Dyadic developmental biology psychotherapy is an evidence-based and effective form of treatment for children with trauma and diseases of the plant. It is an evidence-based treatment, which means that the empirical research in peer-reviewed journals. Craven & Lee (2006) found that DDP is an acceptable support and treatment (category 3 in a six-level). But their only review the results of a partial preliminary presentation of an ongoing follow-up study, which was later completed and published in 2006. This first study compared the results with DDP other forms of treatment, "normal care", 1 year after treatment ended.
It is important to note that more than 80% of children in the study had more than three episodes before treatment, but without any improvement in their symptoms and behavior. Episodes of treatment mean a course of treatment with other mental health providers in other clinics, consisting of at least five meetings. A second study extends these results indicate that 4 years after treatment ended. On the basis of the Craven & Lee classifications (Saunders et al. 2004), recording these studies, the DDP would be considered as an evidence-based Category 2, "Supported and probably effective". There were two related empirical studies to compare the results of treatment Dyadic Developmental psychotherapy in a control group. It is the basis for the evaluation of category two. These criteria are:
1. The treatment has a solid theoretical base in generally accepted psychological principles. Dyadic Developmental psychotherapy has its headquarters in Attachment Theory (see text below cited
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2 A substantial clinical, anecdotal literature exists indicating the effectiveness of treatment with at-risk children and foster children. See reference list.
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3 Treatment is generally accepted in clinical practice for vulnerable children and foster children. As the large number of practitioners of Dyadic Developmental psychotherapy and its presentation as numerous international and national conferences in the last ten or fifteen years.
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4 There are no clinical or empirical evidence or theoretical basis give - that the treatment is a significant risk for those receiving them, compared to its expected benefits.
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5th The treatment has a handbook that clearly states the components and management features of the treatment makes it possible for implementation. Build capacity for investment, construction bonds issued by the plant, and Attachment Focused Therapy family as such material.
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6th At least two studies using some form of control without randomization (eg waiting list, untreated group, placebo group) have established the effectiveness of the treatment of the passage of time, efficacy compared to placebo, or it will be comparable to or better than a pre-treatment established. See ref. List.
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7th If more than one treatment outcome studies have been conducted, the total weight of evidence for the effectiveness of several studies support treatment.
These O'Connor & Zeanah conclusions and recommendations for treatment. They declare (p. 241), "therapies for children with disorders investment should be encouraged only when they are evidence-based."
Dyadic developmental biology psychotherapy, as with any specialized treatment should be determined by a competent, well-trained, professional license. Dyadic Developmental Psychotherapy is a family-oriented treatment .
Dyadic Developmental Psychotherapy is the name for a concept and a number of principles that have proved effective so that children with trauma and attachment control cure diseases, namely the development of healthy, trusting and secure relations to a supervisor. The treatment is based on five key principals.
At the core of the binding disorder is caused by major trauma and extensive experience of neglect, abuse or prolonged and unresolved pain in the first years of life. These experiences disrupt the normal investment process so that the child's ability to a healthy and safe facility with a caregiver is distorted or absent. The child lacks a sense of confidence, security and safety. The child developed a negative working model in the world:
- Adults are considered incompatible or injury.
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- The world is chaotic.
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- The child experiences no effective influence on the world.
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- The child tries only to him /her self.
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- The child feels an overwhelming sense of shame, the child feels inadequate, bad, unlovable, and evil.
Reactive Attachment Disorder is a severe developmental disorder disorder characterized by a chronic history of ill-treatment during the first two years of life . Binding disorder is often fehldiagnostiziert mental health professionals do not have the appropriate training and experience of evaluation and treatment of these children and adults. Often children in the child welfare system have a variety of earlier diagnoses. The symptoms and behaviors that form the basis for these earlier diagnoses are better designed than those resulting from disorderly plant. Defiant Disorder opponents practices are subsumed under binding disorder. Post-Traumatic Stress Disorder symptoms are the result of a significant history of abuse and neglect and are a further dimension of the plant disease. Attention problems and even a psychotic disorder symptoms are often in children with disorganized attachment.
Approximately 2% of the population, and between 50% and 80% of these children have investment disorder symptoms. Many of these children are violent and aggressive and are considered adults at risk of developing a variety of mental problems and personality disorders, including antisocial personality disorder, narcissistic personality disorder, borderline personality disorder and psychopathic personality disorder. Neglected children are at risk of social withdrawal, social rejection and pervasive sense of incompetence. Children have stories of abuse and neglect are at significant risk of developing post-traumatic stress disorder as adults. Children, were sexually abused to be significant risk for the development of 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 (average of 4.3 times) (MacMillian, 2001). The effective treatment of these children is a public health concern (Walker, Goodwin, & Warren, 1992) .
untreated, children, were abused and neglected, and an attachment disorder to adults, whose ability to develop and maintain healthy relationships is deeply damaged. Without the placement in a suitable permanent home and effective treatment of the condition to deteriorate. Many children with attachment disorders develop borderline personality disorder or anti-social personality disorder as adults .
