https://doi.org/10.4081/ripppo.2021.503
Intensive short-term dynamic psychotherapy provided by novice psychotherapists: effects on symptomatology and psychological structure in patients with anxiety disorders
Submitted: October 1, 2020
Accepted: November 27, 2020
Published: April 2, 2021
Accepted: November 27, 2020
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
This study examines the effectiveness of psychotherapy provided by novice therapists, in an attempt to clarify the controversial relationship between treatment effectiveness and therapist experience. To achieve this, we examined the short- and long-term effectiveness of intensive short-term dynamic psychotherapy (ISTDP) in the treatment of patients with the Diagnostic and Statistical Manual of Mental Disorder, IV edition - Text Revision anxiety disorders, as provided by novice psychology trainees. Twenty-two patients with anxiety disorders were provided ISTDP. Patients improved significantly on all outcome indices, including the global assessment of functioning, the symptom checklist and the inventory of interpersonal problems, at the end of the treatment and at 6 and 12 month follow-up. In addition to these results, there was marked structural personality change as evidenced by ratings on the Shedler Westen assessment procedure (SWAP-200), at the same assessment moments; the SWAP-200 psychological health index score showed a meaningful increase in adaptive psychological resources and capacities, while the mean number of personality diagnoses decreased from the beginning to the end of therapy, and all patients maintaining their gains in 6-12 month follow-up. We conclude that ISTDP provided by novice psychotherapists is efficacious in bringing broad and in-depth change to pathology that can perpetuate anxiety disorders and other psychiatric conditions.
Abbass, A. (2002). Office based research in intensive short-term dynamic psychotherapy (ISTDP): data from the first 6 years of practice. Bulletin of Short-term Dynamic Psychotherapy, 6(2), 5-13.
Abbass, A. (2004). Small group videotape training for psychotherapy skills development. Academic Psychiatry, 28(June), 151-155.
DOI: https://doi.org/10.1176/appi.ap.28.2.151
Abbass, A. (2015). Reaching through resistance: advanced psychotherapy techniques. Kansas City: Seven Leaves Press.
Abbass, A., Joffres, M. R., & Ogrodniczuk, J. S. (2008). A naturalistic study of intensive short-term dynamic psychotherapy trial therapy. Brief Treat Crisis Interven. 8, 164-170.
DOI: https://doi.org/10.1093/brief-treatment/mhn001
Abbass, A., Joffres, M. R., & Ogrodniczuk, J. S. (2009). Intensive short-term dynamic psychotherapy trial therapy: qualitative description and comparison to standard intake assessments. Ad Hoc Bulletin of STDP, 13(1), 6-14.
Abbass, A., Kisely, S., Rasic, D., & Katzman, J. W. (2013a). Residency training in intensive short-term dynamic psychotherapy: Methods and cost-effectiveness. Psychiatric Annals, 43(11), 508-512.
DOI: https://doi.org/10.3928/00485713-20131105-06
Abbass, A. A., Kisely, S. R., Town, J. M., Leichsenring, F., Driessen, E., De Maat, S., & Crowe, E. (2014). Short-term psychodynamic psychotherapies for common mental disorders. Cochrane Database of Systematic Reviews, 7, Article CD004687. doi:10.1002/14651858.CD004687.pub4.
DOI: https://doi.org/10.1002/14651858.CD004687.pub4
Abbass, A., Town, J., & Driessen, E. (2012). Intensive short-term dynamic psychotherapy: a systematic review and meta-analysis of outcome research. Harvard Reviews of Psychiatry, Mar-Apr, 20(2), 97-108.
DOI: https://doi.org/10.3109/10673229.2012.677347
Abbass, A., Town, J. M., & Driessen, E. (2013b). Intensive short-term dynamic psychotherapy: a review of the treatment method and empirical basis. Research in Psychotherapy: Psychopathology, Process and Outcome, 16(1), 6-15.
