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development dyadic psychotherapy (DDP) is a substantive and effective form of treatment for children with trauma and attachment disorders [1]. It is a treatment for signs indicating that it has the empirical research published in scientific journals have been based resources. Craven & Lee (2006) found that DDP is supported and acceptable treatment (category 3 in a system with six levels). But their investigation only were the results of a preliminary presentation of a partial continuous monitoring of the study, which was completed later completed and published in 2006. The first study compared the results of the development of dyadic psychotherapy with other forms of treatment, “due diligence”, 1 year after treatment. It is important to note that over 80% children in the study, more than three previous episodes of treatment, but no improvement in their symptoms and behavior had. The treatment effects: treatment with other mental health, which in other clinics, consisting of at least five meetings. A second study extends these results to 4 years after treatment. Based on the classifications Craven & Lee (Saunders et al. 2004), the inclusion of these studies have led to Dyadic Development Psychotherapy as Category 2 based on evidence-based “, supported, and probably more effective. There were two names empirical studies compared the treatment results . Development of dyadic psychotherapy with a control group This is the basis for the rating category two, the criteria are.

* 1 The treatment has a sound theoretical basis in generally accepted psychological principles.

Dyadic Development Psychotherapy is based in attachment theory (see text below

quotes

* 2 An important clinical anecdotal literature on the effectiveness of treatment with at-risk children and foster children.

See the reference list.

* 3 The treatment is usually adopted in clinical practice for vulnerable children and foster children.

demonstrated by the many practitioners of psychotherapy and dyadic development is the submission of many national and international conferences in the last ten or fifteen years.

* 4 There are no clinical or empirical or theoretical basis indicating -. This treatment is a significant risk to those who receive them, compared to its likely benefits

* 5 The treatment has a manual that clearly specifies the components and features of IMRT that the implementation allows.

capacity building for cultivation, the construction of the mounting and attachment focused family therapy are pictures.

* 6 At least two studies with a form of control without randomization (eg, the waiting list, no treatment group, the placebo group) have established the effectiveness of the treatment on the course of time, efficacy over placebo or think it is comparable or better than an existing treatment.

see ref. List

* 7 If multiple outcome studies of treatment were carried out, supported the overall weight of the evidence of the effectiveness of treatment.

These studies support multiple O’Connor & Zeanah [2] conclusions and recommendations for treatment. They claim (p. 241), “The treatments for children with attachment disorders should be encouraged if they are based on evidence.”

, as with any specialized treatment provided must be from a competent, well trained, licensed professional. Dyadic Development Psychotherapy is a treatment on the family [3].

Dyadic Development Psychotherapy is the name of an approach and a set of principles which should be remedied to be effective in children with attachment disorders and trauma is to develop healthy, trust and secure relationships with caregivers. The treatment is based on five principles central basis.

heart of reactive attachment disorder is trauma by a significant and extensive experience of neglect, abuse or prolonged and unresolved pain in the first years of life causes. These experiences disrupt the normal attachment process so that the ability of the child, a healthy and secure attachment with a caregiver form distorted or missing. The child does not feel the confidence, security and safety. The child develops a negative working model of the world, in which:

Ø

adults experienced as inconsistent or hurtful.

to see the world as chaotic.

Ø The child has no real influence on the world.

Ø The child tries to focus only on themselves.

Ø The child feels a sense of shame, the child feels bad, bad, loveable, and evil.

reactive attachment disorder is a severe developmental disorder with a chronic history of maltreatment during the first two years of life causes. Reactive attachment disorder is often caused by mental health professionals who lack training and experience in the assessment and treatment of these children and adults are misdiagnosed. Often the children in the system of protection of children a variety of previous diagnoses. Behaviors and symptoms which are the basis of these earlier diagnoses best described as excessive by mounting are designed. Oppositional Defiant Disorder behaviors are included in the reactive attachment disorder. Post-traumatic stress disorder symptoms were the result of a significant history of abuse and neglect, and another dimension of attachment disorder. Attention problems and even psychotic disorder symptoms are common in children with disorganized attachment observed [4].

