Short-term Dynamic Psychotherapy Research Articles

Intensive short-term dynamic psychotherapy for irritable bowel syndrome: a randomized controlled trial examining improvements in emotion regulation, defense mechanisms, quality of life, and IBS symptoms.

Studies have provided evidence for the effectiveness of intensive short-term dynamic psychotherapy (ISTDP) in treating medically unexplained symptoms (MUS). This study aimed to examine the effectiveness of ISTDP on individuals living with irritable bowel syndrome (IBS) in terms of, emotion regulation (ER) abilities, defense mechanisms, quality of life (QOL), and IBS symptoms. A total of 30 patients diagnosed with IBS were recruited and randomly assigned to either the intervention (n = 15) or control (n = 15) group. Pre- and post-treatment assessments were conducted, along with a follow-up assessment after ten weeks. Repeated measures analyses of variance were employed to analyze the data. The findings revealed that ISTDP led to significant improvements in ER, defense mechanisms, and QOL, as well as a reduction in the severity and frequency of IBS symptoms. These results provide further support for the efficacy of ISTDP as a treatment modality for individuals with IBS.

Effectiveness of intensive short-term dynamic psychotherapy for Tension-Type Headache (TTH): A randomized controlled trial of effects on emotion regulation, anger, anxiety, and TTH symptom severity

Research has demonstrated the potential efficacy of intensive short-term dynamic psychotherapy (ISTDP) in addressing medically unexplained symptoms (MUS). However, the specific application of ISTDP for tension-type headache (TTH), a prevalent and common MUS, has not been extensively studied. In light of this gap in the literature, the current study investigated the effectiveness of intensive short-term dynamic psychotherapy (ISTDP) in treating TTH. The study assessed ISTDP's impact on emotion regulation (ER) capacities, levels of anxiety and anger, and TTH symptoms. 30 patients from the neurology clinic at Hazrat Rasool Hospital in Tehran were randomly assigned to either the intervention (n = 15) or control (n = 15) group. Pre- and post-treatment evaluations were conducted, followed by a ten-week follow-up assessment. Data were analyzed using repeated measures analyses of variance. The results indicated that ISTDP led to significant improvements in ER, reductions in anxiety and anger levels, and a significant decrease in TTH symptoms (ps < 0.001). Findings underscore the effectiveness of ISTDP as a valuable therapeutic approach for addressing TTH.

Effectiveness of Short-term Intensive Dynamic Psychotherapy on the Severity of Gastrointestinal Symptoms and Depression in Patients with the Diarrhea Subtype of Irritable Bowel Syndrome

Objective: Irritable Bowel Syndrome (IBS) is one of the functional gastrointestinal disorders and the most common digestive disorder. The purpose of the current study was to investigate the effectiveness of short-term intensive dynamic psychotherapy on the severity of gastrointestinal symptoms and depression in patients with the diarrhea subtype and concurrent depression of Irritable Bowel Syndrome. Methods and Materials: The present study employed a single-case quasi-experimental design. Three patients with the diarrhea subtype and concurrent depression of Irritable Bowel Syndrome, who had visited neurology and psychiatry clinics in Qom in December 2023, were selected through purposive sampling and each received 18 sessions of short-term intensive dynamic psychotherapy. Data derived from the Somatic Symptom Scale by Solati Dekordi et al. (2009) and the Beck Depression Inventory-II (BDI-II) by Beck et al. (1996) were recorded at three stages (baseline, treatment, and follow-up) and analyzed using visual plotting methods, the Reliable Change Index, and the percentage of improvement formula. Findings: The percentage of improvement in the severity of gastrointestinal symptoms and the severity of depression symptoms for each patient in the treatment and follow-up stages was higher than 50%, indicating therapeutic success. The Reliable Change Index for the severity of gastrointestinal symptoms and depression severity for all three patients was above 1.96, indicating significant improvement. Conclusion: Short-term intensive dynamic psychotherapy appears to be effective in reducing the severity of gastrointestinal symptoms and depression in these patients. Therefore, it is recommended that randomized controlled trials with long-term follow-up be conducted as a continuation of this preliminary study.

