[1] It was originally developed by Arthur Becker-Weidman and Daniel Hughes [2] as an intervention for children whose emotional distress resulted from earlier separation from familiar caregivers.
[3][4] Hughes cites attachment theory and particularly the work of John Bowlby as theoretical motivations for dyadic developmental psychotherapy.
[4] A study by Arthur Becker-Weidman in 2006, which suggested that dyadic developmental therapy is more effective than the "usual treatment methods" for reactive attachment disorder and complex trauma,[7][8] has been criticised by the American Professional Society on the Abuse of Children (APSAC).
According to the APSAC Taskforce Report and Reply, dyadic developmental psychotherapy does not meet the criteria for designation as "evidence based" nor provide a basis for conclusions about "usual treatment methods".
[12] A 2013 review of research recommended caution about this method of therapy, arguing that it has "no support for claims of effectiveness at any level of evidence" and a questionable theoretical basis.
It is anticipated that such children will try to actively avoid the exposure involved in developing a therapeutic relationship and will resist being directed into areas of shame and trauma.
Attunement is a primarily a non-verbal mode of communication between infant and carer, and synchrony in the degree of arousal being expressed, as well as empathy for the child's internal experience.
"[4] In the anticipated frequent disruptions, due to the child's traumatic and shaming experiences, the therapist accepts and works with these and then 'repairs' the relationship.
(Hughes 2004 p18)[4] The active presence of one of the child's primary caregivers is considered to greatly enhance psychological treatment.
(Hughes 2004 p25)[4] DDP has been criticised for the lack of a comprehensive manual or full case studies to provide details of the process.
[13] Although non-verbal communication, communicative mismatch and repair, playful interactions and the relationship between the parents' attachment status and that of a toddler are all well documented and important for early healthy emotional development, Hughes and Becker-Weidman are described as making "a real logical jump" in assuming that the same events can be deliberately recapitulated in order to correct the emotional condition of an older child.
They state that in 2004 Becker-Weidman's claim that dyadic developmental psychotherapy was "evidence based" cited studies on holding therapy by Myeroff, Randolph and Levy from the Attachment Center at Evergreen.
[13] They reported DDP to be an effective treatment for children with complex trauma who met the DSM IV criteria for reactive attachment disorder.
Becker-Weidman's first study was considered by the APSAC Taskforce in their November 2006 Reply to Letters following their main report on attachment therapy.
[26] Between the Taskforce report and Reply to Letters, Craven & Lee (2006) undertook a literature review of 18 studies of interventions used for foster children and classified them under the controversial Saunders, Berliner, & Hanson (2004) system.
[12] This critique noted the absence of a comprehensive manual giving details of the dyadic developmental psychotherapy intervention—one of the necessary criteria for assessment using the Saunders et al. guidelines, and one without which no outcome study can be placed in any of the available categories.
[13] Mercer cites Becker-Weidman's research as an example of the Woozle effect, in which "flawed, limited, or exaggerated data" is uncritically repeated and republished until it achieves popular acceptance.