About 2% of the population and expected to be between 50% and 80% of these children have attachment disorder symptoms is [5]. Many of these children are violent [6] and aggressive [7] and that adults at risk for a variety of mental health problems [8] and personality disorders, including antisocial personality disorder [9], disorder, narcissistic personality, borderline personality disorder and psychopathic personality disorder [10 ]. Neglected children are at risk of social withdrawal, social rejection, feelings of incompetence and widespread [11]. Children who have a history of abuse and neglect have a significant risk of developing PTSD disorder in adults [12]. Child victims of sexual abuse were a significant risk for developing anxiety disorders (2.0 times the average) are major depressive disorder (3.4 times on average), alcohol abuse (2.5 times on average), drug abuse (3.8 times on average), and antisocial behavior (4.3 times average) [13] (MacMillan, 2001). Effective treatment of these children is a public health problem (Walker, Goodwin & Warren, 1992).

Without treatment, children who were abused and neglected and that a bond disorder become adults with the ability to develop and maintain a healthy relationship is deeply damaged. Without placement in permanent homes, adequate and effective treatment will deteriorate. Many children with attachment disorder develop personality disorder or personality disorder, anti-social as adults [14].

first principal . Treatment should experience. Since the roots of the preverbal attachment disorder, treatment should create experiences that are healing. Experience, not words, “active ingredient” in the healing process.

For example, wrote a child of eight, the reactive attachment disorder, had bipolar disorder, and a variety of disorders of sensory integration therapy and attachment of his past therapy in this way (more details of this story is found in the Book Building Capacity Attachment , processed) by Arthur Becker-Weidman and Deborah Shell:

My first treatment was with Dr.Steve. Therapy was fun! We ate lots of snacks. I had a bottle. We played a lot of cool games like thumb to go fight, pillow rides, Giant, Superman rides, guess the goodies, eye blinking contests, hide and seek game goodies. I had to keep to the rules and play games such as Dr. Steve said.

Dr. Steve has taught me to play and have fun with my mother. But I do not know how to love. I would still very angry and try to hurt Mom and break things. Inside I always thought that was a bad boy. I was still afraid Mom and Dad would get rid of me. I had lots of tantrums at home. Sometimes I would even things out of control and try to break and hurt Mom. I even got worse when I’m angry.

I learned my feeling well. Sometimes I have feelings too many things like crazy, scared and sad into my feeling well. That will also run over and I could explode with behaviors. But I can not stop the expression of my feelings. Then, the property does not exceed, because I have some feelings.

I also have pictures of my heart. I was born with a heart good, but if I was the orphanage then I broke my heart. My heart broken because she could not look after me. I was a baby and I needed someone to hold me and rock me. But they could not because there are too many babies. Can I 16 stones to my heart. I was protecting my heart so that he does not get worse. But the stones kept the love too. I would not let Mom’s love on a lot of crazy I had in my heart.

hard work got in the treatment of all the stones free. Then Mom’s love is in. Love is the cracks heal. Now I have a bright red heart, no tears.

I liked Dr. Art now and I’m proud that I am strong. I do not need therapy. !!!!!! I still love the mother in my heart Sometimes I send an email to Dr. Art. I told him how I do it.

I started missing Dr. Art and told Mom. Mom was confused and thought I wanted more therapy. I told Mom “I do not need therapy. I would only have lunch with Dr. Art.” So I sent an e-mail Dr. Art let him know I wanted to have lunch with him. Then one day we had lunch together.