Comparison of the Effectiveness of Short-Term Intensive Dynamic Psychotherapy (ISTDP) and Schema Therapy for Mothers on Social Anxiety in Children Aged 5 to 6

Objective: Social anxiety disorder is among the most common disorders during childhood and adolescence. The present study aimed to compare the effectiveness of short-term intensive dynamic psychotherapy (ISTDP) and schema therapy for mothers on social anxiety in children aged 5 to 6 years in Shahin Shahr. Methods and Materials: This research was a quasi-experimental study with a pre-test, post-test, and follow-up design, including a control group. The research population consisted of all mothers of children aged 5 to 6 years with social anxiety in Shahin Shahr in 2023, from which 45 individuals were purposively selected based on scoring two standard deviations above the mean on the Spence Children's Anxiety Scale (Parent Version) and other entry criteria of the study, and were randomly assigned to two experimental groups and one control group (each containing 15 individuals). One experimental group received 10 weekly sessions of 90 minutes of schema therapy, while the second experimental group underwent 10 weekly sessions of 90 minutes of short-term intensive dynamic psychotherapy (ISTDP). The control group did not receive any intervention. The research tool was the Spence Children's Anxiety Scale (Parent Version, 1999), completed by the mothers at three stages: pre-test, post-test, and a 3-month follow-up. The obtained data were analyzed using repeated measures ANOVA, mixed-design ANOVA, and Bonferroni post-hoc tests with SPSS software version 24. Findings: The results showed that both treatments were effective in improving children's social anxiety (P&lt;0.01), but the effectiveness of schema therapy for mothers on improving children's social anxiety was greater (P&lt;0.01), and the effectiveness of both treatments was sustained until the end of the follow-up period. Conclusion: Both treatment methods, especially schema therapy for mothers, are effective in improving social anxiety in children and can be utilized.

Comparison of the effectiveness of intensive short-term dynamic psychotherapy (ISTDP) and existential therapy on the signs and symptoms of psychosomatic patients referred to Imam Khomeini Hospital in Tehran

Comparison of the effectiveness of intensive short-term dynamic psychotherapy (ISTDP) and existential therapy on the signs and symptoms of psychosomatic patients referred to Imam Khomeini Hospital in Tehran

Intensive Short-Term Dynamic Psychotherapy

Intensive Short-Term Dynamic Psychotherapy (ISTDP) is a transdiagnostic treatment method rooted in the psychodynamic tradition. A basic assumption is that many of our feelings, thoughts, desires and inner conflicts are inaccessible to our consciousness and thereby trigger and maintain psychological problems. In the 1960s, the Canadian psychoanalyst and psychiatrist Habib Davanloo began developing the original ‘standard format’ of ISTDP. After continuously studying video recordings of his treatment sessions, Davanloo systematised effective factors which he could use in subsequent treatment sessions. In the 1990s, he further developed a ‘graded format’ of ISTDP with interventions that could be adapted to patients who are easily overwhelmed by anxiety and other emotions. In this article, we take a closer look at how ISTDP operationalises ‘unconscious anxiety’ and ‘unconscious therapeutic alliance’ as observable markers that provide the therapist with information about the therapeutic process and about the choice of interventions, illustrated through the case of Nadine. Keywords: Intensive Short-Term Dynamic Psychotherapy, ISTDP, conflicting emotions, unconscious anxiety, unconscious therapeutic alliance

The effects of intensive short-term dynamic psychotherapy on depressive symptoms, negative affect, and emotional repression in single treatment-resistant depression: A randomized controlled trial.

Intensive short-term dynamic psychotherapy (ISTDP) is theorized to reduce negative affect by challenging patients' defense mechanisms so that they can experience and work through attachment-trauma-related emotions. While ISTDP has been shown to decrease depressive symptoms in single treatment-resistant depression (TRD), it has not been established whether negative affect and emotional repression are reduced, as theorized. Next to depressive symptoms, this retrospectively registered (https://osf.io/v46gy) randomized controlled trial, therefore, examined the effects of ISTDP on emotional repression and negative affect in adults with TRD. Eighty-six adults with major depressive disorder, who had not responded to at least one trial of antidepressants were randomized to 20 sessions of ISTDP (N = 43) or a waitlist control condition (N = 43). Mixed-effect models on the intention-to-treat sample showed that compared to the control condition, ISTDP resulted in significantly lower posttreatment levels of depressive symptoms (d = -1.73), emotional repression (d = -1.91), and negative affect (d = -1.45). Similarly, ISTDP resulted in significantly lower levels of depressive symptoms (d = -2.67), emotional repression (d = -2.69), and negative affect (d = -1.85) at the 3-month follow-up. These results support the evidence base of ISTDP by showing that it can decrease depressive symptoms, emotional repression, and negative affect in TRD. Future studies should assess whether these effects are specific to ISTDP. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

“Picking up the pieces”: Patients’ retrospective reflections of rupture resolution episodes during treatment

