Search

Purpose: To review and assess theory and research supporting DIR/Floortime™, a method proposed for treatment of young children with autism spectrum disorders (ASD). Methods: Published materials describing the principles of DIR/Floortime™were evaluated. Published outcome research articles were assessed for the adequacy of their design and implementation and the extent to which their conclusions were supported. Results: The theoretical basis of DIR/Floortime™ appears to be generally plausible. Of the 10 outcome research articles in print, all concluding that DIR™ effectively treated ASD, five provided a comparison group, or used a randomized design, or did both. These studies failed to equalize the duration and frequency of DIR™ and the comparison treatment. Conclusions: DIR™ can be considered by social work practitioners as a possibility for evidence-based practice (EBP), but not as an evidence-based treatment (EBT). Further outcome research needs to concentrate not only on randomized design but on other design issues.

The Circle of Security™ interventions are psychosocial treatments intended to increase maternal sensitivity and thus child attachment security in infants and young children. A small number of publications have reported empirical research on outcomes of these treatments. This article reviews the research evidence, plausibility, theoretical background, and generalizability of Circle of Security, and concludes that these interventions are plausible emerging treatments, presently weakly supported by research evidence, but potentially able to receive support from further research. The commercialization of Circle of Security is discussed as a possible obstacle to independent research. The current level of research support is described as similar to support for other interventions for young children.

Dyadic developmental psychotherapy (DDP) is a mental health intervention intended primarily for children with problematic attachment histories. It has received increased attention in the United Kingdom and the United States in the last few years. DDP has been publicized as a research-supported treatment, but a review of research shows that it does not meet ordinary standards for this category. In addition, DDP appears to be based on a number of questionable metaphors that have been used in attempted explanations of personality development and mental illness. Some unanswered questions about the background assumptions of DDP are presented. Caution about this method of therapy is recommended.

This article re-examines material discussed in a recent systematic research synthesis by Craven and Lee. The authors find that two of the interventions for foster children discussed by Craven and Lee were erroneously classified as supported by evidence of efficacy, and one, holding therapy, is shown to be potentially physically harmful to children. Detailed evidence is offered to show that holding therapy and dyadic developmental psychotherapy are not appropriately categorized as supported and acceptable interventions.