DOI: https://doi.org/10.4081/ripppo.2013.84
Abbass, A., Town, J., Ogrodniczuk, J., Joffres, M., & Lilliengren, P. (2017). Intensive short-term dynamic psychotherapy trial therapy: Effectiveness and role of “unlocking the unconscious.” Journal of Nervous and Mental Disease, 205(6), 453-457.
DOI: https://doi.org/10.1097/NMD.0000000000000684
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th.ed., text rev.). Washington, DC: American Psychiatric Association.
Andrews G., Slade T., & Issakidis C. (2002). Deconstructing current comorbidity: data from the Australian national survey of mental health and well-being. The British Journal of Psychiatry, 181, 306-14.
DOI: https://doi.org/10.1192/bjp.181.4.306
Bowbly, J. (1982). Attachment and loss: Vol 1. Attachment (2nd ed.). New York, NY: Basic Books.
Curran, P., West, S., & Finch, J. (1996). The robustness of test statistics to nonnormality and specification error in confirmatory factor analysis. Psychological Methods, 1, 16-29.
DOI: https://doi.org/10.1037/1082-989X.1.1.16
Davanloo, H. (1980). Short-term dynamic psychotherapy. New York: Jason Aronson.
Davanloo, H. (1990). Unlocking the unconscious. Selected papers of Habib Davanloo. Toronto: John Wiley and Sons.
Davanloo, H. (2000). Intensive short-term dynamic psychotherapy. Selected papers of Habib Davanloo. Toronto: John Wiley and Sons.
Derogatis, L. R. (1983). Administration, scoring, and procedures manual for the recise version. Baltimore: Clinical Psychometric Research.
Derogatis, L. R., & Spencer, P. M. (1982). The brief symptom inventory (BSI): administration, and procedures manual-I. Baltimore, MD: Clinical Psychometric Research.
Flegenheimer, W. V. (1977). Technique of brief psychotherapy. Northvale, NJ: Jason Aronson.
Fonagy, P., Roth, A., & Higgitt, A. (2005). Psychodynamic psychotherapies: evidence-based practice and clinical wisdom. Bulletin of the Menninger Clinic, 69(1), 1-58.
DOI: https://doi.org/10.1521/bumc.69.1.1.62267
Freud, S. (1905). Fragment of an analysis of a case of hysteria. S.E., 7, 7-122.
Freud, S. (1909a). Analysis of a phobia in a five-year-old boy. S.E., 10, 5-149.
Freud, S. (1909b). Notes upon a case of obsessional neurosis. S.E., 10, 155-318.
Hall, R. C. (1995). Global assessment of functioning. A modified scale. Psychosomatics, 36(3), 267-75.
DOI: https://doi.org/10.1016/S0033-3182(95)71666-8
Horowitz, L. M., Straub, B., & Kordy, H. (2000). Inventory of interpersonal problems (IIP). Gottingen: Hogrefe.
Jacobson, N., & Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12-19.
DOI: https://doi.org/10.1037/0022-006X.59.1.12
Levy, R. A., Ablon, J. S., & Kächele, H. (2012). Psychodynamic psychotherapy research. evidence-based practice and practice-based evidence. London: Springer.
DOI: https://doi.org/10.1007/978-1-60761-792-1
Lilliengren, P., Cooper, A., Town, J.M., Kisely, S., & Abbass, A. (2020). Clinical- and cost-effectiveness of intensive short-term dynamic psychotherapy for chronic pain in a tertiary psychotherapy service. Australasian Psychiatry, 28(4), 414-417.
DOI: https://doi.org/10.1177/1039856220901478
Lilliengren, P., Johansson, R., Lindqvist, K., Mechler, J., & Andersson, G. (2016). Efficacy of experiential dynamic therapy for psychiatric conditions: a meta-analysis of randomized controlled trials. Psychotherapy, 53, 90-104.
DOI: https://doi.org/10.1037/pst0000024
Lingiardi, V., Muzi, L., Tanzilli, A., & Carone, N. (2018). Do therapists’ subjective variables impact on psychodynamic psychotherapy outcomes? A systematic literature review. Clinical Psychology and Psychotherapy, 25(1), 85-101.