ABSTRACT Objective: Although theorists and researchers have stressed the importance of rupture resolution episodes for successful treatment process and outcome, little is known about patients’ retrospective reflections about rupture resolution. Aim: The overarching goal of the present study was to use a mixed-method approach to examine patients’ retrospective reflections on the frequency, types, and consequences of rupture resolution episodes and the association between rupture resolution episodes and patients’ attachment orientation and treatment outcome. Method: Thirty-eight patients diagnosed with major depressive disorder (MDD) were interviewed, on average three years after termination, about their experiences of ruptures in short-term dynamic psychotherapy. Results: Thirty patients reported having experienced at least one rupture, with patients who showed less improvement in depressive symptoms more likely to report having had a rupture. Ruptures were judged as having been successfully resolved for 13 of these patients; suggesting that patients with a high level of attachment anxiety were less likely to be judged as having had a successful resolution. Patients whose ruptures were successfully resolved with the therapist's help reported better treatment process and outcome than patients whose ruptures were not successfully resolved. Conclusion: Results highlight the importance of hearing patients’ perspectives on ruptures, rupture resolution, and treatment outcome.

Psilocybin-assisted psychotherapy for treatment-resistant depression: Which psychotherapy?

This perspective paper explores the choice of psychotherapy for psilocybin-assisted psychotherapy for treatment-resistant depression. There is evidence to support the use of some psychotherapies in treating 'treatment-resistant' depression, and emerging evidence for the efficacy of psilocybin. The next step which is the focus of this paper is to identify psychotherapies that are both effective and congruent with the psilocybin experience. The evidence for the efficacy of the psychotherapies is drawn from a Cochrane review and the analysis of their congruence with the psilocybin experience is drawn from a qualitative meta-synthesis of the experience of psilocybin. The paper will examine whether three one-to-one psychotherapies identified as effective in the treatment of treatment-resistant depression are compatible with the psilocybin experience. Each psychotherapy will be examined in relation to its congruence with the qualitative evidence that suggests the choice of psychotherapy needs to give priority to the subjective experience, facilitate emotional processing, support connectedness with others, acceptance of the self as emotional and support change based on the person's insights into their relationships with others and the world in which they live. We conclude that interpersonal psychotherapy and intensive short-term dynamic psychotherapy align with that experience, although others are currently being trialled.

Comparison of Effectiveness of Intensive Short-Term Dynamic Psychotherapy and Mindfulness-Based Stress Reduction in Depression and Severity of Symptoms in Women with Fibromyalgia

Background: In addition to pervasive pain, patients with fibromyalgia also complain about impaired cognitive functions, anxiety, and depression. Objectives: This study was conducted with the aim of comparing the effectiveness of mindfulness-based stress reduction (MBSR) and intensive short-term dynamic psychotherapy (ISTDP) in depression and the severity of symptoms in patients with fibromyalgia. Methods: This was an experimental study with a pretest-posttest design and a control group with a 3-month follow-up. The statistical population covered all female patients with fibromyalgia visiting the Rheumatology Clinic of Rasool Akram Hospital in Tehran, Iran. Based on inclusion criteria and the convenience sampling method, 36 individuals were selected and randomly assigned to 3 groups (2 experimental groups and a control group). Each experimental group received treatment (i.e., MBSR, eight 120-minute sessions, or ISTDP, eight 120-minute sessions). The research instruments included the Beck Depression Inventory-Second Edition and the Combined Index of Severity of Fibromyalgia. The results were analyzed using repeated measures analysis of variance (ANOVA). Results: The results showed that both interventions, namely MBSR and ISTDP, effectively reduced depression and the severity of symptoms in patients with fibromyalgia (P &lt; 0.001). Mindfulness-based stress reduction and ISTDP were also significantly different in terms of effectiveness, with ISTDP being more effective with a longer-term follow-up effect (P &lt; 0.001). Conclusions: Mindfulness-based stress reduction and ISTDP were effective and practical methods for reducing depression and the severity of fibromyalgia symptoms. It is recommended that psychotherapists and counselors adopt these approaches to reduce depression and the severity of fibromyalgia symptoms in patients and help improve and reduce their symptoms.