FIRST Principal. The therapy must experience. Since the roots of the plant disruptions occur, pre-verbal, therapy must create experiences, the healing. Experience, not words, are "active" in the healing process.
For example, an eight-year-old boy who had ties disorder, Bipolar Disorder, and a variety of sensory integration disorders wrote about his past treatment and therapy, this facility (for details this history can be found in the book to create capacity for investment, edited by Arthur Becker-Weidman Deborah & Shell):
My was first therapy with Dr. Steve. The therapy was fun! We ate lots of snacks. I had a bottle. We played a lot of cool games like thumb wrestling, pillow rides, giant walk, Superman rides, the guess goodies, eye blinks contests, hide and go looking for goodies. I had to the rules and play games, just as Dr. Steve said.
Dr. Steve taught me how to play and have fun with my mom. But I still do not know how to love. I would still be real mad and try to hurt Mama and break things. Inside I still thought I was a Bad Boy. I was still afraid, Mom and Dad would get rid of me. Although I had many reactions at home. Sometimes I would still out of control and break things and try to hurt Mama. I was even worse than I mad.
Stuff Dr. Art taught me - I learned about my feelings well. Sometimes I have too many feelings like crazy things, fear and sadness in my feeling. Then the overflow, and I could explode with behavior. But I can stop that my feelings. Then it is also not overflow, because some of the feelings I out.
I pictures of my heart. I was born with a kind heart, but when I went into the orphanage I got tears in my heart. My heart is cracked, because they are not good for me. I was a baby, and I needed someone to hold me and "Rock Me. But she could not, because there were too many babies. Then I took 16 stones around my heart. I was protecting my heart, so it would not more hurt. But the stones, for the love. I would not let Mom's love in. I was mad in my heart.
My much hard work in the treatment got rid of all stones. Then Mom's love got in. The love, the cracks heal. Now I have a bright red heart without cracks.
I really liked Dr. Art Now and I am proud that I am strong. I still do not need therapy. I remain let Mom's love in my heart! Sometimes I have via e-mail to Dr. art. I tell him how good I am doing.
I began Dr. missing art and told Mama. Mom was confused and thought I wanted more therapy. I told Mama "I do not need therapy. I just want a lunch with Dr. art. "So I sent Dr. Art an e-mail to let him know that I wanted to have lunch with him. One day we had lunch together.
Sometimes it is still difficult. I I still get mad and sometimes I am not my feelings well. Sometimes, when mom helps me, I can share my feelings and say "I will not pick up my toys. It makes me mad that I, but I will. "When I say that it is not Make Me Feel crazy. It helps me to hear Mama. But sometimes when I am mad and I pout and stomp my Fae run to my room if I forget my feelings. But I would now like Mama help me so that I can talk about my feelings and do what they says
It was a really long time since I tried to hurt Mom or break things, I am mad. I feel good about love. I know that my mom and dad love me. I know that I love you Mom and Dad. I do not think I'm a Bad Boy anymore.
Effective therapy uses experience to help a child experience safety, acceptance, empathy and emotional conformity within the family. A number of techniques and methods used, including psychodrama, interventions congruent with Theraplay and other exercises.
SECOND Principal. The therapy must be family oriented. Therapy helps the child's underlying trauma in a supportive and secure environment, "titrated" and manageable doses, so that what parents have to offer, you can heal and the child. It is the parents the ability to create a secure and care at home, a healing environment. The ability to have empathy for the child, the child accept, love the child, curious about the child, and will be playing are all part of the "attitude", heals. Parents are active in treatment.
THIRD Principal. The trauma must be directly addressed. The therapy helps heal by providing security and safety, so that the child can again experience the painful and shameful emotions that surround the child trauma. Revisiting the Trauma is essential if the child to begin to revise the child's personal narrative and world view. It is by revisiting the trauma and the sharing of anger and shame with an acceptance, sensitive person, the child can integrate the trauma into a coherent self.
FOURTH Principal. A comprehensive environment of safety and security must be created. Traumatisierten children are often hyper-vigilant, insecure, and deeply distrusting. A consistent environment that is safe and secure is essential for the creation of the necessary experience for the child to heal. This environment must be present at home and in therapy. Good communication and coordination between home, school and therapy is another important element of an effective treatment. "Compression wraps," invasive and intrusive stimulation to evoke anger, "re-birth" and other provocative techniques are not part of the Dyadic Developmental psychotherapy. This intrusive and invasive techniques are not therapy, not therapeutic, and have no place in a serious treatment program.
