title: The feasibility of a randomised controlled trial of Dyadic Developmental Psychotherapy.
abstract: BACKGROUND
  Maltreated children have significant and complex problems which clinicians find difficult to diagnose and treat. Previous US pilot work suggests that Dyadic Developmental Psychotherapy (DDP) may be effective; however, rigorous evidence from a randomised controlled trial (RCT) is lacking. The purpose of this study is to establish the feasibility of an RCT of DDP by exploring the ways that DDP is operating across different UK sites and the impacts of current practice on the potential set-up of an RCT.
  
  
  METHODS
  Qualitative methods (interviews, focus groups and teleconferences) were used to explore trial feasibility with therapists and service managers from teams implementing both DDP and possible control interventions. Data were analysed thematically and related to various aspects of trial design.
  
  
  RESULTS
  DDP was commonly regarded as having a particular congruence with the complexity of maltreatment-associated problems and a common operating model of DDP was evident across sites. A single control therapy was harder to establish, however, and it is likely to be a non-specific and context-dependent intervention/s offered within mainstream Child and Adolescent Mental Health Services (CAMHS). Because a 'gold standard' Treatment as Usual (TAU) does not currently exist, randomisation between DDP and TAU (CAMHS) therefore looks feasible and ethical. The nature of family change during DDP was regarded as multi-faceted, non-linear and relationship-based. Assessment tools need to be carefully considered in terms of their ability to capture change that covers both individual child and family-based functioning.
  
  
  CONCLUSIONS
  An RCT of DDP is feasible and timely. This study has demonstrated widespread interest, support and engagement regarding an RCT and permissions have been gained from sites that have shown readiness to participate. As maltreated children are among the most vulnerable in society, and as there are currently no treatments with RCT evidence, such a trial would be a major advance in the field.
authors.affiliation: Institute of Health & Wellbeing, University of Glasgow, Academic Unit of Mental Health & Wellbeing, Caledonia House, Royal Hospital for Sick Children, Yorkhill, Glasgow, G3 8SJ, UK. Fiona.Turner@glasgow.ac.uk.
authors.forename: Fiona
authors.initials: F
authors.lastname: Turner-Halliday
authors.affiliation: Institute of Health & Wellbeing, University of Glasgow, College of Medical, Veterinary and Life Sciences, 1 Lilybank Gardens,, Glasgow, G12 8RZ, UK. Nicholas.Watson@glasgow.ac.uk.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Watson
authors.affiliation: Institute of Health & Wellbeing, University of Glasgow, Health Economics and Health Technology Assessment, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK. Nicki.Boyer@glasgow.ac.uk.
authors.forename: Nicole R S
authors.initials: NR
authors.lastname: Boyer
authors.affiliation: Institute of Health & Wellbeing, University of Glasgow, Health Economics and Health Technology Assessment, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK. Kathleen.Boyd@glasgow.ac.uk.
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Boyd
authors.affiliation: Institute of Health & Wellbeing, University of Glasgow, Academic Unit of Mental Health & Wellbeing, Caledonia House, Royal Hospital for Sick Children, Yorkhill, Glasgow, G3 8SJ, UK. Helen.Minnis@glasgow.ac.uk.
authors.forename: Helen
authors.initials: H
authors.lastname: Minnis
mesh_terms: D000293:Adolescent; D002648:Child; D002649:Child Abuse / Q000175:diagnosis* / Q000523:psychology; D002675:Child, Preschool; D005240:Feasibility Studies; D006282:Health Personnel; D006801:Humans; D002666:Psychology, Child; D066233:Psychology, Developmental; D011613:Psychotherapy / Q000379:methods*; D016032:Randomized Controlled Trials as Topic