A naturalistic pilot study exploring the differences between fragile and resistant patients in ISTDP

IntroductionIntensive Short-Term Dynamic Psychotherapy (ISTDP) defines two spectra of patients based on the patients’ capacity to tolerate anxiety and complex emotions. Resistant patients have a better capacity to tolerate affective stimulus compared to fragile patients. There is, however, little empirical evidence that supports this categorization. This exploratory study seeks to identify reliable differences between 330 resistant and 88 fragile patients. MethodsTo assess which category patients belong to, therapists conducted a specific psychodiagnostic assessment of patients when entering psychotherapy. Patients selfreported on the Brief Symptom Inventory (BSI) and the Inventory of Interpersonal Problems (IIP). Independent samples t-tests estimated differences between psychodiagnostic categories on self-reported measurements. ResultsFragile patients scored significantly higher on five IIP subscales and all BSI subscales, barring “Paranoid Ideation”. As symptom distress might mask underlying pathological processes, we used a matching procedure to compare resistant and fragile patients with the same level of symptom distress, before repeating estimation of differences between the categories. Fragile patients scored significantly higher only on the BSI somatization subscale as well as on three items from the BSI somatization subscale, and one item from each of three other BSI subscales (i.e., “Phobic anxiety”, “Anxiety”, “Psychoticism”). LimitationsThe study used generic psychometric instruments. A specific psychometric instrument developed according to ISTDP theory would likely be more suited to capture group differences. ConclusionsThe results provide support for the notion that fragile patients in general experience more psychological distress and specifically suffer from more somatization and additionally anxiety, phobic anxiety and psychoticism symptoms.

Effect of short-term dynamic psychotherapy on sexual function and marital satisfaction in women with depression: Clinical trial study.

This study aimed to look at the influence of short-term dynamic psychotherapy on sexual function and marital satisfaction in women with depression. Through a clinical trial study using a pretest-posttest design and a control group, this study enlisted the participation of 60 women diagnosed with depression. The patients were interviewed before being randomly assigned to experimental or control groups. Data were obtained through the Beck Depression Inventory, the Enrique Marital Satisfaction Questionnaire, and the Female Sexual Function Questionnaire. The experimental group received intense short-term dynamic psychotherapy intervention, while the control group was on a 2-month waiting list. The SPSS 24 program utilized an analysis of variance to analyze the data. The pre- and posttest study results revealed a significant difference in marital satisfaction, sexual function, and depression between the experimental and control groups (p < 0.01). During the posttest phase, a short-term intensive dynamic psychotherapy intervention helped the experimental group feel better about their marriage and improve their sexual function. It also helped them feel less depressed.

The Effectiveness of Intensive Short-Term Dynamic Psychotherapy on the Alexithymia, Defense Styles, and Ego Strength in Patients with Irritable Bowel Syndrome: A Quasi-Experimental Study

The Effectiveness of Intensive Short-Term Dynamic Psychotherapy on the Alexithymia, Defense Styles, and Ego Strength in Patients with Irritable Bowel Syndrome: A Quasi-Experimental Study

The Effectiveness of Intensive Short Term Dynamic Psychotherapy on Clinical Symptoms and Academic Performance in Adolescents with Oppositional Defiant Disorders

The Effectiveness of Intensive Short Term Dynamic Psychotherapy on Clinical Symptoms and Academic Performance in Adolescents with Oppositional Defiant Disorders

Intensive Short-Term Dynamic Psychotherapy (ISTDP) associated with healthcare reductions in patients with functional seizures

Intensive Short-Term Psychodynamic Therapy (ISTDP) has demonstrated promising evidence for the treatment of Functional Neurological Disorders (FND) including functional seizures.This paper aimed to further examine the therapeutic effects of a 3-session course of this treatment focusing on its potential to maintain reduced healthcare utility within a group of patients with complex difficulties, across an extended time period, post-therapy.The original study followed a mixed methods case series design and recruited 18 patients from secondary adult mental health care and specialist neurology services. Seventeen participants completed the intervention and attendance rates were very high (95%). In this follow-up study, which was solely focused on the utilization of healthcare resources, results showed decreases when comparing 12 months prior and 12 months post three sessions of ISTDP.The results provide further support for the use of ISTDP in this group of participants with complex clinical presentations, specifically, its capacity to reduce healthcare usage over 12 months post-therapy. Further evidence from controlled and randomized studies with larger sample sizes is warranted.