Sometimes it is always difficult. I’m still angry and sometimes I did not express my feelings well. Sometimes when Mom helps me? I can express my feelings and say: “I do not want to take my toys, it makes me mad that I owe But I will.?.” If I say he no longer feels crazy. It helps me to listen to Mama. But sometimes when I’m angry, pout and stomp my feet and run to my room when I forgot to express my feelings. But now I let Mom help me so I can talk about my feelings and do what it says

It was a very long time since I hurt Mom or break things when I’m mad trying. I feel good to buy about love. I know my mom and dad love me. I know I love you mom and dad. I do not think I am a bad boy over.

effective therapy uses experiences to help a child experience safety, security, acceptance, empathy and emotional harmony within the family. A number of techniques and methods are used including psychodrama, interventions, exercise in harmony with Theraplay, and others.

second principal . Treatment must be family oriented. Therapy helps children deal with trauma in the underlying support, safe and secure environment in cans “on” and manageable, so provide that the parents can come and heal have the child. It is the parents the ability to provide a safe and caring home that provides a healing environment. have the ability, empathy for the child to accept the child, love child, be curious and playful child are all part of the “attitude” [15] heals. Parents are actively involved in the treatment.

third most common . The trauma must be addressed directly. Therapy helps by providing the security so that the healing can child relive painful and shameful emotions that surround the child injury. Review of the trauma is essential if the child begin to revise the child personal story and vision of the world. It is through repetition of the trauma and share the anger and shame a note, sensitive person, the child, the trauma of integration

coherent self.

fourth main group . A global security environment and security need to be created. Traumatized children are often hyper-vigilant, insecure, and deeply suspicious. A consistent environment that is safe and secure also create important to heal the necessary experience for the child. This medium must be present at home and in therapy. Good communication and coordination between home, school and therapy is another important component of effective treatment. “Compression-wraps,” invasive stimulation to cause anger, “rebirth” and other provocative techniques are not part of the development of dyadic psychotherapy. These intrusive and invasive techniques are not therapy, not therapeutic, and have no place in a reputable treatment program.

fifth main group . Therapy is consensual and not mandatory. In our center, we are very clear that physical coercion is not used to find a cure and not in the treatment of any other way. The treatment is made available in a manner consisted with the Association for Treatment and Education of Children White Paper on coercion in treatment.

detailed description of the treatment

Dyadic Development Psychotherapy is a treatment of Daniel Hughes, Ph.D., (Hughes 2008, Hughes 2006, Hughes, 2003) was developed. His principles are described by Hughes and summarized as follows:

A focus on both the caregivers and therapists, their investment strategies. Previous research (Dozier, 2001, Tyrell 1999) showed the importance of carers and therapists mood for the success of the measures.
therapists and nurses are sensitive to the subjective experience of the child and take into account the child’s return. to the process of maintaining a connection with the child hear intersubjective help the therapist and guardian of the child regulate affect and construct a coherent autobiographical narrative.
The exchange of subjective experiences.
The use of PACE and place are essential to />
caregivers use interventions to facilitate mounting.
The use of a variety of measures, including cognitive behavior therapy strategies.

Dyadic Development Psychotherapy interventions flow from several

theoretical and empirical lines. Attachment theory (Bowlby, 1980 Bowlby, 1988) provides the theoretical development of dyadic psychotherapy. Early trauma disrupts the normal attachment system in the development of distortions in the internal working models of themselves, others and caregivers. This is one reason for treatment, in addition to the need for sensitive care. As O’Connor & Zeanah (2003, p. 235) stated: “One is most astonishing is the case of adoption or the responsible person at home, the” appropriate “sensitive, but the child has attachment disorder behavior, it seems unlikely that improving response to parental sensitive (parents already taken into account) would result in positive changes in parent-child relationship. “The processing is necessary to respond directly to internalize rigid and dysfunctional working models that children with attachment disorders have developed traumatized.

current thinking and research on the neurobiology of interpersonal behavior (Siegel 1999, Siegel 2000, Siegel, 2002, Schore, 2001) is another part of the basis on the development of dyadic psychotherapy.