Fifth Principal. Therapy is not consensual and coercive measures. In our center, we are very clear that physical restraint is no treatment and is not in treatment in any way. The treatment is done in a way there with the Association for the treatment and education of children White Paper on coercive treatment.
The therapist must be well trained, licensed and have significant experience in the treatment of trauma facility disordered children. A good resource for such therapists is the Association for the treatment and training in the installation of children, attach. When selecting a therapist, you should apply to the following:
- Significant training of a recognised training programme. Ask where the therapist was trained, how long ago, and for how long.
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- training. Questions, when was the last event training the therapist visited and how long was the event.
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- Licensure in the state in a recognized discipline of mental health.
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- membership in attach.
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- A comprehensive informed consent document and related publications.
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- A first assessment of the development of a differential diagnosis and treatment plan.
DETAILED DESCRIPTION OF TREATMENT
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Developmental psychotherapy is a treatment developed by Daniel Hughes, Ph.D., (Hughes, 2008, Hughes, 2006, Hughes, 2003,). Its basic principles are by Hughes and summarised as follows:
1. A concentration on the two nurses and therapists own investment strategies. Previous studies (Dozier, 2001, Tyrell 1999) has shown how important the workers and therapists state of mind for the success of interventions.
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2 Therapists and tutors are matched to the child's subjective experience and reflect back to this child. In the process of maintaining a coordinated inter-connection with the child, therapists and caregivers to help the child influence and regulate construction of a coherent autobiographical narrative.
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3 The sharing of subjective experience.
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4 The use of PACE and place are essential to the healing.
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5th Right on the inevitable misattunements and conflicts that are in interpersonal relations.
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6th Caregivers use investment interventions.
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7th Use a variety of measures, including cognitive behavioral strategies.
Dyadic developmental biology psychotherapy interventions flow from several theoretical and empirical lines. Attachment theory (Bowlby, 1980, Bowlby, 1988) provides the theoretical basis for Dyadic Developmental psychotherapy. Early trauma disrupts the normal development of the system to create distorted internal working models of self, and other caregivers. This is one reason for the treatment in addition to the need for sensitive caregivers. As O'Connor & Zeanah (2003, p. 235) have stated, "A case is puzzling that one adoptive /foster carers, is" adequate "sensitive, but the child exhibits behavior disorder facility, it seems unlikely that the improvement of parental sensitive (in already-sensitive parent company) would yield positive changes in the parent-child relationship. "The treatment is necessary to go directly to the rigid and dysfunctional internalized working time models, the traumatized children with plant diseases have developed.
Current thinking and research in the neurobiology of human behavior (Seal, 1999, Siegel, 2000, Siegel, 2002, Schore, 2001) is another part of the basis on which Dyadic Developmental psychotherapy rests.
The primary approach is to create a secure base in treatment (with techniques that fit with maintaining a cure PACE (Playful, accepting, curious, and Empathic) and at home with clients, the safe structure and a cure CITY (Playful, Loving, acceptance, Curious, and Empathic ). Developing and maintaining a coordinated relationship within the conditional cooperative communication occurs helps heal the child. Coercive interventions such as rib-stimulation, operating restraining a child in anger or to provoke an emotional response, shaming a child with anxiety to elicit compliance and Intervention on the basis of power and control and subjugation, etc., are never used and do not have a treatment rooted in attachment theory and current knowledge about the neurobiology of interpersonal behavior.
Dyadic developmental biology psychotherapy, as the Center for Family Development, uses two-hour meetings with a therapist, parent (s), and child. Two offices are used. If the caregivers are in the treatment room, the caregivers ads are treatment from another room by closed circuit TV or a One-Way Mirrors. The usual structure of a meeting consists of three components. First, the therapist meets with the supervisor in an office while the child sits in the treatment room. During this part of the treatment, the carer is responsible, in the supplement parenting methods (Becker-Weidman & Shell (2005) Hughes, 2006). The supervisor of their own problems, which may lead to difficulties with developing affective conformity with their child may also be investigated and resolved. Effective parenting methods for children with trauma plant diseases require a high degree of consistency and structure, together with an emotional environment that demonstrates playfulness, love, acceptance, curiosity and empathy (place). During this part of the treatment, care and support people are given the same level of response capability voted that we wish that child. caregivers often feel guilty, devalued, incompetent, exhausted and angry. Parent support is an important aspect of treatment to help carers are better able to access a coordinated relationship with their child. Second, Therapist with the supervisor meets with the child in the room of the treatment. This usually takes one to one and a half hours. Third, the therapist meets with a supervisor without the child. By and large, treatment with the child uses three categories of actions : Conformity emotional, cognitive restructuring, and psychodramatic reenactments. Treatment with the supervisor uses two categories of measures: First, teachers and parents effective methods and support of caregivers avoid power struggles and, secondly, to maintain the right place or the child attitude.
