disorder as adults[12]. Children who have been sexually abused are at significant risk of developing anxiety disorders (2.0 times the average), major depressive disorders (3.4 times average), alcohol abuse (2.5 times average), drug abuse

(3.8 times average), and antisocial behavior (4.3 times average)[13] (MacMillian, 2001). The effective treatment of such children is a public health concern (Walker, Goodwin, & Warren, 1992).


April 30, 2009 - Posted by | Arthur Becker-Weidman, Child Abuse, Child Welfare, Dyadic Developmental Psychotherapy, Education, Empirically supported, Evidence-based, Research, Special Education, Treatment

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