The first approach is playful in a secure base in treatment (using techniques that must be prepared in accordance with the maintenance of healing of PACE (suppose, curious and sensitive) and at home with the guidelines that structure and provide a safe healing PLACE (Playful, Loving, acceptance, curiosity and empathy). Develop and maintain a relationship to hear that reveal contingent collaborative communication helps to heal the child. coercive interventions such as the coast-stimulation, the holding company controlling a child in anger or provoke an emotional reaction that shame a child to win with fear to the compliance, and intervention on power / control and submission, etc. are never used and are based are inconsistent with the treatment rooted in the theory and current knowledge on the neurobiology of interpersonal behavior.

usual structure of a session consists of three components. First, the therapist meets with the parties in an office while the child sits in the treatment room. During this part of the treatment, the nurse instructed in attachment parenting methods (Becker-Weidman and Shell (2005) Hughes, 2006). own problems of the caregiver, the difficulties of developing an emotional bond with their child can be investigated and resolved to create. Effective methods parents of children with trauma-attachment disorders require a high degree of structure and consistency, with an emotional environment, fun, love, acceptance, curiosity and empathy (place) shows. During this part of the treatment received support carers and to maintain the same level of responsiveness to hear that we want to see the child. Managers often feel blamed, devalued, incompetent, exhausted and angry. Parent support is to help an important dimension of treatment caregivers longer able to hear one on the link to keep up with their child. Second, the therapist carries with caregivers with children in the treatment room. It usually takes an hour and a half. Third, the therapist meets with the parties concerned, without the child. In general, treatment with the child used three categories of measures: an emotional, cognitive restructuring and reconstruction psychodrama. Treatment with the nursing staff used two sets of measures: first, teaching methods and effective training to help supervisors avoid power struggles, and secondly, to have the place or position.

treatment of the child is an important non-verbal dimension since much of the trauma occurred at a pre-verbal and is often inseparable from explicit memory. As a result of child abuse and injuries caused by barriers to successful participation and treatment of these children. Therapeutic interventions are designed to create experiences of safety and emotional connection, so that the child is emotionally involved and to explore and resolve past trauma. This emotional bond is the same process for non-verbal communication between caregiver and child to use when setting to facilitate interactions (Hughes, 2003, Siegel 2001). The therapist and nursing staff results of harmonization in the co-regulation relates to the child, so it manageable. cognitive restructuring interventions designed to help children develop provide secondary mental representations of traumatic events, children to integrate these events and a coherent autobiographical narrative. The treatment consists of several repetitions of the cycle of parent-child privilege. The cycle begins by the emotional experience, followed by a breach in the relationship (separation or discontinuity), and ends with a reattunement emotional states. Non-verbal communication, with eye contact, tone of voice, touch and movement to create an emotional bond.

often involve a multi-dimensional structure. It is shown in Figure 1. First, the behavior is identified and explored. The behavior has occurred or has occurred in the immediate interaction, the place at some time in the past. Use of curiosity and acceptance the behavior is investigated. Second, with curiosity and acceptance the behavior is to explore and make sense for the child begins to emerge. Third, empathy is used to reduce the shame and child, to accept the feeling of the child and to enhance understanding. Forth, the child’s behavior is then normalized. In other words, if the meaning of the behavior and the basis of past trauma is identified, it is understandable that the symptom is present. An example of such an interaction is as follows:

Wow, I see you so angry when your mom asked you to pick up your toys are. She thought she was angry and did not want to have fun or you want to. They thought they would take everything and leave your mother first, like when your mother first took your toys and then left you alone in the apartment this time. Oh, I can really understand how hard that must be for you when Mom said to clean. You’re feeling really crazy and scared. It must be hard for you.

Fifth, the child communicates this understanding to the caregiver.

sixth, finally a new meaning is for the behavior and actions of children are integrated into a coherent narrative autobiographical experiences and connect a new meaning to the caregiver.

past traumas are revisited by reading documents, and through reenactments of Psychodrama. These procedures are performed in a secure relationship to hear, so the child to integrate the trauma of the past and understand the past and present experiences that create the feelings and thoughts associated with other disorders behavior of children. The child develops secondary representations of events, feelings and thoughts that affect a stronger regulation and a more integrated autobiographical narrative.

