Dyadic Developmental Psychotherapy – DDPI Worldwide Version (DDP-DDPI )

Children ages 2-18 who are struggling to overcome the effects of early-childhood trauma, particularly trauma that occurred within the caregiver-child relationship including children who meet criteria for Reactive Attachment Disorder, Disinhibited Social Engagement Disorder, or any number of effects of developmental trauma; and who may struggle with managing emotions, trusting, or otherwise engaging in healthy relationships due to early abuse and neglect; and their caregivers 

For children/adolescents ages: 2 - 18

For parents/caregivers of children ages: 2 - 18

Dyadic Developmental Psychotherapy – DDPI Worldwide Version (DDP-DDPI) is a trauma-focused, attachment-informed intervention for children and adolescents who have experienced developmental trauma, particularly trauma arising within early caregiving relationships. DDP-DDPI is delivered with the child and caregiver together, alongside work with the caregiver individually as needed. The model helps caregivers increase their capacity to respond with PACE (Playfulness, Acceptance, Curiosity and Empathy), support co-regulation, and make sense of the child’s behavior in the context of trauma, loss, and disrupted attachment. Using affective-reflective dialogue, the therapist supports the child and caregiver to develop greater emotional safety, improve communication, strengthen their relationship, and build more coherent narratives about the child’s experiences.

Vicky Sutton 

• Title: Clinical Director
• Agency/Affiliation: DDPI Worldwide
• Website: https://ddpnetwork.org
• Email: clinical.director@ddpnetwork.org

The goals of Dyadic Developmental Psychotherapy – DDPI Worldwide Version (DDP-DDPI) are:

For children/adolescents:

• Increase capacity for emotional regulation (including co-regulation within the caregiving relationship)
• Increase felt safety in relationships with caregivers
• Increase capacity to resolve and integrate the impact of developmental trauma and loss
• Improve capacity for reflective functioning
• Increase capacity to engage in developmentally appropriate, socially adaptive relationships with peers and adults

For caregivers:

• Increase capacity to respond with PACE (Playfulness, Acceptance, Curiosity, and Empathy)
• Improve capacity to co-regulate the child/adolescent’s emotional states and behavior
• Increase reflective functioning and understanding of meaning beneath behavior
• Strengthen emotional connection and communication with child/adolescent
• Increase caregiver confidence in managing highly complex, trauma-related behaviors

The essential components of Dyadic Developmental Psychotherapy – DDPI Worldwide Version (DDP-DDPI) include:

• Begins with a collaborative relationship between the therapist and caregiver that focuses on building trust and safety
• Essential for caregivers to feel that the therapist:
  • Is attuned to them
  • Understands their values
  • Understands what they are trying to communicate to their child
• Mutual understanding allows the therapist to have a meaningful impact and help them build stronger relationships with their child
• Process starts with PACE (Playfulness, Acceptance, Curiosity and Empathy), highlighting empathy as a key element
• Initial sessions examine:
  • Caregiver’s attachment history
  • Caregiver’s story of their relationship with their child
  • Areas of vulnerability
  • Opportunities for deeper connection
  • Caregiver’s own struggles, such as:
    • Anxiety
    • Depression
    • Feeling rejected
    • Difficulty trusting
    • Hypervigilance (feeling “on edge”)
    • Withdrawal
    • Dissociation
    • Any number of other symptoms of high stress/burnout
    • Feeling helpless or hopeless
    • Feeling stuck
    • Low confidence in managing highly complex, trauma-related behaviors
  • The therapist first works to help the caregiver cope with their feelings and responses to parenting their child.
• Through these sessions, the therapist helps the caregiver experience:
  • Acceptance
  • Curiosity
  • Empathy
  • Coregulation
  • Increases in their own regulatory capacity
  • A better understanding of their story and their child’s story in a different light
  • A strong bond with the therapist
  • A sense of safety and trust with the therapist
• Once the therapist feels the caregiver is able to be open and curious with their child in the room, dyadic (family) sessions can begin.
• During dyadic sessions:
  • The therapist will still begin sessions by checking in with the caregiver and giving them space to work through their emotions at the beginning of the session
  • The therapist’s and caregiver’s attention turns to child when they enters
  • Focus is on the caregiver attuning to the child and interacting with them with an attitude of PACE
  • Whenever possible, the therapist and caregiver work together with the child to help them create an understanding of the their inner world with the hope of helping them feel some comfort in being seen and understood by their caregiver.
  • Therapist uses principles of DDP—affective-reflective dialogue, talking for, talking about—to help caregiver practice new ways of emotionally supporting/coregulating their child
  • Over time, caregiver and child ideally begin to communicate differently, and the caregiver develops an increased sense of confidence in their ability to connect with and coregulate their child.
  • The therapist and family work toward helping the child develop:
    • A healthier understanding of themselves and their relationships
    • An increased capacity for emotional regulation
  • The therapist explores of trauma, loss, and meaning beneath behavior, supporting the caregiver and child to make sense of emotional responses and relational difficulties

