DIR-Floortime

Domain VIII · Creative & expressive arts therapies · Stanley Greenspan, Serena Wieder

What it is

DIR stands for the Developmental, Individual-differences, Relationship-based model, developed by Stanley Greenspan and Serena Wieder. ICDL presents DIR as a framework for understanding development across the lifespan. DIRFloortime is its applied practice, the "way to put this philosophy into…

Format

• There are no fixed phases or session count. The "framework" is a developmental profile. Treatment means working continuously at the child's current capacity, while strengthening it and inviting the next one.
• Typical work-up and format.

Who practises it, and how they are trained or regulated

• I. Self-regulation and interest in the world
• Profile and plan. Map which FEDCs are solid, partial or emerging, and the child's individual differences. Then plan a team programme. ICDL says it will probably be multidisciplinary: caregiver–child interaction consultation, speech and language therapy, OT with sensory-integration training, peer play and playdates, and home and educational programmes.
• Drop back a level whenever the child is dysregulated.

Evidence status, as the guide reports it

• Evidence status, as sources give it (brief).

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• scripts turning into flexible, shared exchanges.
• routines becoming rushed tests. Keep them light.
• signals becoming clearer, more frequent and better directed at you.
• guilt and self-blame. Frame the discussion as noticing, not judging.
• pitching above the child's level. Chains break and arousal rises. Drop down a level.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.