Theory Philosophy & Treatment



At the heart of the approach to treatment at the Villa Santa Maria is a theory of treatment that emphasizes recent neurobiological advancements in early childhood development and self-regulation. We begin with the understanding that the brain is genetically coded while emphasizing the need for affective experiences to promote a healthy way of being and relating in context to another and the environment.  As such, we view the brain as a dyadic organ which develops in relation to another brain.  In short, brain development is seen as experience dependent. The neurobiology of the interpersonal experience is therefore a key element in the treatment impacting the internal working model of the children we work with.




At Villa Santa Maria, we understand our responsibility as being one of building healthy relationships with children who do not trust the care of others. This task begins with one fundamental attitude towards children, "WE WILL TAKE CARE OF YOU." This approach extends into every aspect of the child's life here including the residential milieu, school and in therapy.


Villa Santa Maria is a therapeutic community where children learn the fun and satisfaction inherent in healthy relationships with adults. We create a living environment in which every interaction that a child has with an adult is an opportunity for change - where every interaction is a corrective emotional experience.


Children who do not trust the care of others are taught through daily living that they will be taken care of. This is accomplished with THREE RULES  & hundreds of expectations.

The first rule states, "Ask for everything you need and want." We help children learn that by verbalizing their needs, they are more likely to have them met by an adult. Self parentified behaviors, common in children with Reactive Attachment Disorder (RAD), prevent children from learning that their care is an adult's responsibility. This focus provides continuous opportunities for children to discover that the staff at the Villa consistently responds to the child's need at the time.


The second rule states, "Let staff know where you are at all times." In order to keep children safe, we must always know where they are. A child cannot be outside of an adult's eyesight without explicit permission.


The third rule states, "No touching without permission."

Beyond these three rules, everything else is negotiable with the exception of closeness. The essence of our treatment model is dependent on the child's relationship with a person as opposed to his or her ability to maneuver and manipulate to an artificial system of points and levels. The limited rules also reinforce to the child that the care giver is the most important tool available to gain trust, independence and permission to participate in the fun opportunities that are ongoing in the community.

To establish this culture, we approach the child with the overall message that we will and want to care for them.  The core of treatment is based on inter-subjective or intense interpersonal experiences between the adults and the children.  Therefore, the relational environment and interactive regulation with another is paramount. As such, behavior modification systems, as seen in more traditional settings, are not utilized as they have proven ineffective with the children we serve.




Dyadic Developmental Psychotherapy (DDP) is used as the primary treatment approach within the Villa. DDP is based on the premise that the development of the child is dependent and influenced by the nature of the adult child relationship. These relationships, in regards to emotional development, require repeated, dyadic (reciprocal) affective experiences in the context of the ongoing relationships.

The central therapeutic process of DDP is attunement — an affective process in which the relationship is in an emotional sync. The process is one of creating a healing PACE: Playful, Accepting, Curious and Empathetic. The goal of this process is to promote interactions that best meet the child’s needs in an environment that is real and safe while integrating the child’s neurological, emotional, cognitive and behavioral functioning.

Guiding Cultural Principals


  • Children get what they need, not what they earn

  • Nurturance is a right of every child

  • Fairness is getting what you need, not getting the same things or amount as others

  • Everyone has permission to feel

  • All moments in the interactions with the child are seen as therapeutic opportunities

  • Treatment prioritizes alliance in the relationship over compliance

  • Care is delivered in what is believed to be the most facilitative manner

  • Relationships are never denied — healing is in relation to another

  • Isolation is never used

  • We use interventions to deliver people (relationships) not people to deliver interventions