Brief dynamic interpersonal therapy : a clinician's guide.

Format:

Book

Author/Creator:

Lemma, Alessandra, author.

Target, Mary, author.

Fonagy, Peter, 1952- author.

Abrahams, Deborah, author.

Luyten, Patrick, author.

Contributor:

Lemma, Alexandra.

Series:

Oxford scholarship online.

Oxford scholarship online

Language:

English

Subjects (All):

Interpersonal psychotherapy.

Psychodynamic psychotherapy.

Brief psychotherapy.

Physical Description:

1 online resource (421 pages)

Edition:

Second edition.

Place of Publication:

Oxford : Oxford University Press, [2024]

Summary:

Dynamic Interpersonal Therapy (DIT) is a brief psychodynamic psychotherapy developed for the treatment of mood disorders. It is now offered in the UK in NHS for the treatment of depression & has been applied worldwide in public health care settings as well as private settings. This book is a user-friendly, practical guide for the implementation of a brief psychodynamic intervention in routine clinical practice as well as in research protocols. It has been substantially updated since the first edition in 2011 with the addition of five new chapters to reflect new applications of the model in complex care, for patients with functional & somatic disorders & for internet delivered DIT & it outlines the changes in the training of DIT practitioners.

Contents:

Cover

Brief Dynamic Interpersonal Therapy

Copyright

Contents

List of figures

List of tables

List of boxes

List of abbreviations

1 Why Dynamic Interpersonal Therapy for Mood Disorders?

The rationale of DIT

Psychodynamic approaches and diagnostic classification

Mood disorders: depression and anxiety

Assessing suitability for DIT

The patient's response to an exploratory approach

The patient's interest in working with interpersonal and affective themes

The patient's capacity to reflect on the therapeutic relationship

The patient's curiosity about their role in their difficulties

The external resources that could support the patient during the course of DIT

The therapist's experience with the patient in the session

This second edition

2 Key Analytic Models and Psychoanalytic Concepts Informing Dynamic Interpersonal Therapy

The theoretical framework of DIT

Object-​relations theory

Ego functioning and theories of attachment

Interpersonal psychoanalysis: The contribution of Harry Stack Sullivan

Mentalizing

Key psychoanalytic technical concepts that inform DIT

Ability to establish and manage the therapeutic frame and boundaries

Ability to work with unconscious communication

Ability to recognize and work with defences

Attachment perspective on defences

Ability to work in the transference

Ability to work with countertransference

Ability to make dynamic interpretations

Conclusions

3 Core Features and Strategies

Aims

Trajectory of the therapy

The initial phase (sessions 1-​4)

The middle phase (sessions 5-​12)

The ending phase (sessions 13-​16)

The DIT foci

The interpersonal-​affective focus

Here-​and-​now focus

Focus on the patient's mind

Therapeutic stance

4 The Initial Phase

Engagement.

Listening out for 'cautionary tales'

Case examples of 'cautionary tales'

What do we need to know in order to formulate a dynamic focus for intervention?

History-​taking versus history-​making

History of the presenting problem: the symptom/​problem from the patient's point of view

Family history

Medical history and the patient's bodily self

Mapping the interpersonal landscape

How many relationships need to be explored before sharing a formulation with the patient?

Negotiating the therapeutic content and goals for therapy

How much information does the patient need about DIT in order to consent to it?

Managing risk and self-​harm

Managing the frame and the setting

The use of outcome monitoring and video/​audio recording of sessions

5 The Interpersonal-​Affective Focus

What is a psychodynamic formulation?

The interpersonal-​affective focus: an overview

The patient's experience of the IPAF

Case example

Constructing a formulation: a step-​by-​step guide

Step 1: Describe the problem

Step 2: Describe the cost of the problem

Step 3: Contextualize the problem

Step 4: Describe the recurring object relationship that is meaningfully connected to the onset and/​or maintenance of symptoms and the affect that is linked with the activation of the pattern

Step 5: Identify the defensive function of the recurring pattern

The trial interpretation: working towards sharing the IPAF

Using the patient's language and metaphors

Using the transference and countertransference to inform the formulation

How to select a focus

Sharing the IPAF with the patient

6 The Middle Phase

Sequence of movement in middle phase sessions

Tracking the IPAF: eliciting interpersonal narratives to illustrate the activation of the IPAF.