described by Hughes (2006, 2003), therapy is an active member to influence the experience modulates implies acceptance, curiosity, empathy, and playfulness. Co-regulation of the child’s emerging affective states and the development of the secondary representations of thoughts and feelings is the child’s ability to engage emotionally in a relationship of trust strengthened. Caregivers take on the same principles. If reference is to help people have to struggle to engage their children in this way, then the treatment, said.

children victims of abuse and chronic trauma resulting complexes are a significant risk for a variety of other behavioral disorders, neuropsychological, cognitive, emotional, interpersonal, and psychobiological (Cook, A., et al, 2005; .. van der Kolk, B ., 2005). Children and adolescents with complex trauma requiring treatment approach that focuses on various aspects of disability (Cook, and. Al, 2005). chronic abuse and amortization resulting complex cause trauma in a variety of areas, including the following:

Ø

itself

to trust Ø Interpersonal

as the potential and secure comfort

Attachment

Ø

Ø

biology, somatization

Affect Regulation

Ø

* Increase the use of defense mechanisms such as dissociation

Ø

to control behavior

Ø cognitive functions, including regulation of attention, interest and other executive functions.

self-concept.

Dyadic Development Psychotherapy is concerned with these areas lack. Dyadic Development Psychotherapy share many important elements with optimal social events and good clinical practices. For example, the attention to client dignity, respect for the customer experience, and from where the customers are all secular principles of clinical practice and are also key elements

Dyadic Development Psychotherapy

summary, therapy for traumatized children, the disordered systems have had to learn, consensus, and an environment of safety, acceptability, safety, empathy, and playfulness.

[1] Becker-Weidman, A. (2006) “treatment for children with trauma-attachment disorders: Dyadic Development Psychotherapy” The children and Adolescent Social Work Journal. Vol 23 No. 2, April 2006, 147-171.

Becker-Weidman, A. (2006). “Dyadic Development Psychotherapy: a multi-year monitoring” of new developments in Child Abuse Research, Stanley M. Sturt, Ph.D. (Ed.) Nova Science Publishers, New York, p. 43-61 ‘. / P>

Becker-Weidman, A. (2007) “Treatment for Children with Reactive Attachment Disorder: Dyadic Development Psychotherapy,” http://www.center4familydevelop.com/research.pdf

Becker-Weidman

, A., & Hughes, D. (2008) “Dyadic Development Psychotherapy: An evidence-based treatment for children with complex trauma and attachment disorders, children and young people Social Work, 13, pp.329-337 <. / P>

Craven, P. & Lee, R. (2006) Therapeutic interventions for foster children: a systematic research synthesis. Research on social work practice, 16, 287-304.

[2] O’Connor, T., & Zeanah, C. (2003) Attachment disorders: Assessment strategies and treatment methods. Attachment and Human Development, 5, 223-245.

[3] Hughes, D. (2008) focused on the involvement of family therapy. NY: Norton.

[4] Lyons-Ruth, K., & Jacobvitz, D. Attachment disorganization: Unresolved loss, relational violence and gaps in the behavioral and attentional strategies. In Cassidy, J. & Shaver, P. (Eds.), Handbook of the plant. pp 520-554, NY: Guilford, 1999.

, J. & George, C. (Eds.). Attachment disorganization. Guilford, 1999

: NY.

Main, M. & Hesse, E. Parents unresolved traumatic experiences in the state child attachment disorganization name. In Greenberg, MT, Ciccehetti, D., & Cummings, EM (eds) Attachment in the preschool age: Theory, Research and Intervention, pp.161-182, Chicago. University of Chicago Press, 1990

Carlson

, É.A. (1988). A prospective longitudinal study of disorganized / disoriented attachment. Child Development 69, 1107-1128.

[5] Carlson, V., Cicchetti, D. Barnett, D., & Braunwald, K. (1995). Finding order in disorder: lessons from research on child abuse facilities to their carers. In D. Cicchetti and V. Carlson (Eds), Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 135-157). NY. Cambridge University Press

Cicchetti, D., Cummings, EM, Greenberg, MT, and Marvin, RS (1990).

Boost treatment