ISTDP Therapy

ISTDP has demonstrated efficacy in alleviating symptoms, as well as interpersonal and characterological problems in many studies, including case studies and randomized controlled trials.

It is found to be effective in many different psychiatric conditions including chronic pain (Lilliengren et al, 2020), anxiety disorders (Rocco et al., 2014), generalized anxiety disorder (Lilliengren et al, 2017), depressive disorder, panic disorder (including obsessive compulsive disorder and phobia),  somatic symptom disorders (Abbass et al, 2008, 2009).

It also has showed effectiveness in  treatment-resistant depression (Abbass, 2006; Cornelissen & Verhuel, 2002), eating disorders (Nowoweiski et al, 2011), as well as personality disorders (Abbass et al., 2008, 2012, 2013; Town & Driessen, 2013).

In a metanalysis of all ISTDP studies (Abbass et al, 2012) ISTDP was found to have large effects in long-term follow-up and to be cost-effective.

It can be effective for a broad range of symptoms and problems, including:

• Anxiety/panic
• Depression
• Low self-esteem/assertiveness
• Self-defeating patterns
• Intimacy/relationship difficulties
• Stress-induced physical symptoms/psychosomatic illnesses, e.g. IBS, chronic fatigue, fibromyalgia etc.
• Anger/impulse control problems
• Addictive and compulsive behaviors, etc.

Other treatment options should be considered for patients suffering from organic syndromes, brain injury, active psychosis, active alcohol and/or drug addiction, severe acting out, antisocial personality disorder, life-threatening active health conditions (i.e. active inflammatory bowel disease) and conditions involving neurological deficits such as Asperger’s syndrome and autism.

Things you’ll notice right away: ISTDP is not your typical “talk therapy.” In this unique model, therapist and client establish a specific set of therapeutic goals at the onset of treatment and work together in a structured, purposeful way.

Initially, this may seem strange or even challenging for people accustomed to using their therapy hour to discuss whatever they wish in an open-ended or free-flowing manner.

One other thing that sets ISTDP apart from other therapies is the use of videotape. The highly complex nature of the work means that a great deal of verbal and non-verbal material surfaces during treatment.

It is often difficult for an ISTDP clinician to see it all at once. With their client’s permission, most ISTDP clinicians use videotape to later review what has occurred. It is of course always left up to the client to decide whether or not to allow videotaping of their sessions.

ISTDP is designed to produce as rapid change as possible with respect to the patient’s specific capacities. Research suggests that the initial 1-3-hour trial therapy can lead to significant symptom reduction for many patients (Abbass, Joffres & Ogrodniczuk, 2009).

In practice, each treatment course is tailored to the patient and a course of therapy ranges depending on patient capacity, goals of therapy and the level of therapist skill. Meta-analytic findings suggests that ISTDP takes about 20 sessions across disorders on average (Abbass, Town & Driessen, 2012).

The treatment is not a “one size fits all” model: it is tailored to the individual and his anxiety tolerance.

Of course, no treatment is the treatment of choice for all conditions. At this point there is no research to support any claim that any kind of therapy is uniquely more effective than all other kinds of therapy for all conditions. That is why we always start with an initial consultation to determine what the patient needs and whether ISTDP is the treatment of choice for that person. We can’t make that assessment in advance based on our assumptions, but only as a result of how that person responds to treatment in the initial session.