DOI: https://doi.org/10.1002/cpp.2131
Lo Coco, G., Mannino, G., Salerno, L., Oieni, V., Di Fratello, C., Profita, G., & Gullo, S. (2018). The Italian version of the inventory of interpersonal problems (IIP-32): psychometric properties and factor structure in clinical and non-clinical groups. Frontiers in Psychology, 9, 341.
DOI: https://doi.org/10.3389/fpsyg.2018.00341
Luborsky, L. (1962). Clinicians’ judgements of mental health. A proposed scale. Archives of General Psychiatry, 7, 407-417.
DOI: https://doi.org/10.1001/archpsyc.1962.01720060019002
Malan, J. (1963). A study of brief psychotherapy. London, Tavistock, New York: Reprint by Plenum Press.
Prunas, A., Sarno, I., Preti, E., Madeddu, F., & Perugini, M. (2012). Psychometric properties of the Italian version of the SCL-90-R: a study on a large community sample. European Psychiatry 27(8), 591-597.
DOI: https://doi.org/10.1016/j.eurpsy.2010.12.006
Rahmani, F., Abbass, A., Hemmati, A., Ghaffari, N., & Rezaei Mirghaed, S. (2020a). Challenging the role of challenge in intensive short-term dynamic psychotherapy for social anxiety disorder: A randomized controlled trial. Journal of Clinical Psychology, 76(12), 2123-2132.
DOI: https://doi.org/10.1002/jclp.22993
Rahmani, F., Abbass, A., Hemmati, A., Mirghaed, S. R., & Ghaffari, N. (2020b). The efficacy of intensive short-term dynamic psychotherapy for social anxiety disorder: randomized trial and substudy of emphasizing feeling versus defense work. The Journal of Nervous and Mental Disease, 208(3), 245-251.
DOI: https://doi.org/10.1097/NMD.0000000000001097
Rocco D., De Bei, F., Negri, A., & Filipponi, L. (2021). The relation between self-observed and other-observed countertransference and session outcome. Psychotherapy. Advance online publication, doi:10.1037/pst0000356.
DOI: https://doi.org/10.1037/pst0000356
Rocco, D., Gennaro, A., De Bei, F., Zanelli, D., & Condino, V. (2013a). Development and characteristics of the therapeutic alliance in a short term dynamic psychotherapy: a descriptive case study. Research in Psychotherapy: Psychopathology, Process and Outcome, 16(1), 33-41.
DOI: https://doi.org/10.4081/ripppo.2013.152
Rocco, D., Gennaro A., Salvatore S., Stoycheva V., & Bucci, W. (2017). Clinical mutual attunement and the development of therapeutic process: a preliminary study. Journal of Constructivist Psychology, 30(4), 371-387.
DOI: https://doi.org/10.1080/10720537.2016.1227950
Rocco D., Gennaro, A., Filugelli, L., Squarcina, P., & Antonelli, E. (2019). Key factors in psychotherapy training: an analysis of trainers’, trainees’ and psychotherapists’ points of view. Research in Psychotherapy: Psychopathology, Process and Outcome, 22(3), 369-378. doi:10.4081/ripppo.2019.415.
DOI: https://doi.org/10.4081/ripppo.2019.415
Rocco, D., Mariani, R., & Zanelli, D. (2013b). The role of non-verbal interaction in a short term psychotherapy: preliminary analysis and assessment of paralinguistic aspects. Research in Psychotherapy: Psychopathology, Process and Outcome, 16(1), 54-64.
DOI: https://doi.org/10.4081/ripppo.2013.102
Rocco, D., Pastore, M., Gennaro, A., Salvatore, S., Cozzolino, M., & Scorza, M. (2018). Beyond verbal behavior: an empirical analysis of speech rates in psychotherapy sessions. Frontiers in Psychology, 9, 978.