Comparing the Effectiveness of Intensive Short-Term Dynamic Psychotherapy (ISTDP) and Acceptance and Commitment Therapy Enriched with Compassion on the Components of Marital burnout in Women Seeking Divorce

Objective: This study aims to compare the effectiveness of Intensive Short-Term Dynamic Psychotherapy (ISTDP) and Acceptance and Commitment Therapy (ACT) enriched with compassion in altering marital burnout among women seeking divorce. Methods and Materials: Statistical population of this study consisted of all women seeking divorce in District 4 of Tehran city in the year 2021, who were selected from counseling centers supervised by the Organization of Psychology and Welfare through convenience sampling. Next, Pines’ (1996) Marital Burnout Questionnaire were distributed for completion, and 45 individuals who scored high on these scales were selected as the sample and randomly placed into two experimental groups and one control group (each group consisting of 15 individuals). For data analysis, descriptive statistical methods (frequency indices, mean, and standard deviation) and inferential statistics (multivariate repeated measures analysis of variance) using SPSS-24 were employed. Findings: Results indicated no significant difference between the ISTDP and ACT enriched with compassion in altering marital burnout. Both groups showed improvement compared to the control group, but no significant difference was noted between the two in terms of effectiveness. Conclusion: Both ISTDP and ACT enriched with compassion are effective in reducing marital burnout among women seeking divorce, with no significant difference in effectiveness between the two. This suggests that both therapeutic approaches can be beneficial in this context. Future research should consider broader and more diverse samples, longer follow-up periods, and comparisons to active control groups to further understand the sustained impact and efficacy of these therapies.

Intensive short-term dynamic psychotherapy (ISTDP) offers unique procedures for acceptance of emotion and may contribute to the process-based therapy movement

A variety of contemporary cognitive behavioral therapy (CBT) frameworks have collectively converged on acceptance of emotion as a therapeutic process central to producing positive outcomes. However, evidence shows that not all patients respond to these treatments, such as those with more severe and complicated symptomatology and more entrenched emotion avoidance tendencies. Intensive short-term dynamic psychotherapy (ISTDP) is a specific, highly active, emotion-focused model of therapy grounded in empirical research that was designed to treat complex patients with entrenched emotion avoidance behaviors. This paper presents the clinical techniques of ISTDP to illustrate its methods of facilitating acceptance of emotion, which is likely unfamiliar to many CBT therapists. Leaders of the field in CBT have recently made calls for psychotherapy, including CBT, to move toward a focus on process-based therapy (PBT), which seeks to highlight and investigate promising change processes and their related change procedures, no matter their original therapeutic framework. In introducing ISTDP techniques to CBT and PBT researchers and therapists, we seek to stimulate awareness, curiosity, and further collaboration in the study and use of these techniques in the hopes that ISTDP may contribute to the PBT movement.

The efficacy of intensive short-term dynamic psychotherapy on job stress coping strategies, health-related quality of life, and self-efficacy of iran air traffic controler staff

The efficacy of intensive short-term dynamic psychotherapy on job stress coping strategies, health-related quality of life, and self-efficacy of iran air traffic controler staff

The efficacy of intensive short-term dynamic psychotherapy (ISTDP) on self-esteem, emotion regulation, and defense mechanisms in men with social anxiety disorder

The efficacy of intensive short-term dynamic psychotherapy (ISTDP) on self-esteem, emotion regulation, and defense mechanisms in men with social anxiety disorder

The anger-depression mechanism in dynamic therapy: Experiencing previously avoided anger positively predicts reduction in depression via working alliance and insight.

A central tenet of psychodynamic theory of depression is the role of avoided anger. However empirical research has not yet addressed the question of for which patients and via what pathways experiencing anger in sessions can help. The therapeutic alliance and acquisition of patient insight are important change processes in dynamic therapy and may mediate the anger-depression association. This study was embedded into a randomized trial testing the efficacy of Intensive Short-Term Dynamic Psychotherapy (ISTDP) for treatment resistant depression. In-session patient affect experiencing (AE) was coded for every available session (475/481) by blinded observers in 27 patients randomized to ISTDP. Dynamic Structural Equation Modeling was used to examine within-person associations between variation in depression scores session-by-session and both patient ratings (alliance) and observer ratings (AE and insight) of the treatment process. Alliance and insight were independent mediators of the effect of anger on next-session depression. However, the relative importance of these two indirect effects of anger on depression was conditional on pretreatment patient personality pathology (PP). In patients with higher PP, in-session anger was negatively related to depressive symptoms next session, with this effect operating through higher alliance. In patients with low PP, in-session anger was negatively related to depressive symptoms next session, with this effect operating through enhanced patient insight. These findings highlight an anger-depression mechanism of change in dynamic therapy. Depending upon patient personality, either an "insight pathway" or a "relational pathway" may promote the effectiveness of facilitating arousal and expression of patients' in-session feelings. (PsycInfo Database Record (c) 2022 APA, all rights reserved).