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Dyadic Developmental Psychotherapy" (DDP)

Child's Initials*

Child's DOB*

Person completing this form*

What is DDP?

1. DDP® helps parents and children relate to each other and form healthy relationship patterns. It assists the child to integrate the impact of their trauma and/or loss experience, to increase their ability to regulate their emotional state. It assists adults with the day-to-day parenting, it increases parental sensitivity and heightens the intersubjective connection with their child. Furthermore, it will give the care giver the opportunity to bear witness to their child exploring their memories, emotions and behaviours associated with their past losses/traumas, in a safe and therapeutic setting. In this process, the facilitator will be modelling an empathic dialogue based on PACE principles (Playfulness, Acceptance, Curiosity and Empathy) for adults to use, when engaging in emotive discussions with their children. Part of the DDP® process is to also systemically explore adult’s trauma histories to ensure they understand when they, themselves, have become triggered and are reacting, rather than responding to children. This assists in daily parenting and understanding children’s early unmet needs on a deeper level. DDP ®/PACE helps increase parental sensitivity and heightens the intersubjective connection the parent shares with their child. Furthermore, it will give the parent the opportunity to bear witness to their child exploring their memories, emotions and behaviours associated with their past losses/traumas, in a safe and therapeutic setting.*

I have read and understood the above information.

Consent to records

2. This is an agreement between the individual completing this document and Amelie’s Place regarding this therapeutically informed intervention. To develop a deeper understanding of the children in your care, it would be helpful to review information stored on the local authorities servers about their journey into care/adoption. Similarly, it is important that we have either your PAR or Form F to gain a better understanding of your background, prior to commencement of this intervention to formulate risk assessments, to tailor the interventions to maximize its effectiveness and to navigate sensitive subjects, whilst addressing the parent/carer or children in question.

I provide Amelie's Place consent to access the above information for this therapeutically informed intervention.

Videotaping/Recording Consent

3. This is an agreement between the individual completing this document and Amelie’s Place regarding the videotaping/recording of this therapeutically informed intervention. This therapy requires the use of videotaping/recording to deliver the service. It is necessary to use this method to enable supervision, feedback and analysis of the therapy provided by certified supervisors and/or clinical psychologists with a view that beneficiaries get the best possible service. At the end of the intervention, all videos will be deleted unless you give us consent to use them for our ongoing training. We will store contact details, electronic records and reports in accordance with General Data Protection Regulations (GDPR). The video footage will be stored on the therapist’s secure work drive, password protected and only available to the therapist. When we are required to pass video footage onto our therapeutic supervisors, this will be done via a secure method using encryption.*

I provide consent on behalf of the individual completing this intervention, to be recorded for this therapeutically informed intervention.

Is there any additional information which the facilitators will need to be aware of before this intervention begins? For example, are there any sensory issues (parent and/or child), food allergies (parent and/or child), specific learning or physical difficulties (parent and/or child) etc?*

Information gathering

4. What are the three greatest challenges for you as a carer/parent, with regards to looking after your child?*

5. What are your child's three emotional triggers (for example, being asked to go to bed, to come away from their tablet etc)*

6. Effective methods to settle your child in heightened moments?*

7. What consequences are introduced, when your child in not conforming with boundaries within the family home?*

8. What is you child like, when presented to a person they are unfamiliar with?*

Less demanding

More demanding

Becomes controlling

More "clingy" t o parent/carer

No obvious difference in behaviour

9. What is you child like, when presented to a person they are familiar with?*

Less demanding

More demanding

Becomes more controlling

More "clingy" towards parent/carer

No obvious difference in behaviour

10. How does the child respond to structured activities? For example, games which have boundaries, rules, and/or directed by adults? *

Highly tolerant

Tolerant

Challenging

Oppositional

11. How does the child respond to nurturing activities? For example, are they accepting of cuddles, touch etc?*

Highly tolerant

Tolerant

Challenging

Oppositional

12. How does the child respond to challenging activities? For example, competitive games, games which have a clear “winner and loser” or games which push their competency level?*

Becomes disinterested if not immediately succeeding?