Treatment has an important non-verbal dimension, since a large part of the trauma took place at a pre-verbal stage and is often divorced from explicit memory. As a result of childhood abuse and trauma resulting obstacles to the successful use and treatment of these children. treatment interventions are designed to share experience on the safety and emotional conformity, so that the child engaged and affectively can explore and solve past trauma. affective conformity This is the same procedure used for non-verbal communication between a supervisor and investment facilitation during child interactions (Hughes, 2003, Siegel, 2001). A therapist and supervisor "conform results in co-regulation affecting the child, so that it manageable. Cognitive restructuring interventions are designed so that the child develop secondary mental representations of traumatic events, with which the child to integrate these events and the development of a coherent autobiographical narrative. The treatment includes several repetitions of the basic caretaker-child investment cycle. The cycle begins with common emotional experience, followed by a breach in the relationship (a separation or discontinuity ), And ends with a reattunement the affective states. Nonverbal communication, with eye contact, tone of voice, touch and movement, are essential elements for the creation of affective attunement.
The treatment often have a structure with multiple dimensions. Shown in Figure 1, below. First behavior is identified and explored. The behavior may have occurred in the immediate interaction took place or at some time in the past. With curiosity and acceptance is the behavior. Second, with curiosity and acceptance of the conduct research and the importance for the child begins to emerge. Third, empathy is to reduce the child's sense of shame and the increase in the child sense of being accepted and understood. Forth, the child's behavior is normal. In other words, once the importance of behavior and its base in the past trauma identified, it is understandable that the symptom. An example of such interaction is as follows:
Wow, I see, as you so angry when your mother asked you, your toys. They thought it was mean and do not want you to have fun or love you. They thought they wanted everything away and leave you like your first Mom did as when you first time Mom has your toys and then left you alone in the apartment this time. Oh, I can now really understand how hard this is for you when Mom said to clean. She felt really mad and fear. That has to be so hard for you.
Fifth the child communicates this understanding to finally caregiver.
Sixth a new meaning for the conduct is found and the child actions are integrated into a coherent autobiographical narrative by communicating the new experience and the sense of trauma caregiver.
Past are revisited reading of documents and psychodramatic reenactments. These interventions, within a secure relationship voted, leave The child to integrate traumas of the past and to understand the past and present experiences, the feelings and thoughts in connection with the childish behavior disorders. The child developed secondary representations of these events, feelings and thoughts lead to graere Impact regulation and a more integrated autobiographical narrative.
As described by Hughes (2006, 2003), the therapy is an active influence modulated experience that with the adoption, curiosity, empathy and playfulness. By CO - regulation of the child emerging countries and emotional development of secondary representations of thoughts and feelings, the child's ability to affectively in a trusting relationship improved. The caregivers adopt the same principles. If the caregivers have difficulty dealing with her child in this way, then the treatment Caregiver is indicated.
Children have experienced chronic ill-treatment and the resulting trauma are complex to considerable risk for a variety of other behavioral, neuropsychological, cognitive, emotional, social and psychobiological disorders (Cook, A., et al .., 2005 ; Van der Kolk, B., 2005). Children and young people with trauma require a complex approach to the treatment, in several dimensions of impairment (Cook, et al .., 2005). Chronic ill-treatment and the resulting complex trauma cause impairment in a variety of crucial domains including the following:
- Self-regulation
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- Interpersonal in connection with the ability to secure confidence and comfort
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- Investment
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- biology, leading to somatization
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- Does Regulation
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- Increased use of defense mechanisms, such as dissociation
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- Behavioral control
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- cognitive functions, including regulation of attention, interest and other executive functions.
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- self-concept.
Dyadic developmental biology psychotherapy deals with these domains of impairment. Dyadic Developmental psychotherapy shares many important elements with optimal sound social case work and clinical practice. For example, his attention to the dignity of the customer, respect for the client experiences, and start where the client is, are all time-honored principles of clinical practice and all are central elements of Dyadic Developmental Psychotherapy
In summary, Therapy for traumatized children, plants must have disordered experimental, consensual and provide an environment of safety, acceptance, security, empathy and playfulness. Only an experienced and trained therapists can plant therapy.
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