Child/Adolescent Services

Dyadic Developmental Psychotherapy – DDPI Worldwide Version (DDP-DDPI ) directly provides services to children and addresses the following:

• Experienced developmental trauma, possible developmental delay, anxiety, depression, temper tantrums, difficulty trusting, managing peer relationships or familial relationships, difficulty following rules at home or school or community, volatile emotions/emotional dysregulation, flashbacks, physical or sexual acting out, withdrawn or isolated, struggles with substance misuse, memory loss or impairment, disconnection from reality, dissociation 

Parent/Caregiver Services

Dyadic Developmental Psychotherapy – DDPI Worldwide Version (DDP-DDPI ) directly provides services to parents/caregivers and addresses the following:

• May struggle with parenting a child who is developmentally much younger than their chronological age and needing specialized support due to this developmental immaturity, trauma, attachment concerns, significant secondary stress, decreased capacity to attune to and co-regulate their child, anxiety, low mood/depression, high stress/burnout, hypervigilance (feeling “on guard”), emotional dysregulation, withdrawal, dissociation, feelings of helplessness or hopelessness, feeling “blocked” or stuck, reduced confidence in managing highly complex, trauma-related behaviors, sometimes feeling close to breakdown

Recommended Intensity

Following a comprehensive initial assessment, therapy is delivered flexibly according to the needs of the family. Sessions may involve parent/caregiver-only work, dyadic sessions with the child and caregiver together, or a combination of both. Sessions are typically 1 to 2 hours in length, and frequency may vary depending on clinical need, with sessions offered weekly, fortnightly, or monthly.

Recommended Duration

The length of treatment varies widely based on each family’s unique situati

Delivery Settings

This program is typically conducted in a(n):

• Adoptive Home
• Birth Family Home
• Community-based Agency / Organization / Provider
• Foster / Kinship Care
• Group or Residential Care
• Outpatient Clinic
• School Setting (Including: Day Care, Day Treatment Programs, etc.)
• Virtual (Online, Smartphone, Zoom, Telephone, Video, etc.)

Homework

This program does not include a homework component.

Languages

Dyadic Developmental Psychotherapy – DDPI Worldwide Version (DDP-DDPI ) has materials available in the following languages other than English:

• Spanish

For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed in this page).

Dyadic Developmental Psychotherapy – DDPI Worldwide Version (DDP-DDPI) is provided in a number of countries worldwide, and services are available in several languages based on each therapist’s linguistic abilities. DDPI Worldwide is working to develop resources in multiple languages, but this is an ongoing process.

Resources Needed to Run Program

The typical resources for implementing the program are:

• Typical therapy office 

• Videotaping equipment (to review with DDP-DDPI supervisor to ensure fidelity to the model and a certain standard of practice) 

Prerequisite/Minimum Provider Qualifications

• Licensed or otherwise regulated mental health practitioner, with authority to practice in their jurisdiction 
• Completion of DDP Level One and Level Two training through a DDPI Worldwide Certified Trainer  
• Ongoing supervision or consultation with a DDPI Worldwide Certified Consultant or Certified Trainer 
• Participation in a structured pathway toward certification (e.g. practicum) 

Manual Information

There is a manual that describes how to deliver this program.

Program Manual(s)

Manual details: 

• Golding, K. S. (2026). DDP Guide: Healing Childhood Trauma. Jessica Kingsley Publications. https://us.jkp.com/products/the-ddp-guide-to-healing-childhood-trauma  
• Hughes, D. A., & Golding, K. S. (2024). Healing relational trauma workbook: Dyadic Developmental Psychotherapy in practice. Norton Professional Books. https://wwnorton.com/books/9781324030584 

Training Information

There is training available for this program.

Training Contact

Training Type/Location:

Individual therapists or organizations can consult the DDPI website (https://ddpnetwork.org/professionals/events/), find a training near them, and book it. Alternatively, organizations can contact and request training using the online form: https://ddpnetwork.org/contact/ 

Number of days/hours:

28 to 56 hours, depending on trainee’s goals. 

 The number days/hours for the DDP Level 1 and Level 2 (which are the prerequisites for Practitioner Certification) are 4 days and 28 hours each. The website may be consulted for other DDPI sponsored activities: www.ddpnetwork.org – resources – latest news, resource library and newsletters (UK, US/CA). 

What is included in the Relevant Published, Peer-Reviewed Research section? 

• There are currently no published, peer-reviewed research studies on outcomes with the appropriate target population for the topic area(s) in which Dyadic Developmental Psychotherapy – DDPI Worldwide Version has been reviewed.

There are currently no references available for Dyadic Developmental Psychotherapy – DDPI Worldwide Version.