Becomes angry

Tries to control what game or activity is being played

Generally tolerant

13. How does the child respond to moments of emotional intimacy? For example, maintaining eye contact or standing in close proximity?*

Avoidant

Uncomfortable

Comfortable

Seeks out emotional intimacy

14: Is there any additional information which the facilitators will need to be aware of before this intervention begins? For example, are there any sensory issues (parent and/or child), food allergies (parent and/or child), specific learning or physical difficulties (parent and/or child) etc?

Important information about this therapy

Structure of intervention

In some instances, we can introduce the child into the dyad and, in others, we may be unable to. This is for lots of different reasons which are all orientated around the best interests of the child and/or the adults in question. It is at the practitioner’s discretion to determine how to use the allocated sessions and whether it is/is not beneficial to involve the child in this intervention.*

I have read and understood the above

Cancelled sessions

Parents/carers are asked to provide at least 48hrs notice if they need to cancel a session. We may be able to provide alternative dates for this missed session prior to our next meeting however, sometimes, this will not be possible. In the event that it is not possible to reschedule, this cancelled appointment will be included within your overall session count.

I have read and understood our cancellation policy

Safeguarding concerns

As social care professionals we have a statutory obligation to diseminate information to the relevant professionals if we believe there are actual or percieved safeguarding concerns. In our capacity as practitioners, it is not within our duristiction to determine or assess whether the information presented meets threshold for social care intervention. Due to this, we are required to delegate that responsibility to those who can make these determinations. Therefore, should we need to pass information to social care, it does not mean there is a safeguarding concern; it just means we are consulting those who can make these decisions, to ensure everyone in question is as safe and supported as possible.*

I have read and understood our safeguarding obligations

Historic information

This document, along with historic information ( for example, carers form F, CPR, PAR and any reports from previous interventions) must be completed and returned/sent prior to the intervention beginning. We cannot start an intervention until we have this information.*

I have read and understood the above

Professional’s meetings

Although Amelie’s Place is committed to working in joint-up way with professionals, all practitioners are bound by confidentiality. Therefore, our contributions in professionals meetings will be made with this in mind, unless there is a safeguarding concern. *

I have read and understood the above.

Holiday's

Parents/carers are asked to provide at least four weeks’ notice if they are to miss sessions, owing to pre-planned holidays or known absences. With this notice period, we can explore rescheduling the missed appointments before the known absence or holiday. Similar to the above, in some instances, this will be possible. At other times, this will not be. In the event that it is not possible to reschedule, this cancelled appointment will be included within your overall session count.*

I have read and understood the above

Early termination

Should the parents/carers wish to terminate the therapeutic intervention, we would need a four-week written notice period of the intention to do so, detailing why they wish to discontinue the work. This will enable us to prepare an appropriate ending to the sessions for the parents/carers and the children in their care. Should the practitioner need to stop the therapeutic intervention due to unforeseen events, the LA and the parents/carers will be informed; a way forwards being discussed before the termination of a service. *

I have read and understood the above

Reports

A report will be provided to the respective local authority at the conclusion of the intervention. Prior to doing so, Amelie’s Place will send a copy to parents/carers, offering the opportunity to share their thoughts and feelings on the information detailed in the report. This feedback is extremely valuable to us, as we strive to continue to provide therapeutic services at the highest standard for each and every family we meet. We kindly ask that responses are returned within five working days, after which the report will automatically be sent to the local authority for processing.

I have read and understood the above.

GDPR statement

We will store contact details, electronic records and reports in accordance with General Data Protection Regulations (GDPR) on the therapist’s secure work drive, password protected and only available to Amelie’s Place. *

I have read and understood the above.

Please indicate whether or not you would you be happy for Amelie’s Place to send you information via email about other services we offer, once this intervention has concluded?*

Yes we are happy to be contacted!

We would prefer not to be contacted

Date completed*

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