"Exposed, Scaffolded and Connected – Foster Carers’ Experiences of Dyadic Developmental Psychotherapy: An Interpretative Phenomenological Analysis

Objective
Research is required to better understand the experience and effectiveness of Dyadic Developmental Psychotherapy (DDP), a promising intervention developed to meet the complex needs of developmental trauma-experienced children in substitute care. DDP is a systemic intervention, within which the child’s carer plays a significant role. Given their significant role and the lack of existing research, this study aimed to explore how foster carers experience DDP.

Design
A qualitative design using semi-structured interviews with ten foster carers was implemented.

Method
Interviews conducted via Microsoft Teams and telephone were recorded, transcribed and analysed using Interpretative Phenomenological Analysis (IPA).

Results
Four group experiential themes and eleven subthemes were formed; ‘from disbelief to clarity’, ‘scaffolded and safe’, ‘attuned and connected’, and “it’s worth it”. From initial confusion and disappointment, came clarity of self-understanding and a more attuned, connected attachment relationship. DDP was experienced as both fulfilling and demanding.

Conclusions
Though the need to explore DDP’s effectiveness remains, this study suggests foster carers experience DDP as a demanding yet worthwhile intervention. Implications for practice, especially an increased need for relational safety and carer support are explored, as well as avenues for future research.

Practitioner points

• DDP can be personally and professionally rewarding for foster carers and may increase their insight into the child’s world and develop attachment security, with relational benefits beyond those seen with the index child in therapy.
• More effort should be made to ensure foster carers are explicitly made aware of the requirements within DDP, to ensure foster carers can provide informed consent that considers their capacity to engage. Alternative support, such as DDP-informed consultation, should be explored if the foster carer is not consenting.
• Foster carers could be provided with testimonies from other DDP-experienced foster carers to help inform their decision to partake and to possibly help reduce confusion and frustration when engaging in therapy, reducing the risk of rupture and disengagement.
• Due attention should be paid to the experience and therefore support needed for foster carers’ engaging in DDP, by both DDP therapists (such as providing more frequent check-in sessions) and wider social care (such as increased provision of supervision and peer support), given the reported toll of engaging in the therapy.