Treatment for Children with Trauma-Attachment Disorders: Dyadic Developmental Psychotherapy

Children with histories of maltreatment are at significant risk of developingsevere psychiatric problems. Treatment of such children is difficult and there are noempirical studies evaluating the effectiveness of outpatient treatment for children withtrauma-attachment disorders. The present study examines the effectiveness of DyadicDevelopmental Therapy, a treatment based on attachment theory, provided by onetherapist in an outpatient setting. The 64 subjects all had trauma-attachment disorders,met the DSM-IV criteria for Reactive Attachment Disorder, and had histories of seriousmaltreatment. The 34 children in the treatment group were treated in weekly outpatienttherapy at The Center For Family Development with Dyadic DevelopmentalPsychotherapy. The 30 children in the control group were evaluated but did notreceived Dyadic Developmental Psychotherapy and received treatment from otherproviders at other clinics. Eligible subjects were children between the ages of five andseventeen years whose case had been closed in 2000 or 2001. All children hadsignificant past histories of abuse, neglect, or orphanage care. Findings for children inthe treatment group, as measured by the Achenback and Randolph AttachmentDisorder Questionnaire, were significant decreases (p<.01) in symptoms of attachmentdisorder, withdrawn behaviors, anxiety and depression, social problems, thoughtproblems, attention problems, rule-breaking behaviors, and aggressive behaviors. Thefindings for children in the control group showed no changes in the variables measured.Dyadic Developmental Psychotherapy appears to be an effective treatment for childrenwith trauma-attachment disorders.The author would like to gratefully acknowledge Ms. Geraldine Gallucci, a master’s level social work intern, who was placed with The Center For Family Development. Ms. Gallucci ensured that the follow-up questionnaires were mailed to the families and returned to the agency.Arthur Becker-Weidmann is affiliated with Center for Family Development, Williamsville, USA.