DOI: https://doi.org/10.3389/fpsyg.2018.00978
Sarno, I., Preti, E., Prunas, A., & Madeddu, F. (2011). SCL-90-R symptom checklist-90-R Adattamento italiano. Firenze: Giunti, Organizzazioni Speciali.
Shadish, W. R., Cook, T. D., & Campbell, D. T. (2002). Experimental and quasi-experimental designs for generalized causal inference. Boston: Houghton Mifflin Company.
Shapiro, D. A., & Shapiro, D. (1982). Meta-analysis of comparative therapy outcome studies: A replication and refinement. Psychological Bulletin, 92(3), 581-604. doi:10.1037/0033-2909.92.3.581.
DOI: https://doi.org/10.1037/0033-2909.92.3.581
Shedler, J. (2009). Guide to SWAP-200 interpretation. Denver, CO: SWAP assessment LLC. Retrieved from: www.SWAPassessment.org.
Shedler, J., & Westen, D. (2004). Dimensions of personality pathology: an alternative to the five factor model. American Journal of Psychiatry, 161, 1743-1754.
DOI: https://doi.org/10.1176/ajp.161.10.1743
Shedler, J., & Westen, D. (2007). The Shedler-Westen assessment procedure (SWAP): making personality diagnosis clinically meaningful. Journal of Personality Assessment, 89(1), 41-55.
DOI: https://doi.org/10.1080/00223890701357092
Shrout, P., & Fleiss, J. (1979). Intraclass correlations: uses in assessing rater reliability. Psychological Bullettin, 86, 420-428.
DOI: https://doi.org/10.1037/0033-2909.86.2.420
Smith, M. L., Glass, G. V., & Miller, T. I. (1980). The benefits of psychotherapy. Baltimore, MD: Johns Hopkins University Press.
Somers, J. M., Goldner, E. M., Waraich, P., & Hsu, L. (2006). Prevalence and incidence studies of anxiety disorders: a systematic review of the literature. Canadian Journal of Psychiatry, 51(2), 100-13.
DOI: https://doi.org/10.1177/070674370605100206
Speer, D. (1992). Clinically significant change: Jacobson and Truax (1991) revisited. Journal of Consulting and Clinical Psychology, 67, 894-904.
DOI: https://doi.org/10.1037/0022-006X.60.3.402
Stein, D. M., & Lambert, M. J. (1995). Graduate training in psychotherapy: are therapy outcomes enhanced? Journal of Consulting and Clinical Psychology, 63(2), 182-196. doi:10.1037/0022-006X.63.2.182.
DOI: https://doi.org/10.1037/0022-006X.63.2.182
Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: the evidence for what makes psychotherapy work. Abingdon, England: Routledge.
DOI: https://doi.org/10.4324/9780203582015
Westen, D., & Shedler, J. (1999). Revising and assessing Axis II, Part 2: Toward an empirically based and clinically useful classification of personality disorders. American Journal of Psychiatry, 156, 273-285.
Westen, D., Shedler, J., Bradley, B., & DeFife, J. (2012). An empirically derived taxonomy for personality diagnosis: Bridging science and practice in conceptualizing personality. American Journal of Psychiatry, 169, 273-284.
DOI: https://doi.org/10.1176/appi.ajp.2011.11020274
Westen, D., Novotny, C. M., & Thompson-Brenner, H. (2004). The Empirical Status of Empirically Supported Psychotherapies: Assumptions, Findings, and Reporting in Controlled Clinical Trials. Psychological Bulletin, 130(4), 631-663. doi:10.1037/0033-2909.130.4.631.
DOI: https://doi.org/10.1037/0033-2909.130.4.631
How to Cite
Rocco, D., Calvo, V., Agrosì, V., Bergami, F., Busetto, L. M., Marin, S., … Abbass, A. (2021). Intensive short-term dynamic psychotherapy provided by novice psychotherapists: effects on symptomatology and psychological structure in patients with anxiety disorders. Research in Psychotherapy: Psychopathology, Process and Outcome, 24(1). https://doi.org/10.4081/ripppo.2021.503
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