Staying focused

Working in the transference

Working with defences

Supporting attempts at new behaviour in relationships

7. Techniques

Listening with an analytic ear

Emergence versus structure in the sessions

Expressive/​exploratory techniques

Confrontation

Clarification

Interpretation

Features of helpful interpretations

Focusing on affect

Supportive techniques

Mentalizing interventions

How to identify failures of mentalizing

How to use mentalizing interventions

Communication analysis

Directive interventions

8 Working in the Transference

Using the transference to explore the IPAF

Formulating a transference interpretation

Criteria for interpreting the transference in DIT

The bridge to change

9 The Ending Phase

The patient's response to endings

Preparing for ending

Interpreting the unconscious meaning of endings

Paranoid and manic phantasies

Neurotic phantasies

Premature and prolonged endings

The therapist's perspective on ending

The goodbye letter

The goodbye letter in practice

Examples of goodbye letters

Revisiting the attachment descriptors

Working with resistances in the ending phase

Therapeutic stance in the ending phase

10 When Things Go Wrong

Managing difficulties in the therapeutic relationship

Reflective practice: monitoring the countertransference

Therapeutic stance when managing misunderstandings and misattunements in the therapist-​patient relationship

Forms of resistance

Requests for information about DIT

Personal questions about the therapist

Requests for direction or advice

Challenging the boundaries of the therapeutic relationship

The IPAF as an intellectual defence against feeling

The compliant patient.

Difficulty in being the patient

Idealizing the therapist

Sexualized behaviour

The therapist's resistance to time-​limited work

Working with resistance

When things go wrong for the DIT therapist when learning this model

Initial phase difficulties

Middle phase difficulties

Ending phase difficulties

Summary

11 Frequently Asked Questions

How does DIT differ from interpersonal psychotherapy?

How does DIT differ from other brief psychodynamic therapies?

Is DIT a supportive psychotherapy?

Is DIT an adaptation of mentalization-​based treatment for mood disorders?

How central is working in the transference in DIT?

What training do I need to practise DIT?

Does the DIT therapist work with dreams and unconscious phantasies?

Does the DIT therapist use the countertransference as the basis for intervening?

Does DIT focus on the patient's past?

What should I expect if I choose to train in DIT?

12 Research on Psychotherapy Outcomes, Fidelity and Mechanisms of Change in Dynamic Interpersonal Therapy

The meta-​analytic evidence base of psychodynamic therapy for depression

The evidence base for DIT

Research on fidelity to psychodynamic principles in DIT

Fidelity as a predictor of outcome

Developing a measure of competence

Clinical implications

Working mechanisms of DIT

13. Dynamic Interpersonal Therapy for Complex Care (DITCC)

Who is DITCC for?

The complex case: the failure of mentalizing in depression

DITCC and DIT: commonalities and differences

DITCC in practice

Structure of DITCC

The model in detail

Techniques in DITCC

14 Dynamic Interpersonal Therapy for Patients with Functional Somatic Disorders

The DIT approach to understanding patients with functional somatic disorders

Introduction.

A contemporary psychodynamic approach to FSDs

DIT-​FSD

Background and basic principles of DIT-​FSD

The initial phase (sessions 1-​4): engagement and case formulation

The middle phase (sessions 5-​12): fostering embodied mentalizing and working through

The ending phase (sessions 13-​16): empowerment and improvement

15 Internet-​Delivered Dynamic Interpersonal Therapy (i-​DIT) for Depression and Anxiety

The structure of blended i-​DIT

Specific competences needed to deliver blended i-​DIT

Assessment of suitability

Motivating patients to engage in online work

Recognizing and dealing with resistance to online work

Formulation of the IPAF

Balancing the content focus and the process focus

Managing the ending phase

16 Future Directions for Dynamic Interpersonal Therapy

The broadening scope of DIT

Training in DIT

Appendix 1 Patient Information Leaflet: Dynamic Interpersonal Therapy (DIT) for Depression and Anxiety

Appendix 2 DIT Checklist

Appendix 3 DIT Competence Rating Scale

Appendix 4 DIT Patient Complexity Subscale

Appendix 5 Training and Supervision Model for DIT

Index.

Notes:

Previous edition: published as by Alexandra Lemma, Mary Target, Peter Fonagy. 2011.

Includes index.

Description based on online resource and publisher information; title from PDF title page (viewed on September 25, 2024).

Related Work:

Lemma, Alexandra. Brief dynamic interpersonal therapy. First edition.

ISBN:

9780191904219

019190421X

9780192637444

0192637444

OCLC:

1429300920