Understanding the similarities and differences between psychotherapy approaches can be challenging.

Broadly speaking, there are two main approaches to therapy:
The first is a Psychodynamic approach, which, in contemporary treatment, involves an active and engaged therapist working with clients on overcoming the negative effects of anxiety provoking emotions about life events to allow healthy emotional connections. The second is Cognitive-Behavioral, which involves a more structured and directive approach, using worksheets and homework, to identify and change thought patterns and problematic behaviors. Individuals can benefit from both approaches and sometimes a combination of both can be helpful.

At Dynamic Health we offer specialist psychotherapy, in that the treatment process is tailored to each individual’s specific needs. We utilise a specific psychodynamic approach known as Intensive Short-Term Dynamic Psychotherapy (ISTDP). Find out more about ISTDP and how it could help you.

What is ISTDP?

ISTDP is designed to help achieve meaningful and long-lasting changes in as short of a time period as is possible. It is an active but non-directive talk therapy. This means that the therapist carefully listens to the client and provides immediate feedback. In this way, therapy is a collaboration from the onset to establish a clear direction for change, much like an active two-way conversation.

In a longer first meeting (typically 2 hours), ISTDP therapists work together with clients to assess thoughts, feelings, behaviours and relationships, including: Focus on examining a client’s feelings triggered in their key relationships; examining anxiety tolerance for the triggered feelings; and identifying helpful and unhelpful patterns used for coping with anxiety provoking feelings. Where possible, clients are encouraged to experience feelings and where necessary they are helped to regulate anxiety related to these feelings. This is reviewed and a plan for tailoring treatment to their needs can be agreed-upon. Subsequent treatment sessions follow the same model of ongoing assessment and response to emotional processes.

HOw does it work?

ISTDP emphasizes the importance of early human attachment experiences and the impact these can have on shaping the way people subsequently think and act. Adversity through life events affects attachment experiences and elicits complex emotions. When these emotions create anxiety, they can become blocked and avoided. When later life events trigger these emotions, normally without our awareness, the result can be unpleasant symptoms, relationship difficulties and problems in day-to-day coping.

Science tells us that a large part of our minds and decision making occurs without our awareness. ISTDP relies not only on what an individual tells us is important but also what their behaviour shows about non-conscious decision making. For this reason, when our thoughts or behaviours repeatedly interfere with more helpful ways of responding, it is important to pay attention to our non-conscious decision-making as well as the more deliberate choices we make.

ISTDP helps people to become much better at recognizing the situations and relationships that can stir up (often non-consciously) anxiety-provoking feelings, which intensify their difficulties. Treatment involves helping the individual overcome the blockage of emotions to enable experiencing of their feelings. With practice, paying attention to feelings allows individuals to start to regulate the anxiety this creates. Instead of non-consciously avoiding feelings and behaving in ways that move them further away from their goals, individuals develop more healthy coping.

While the immediate goal is to reduce distress and start to feel better, ISTDP offers the option for resolving non-conscious patterns to allow for rapid, meaningful and long-term changes. If anxiety tolerance of emotions is very low, an individual may first require therapy to first help them regulate anxiety before the emotions can be experienced.

Is it evidence-based?

The application and effectiveness of ISTDP is actively researched at the Centre for Emotions & Health at Dalhousie University and Nova Scotia Health Authority. ISTDP and variants of it have been studied in controlled trials and routine clinical practice in other centres in Canada and around the world. Results show it can be effective for a range of presentations including depression, somatic symptoms, anxiety, substance use, personality problems, and trauma related symptoms. These studies suggest that ISTDP can be helpful for clients who have previously tried other therapies but continue to experience difficulties.

In addition to showing that clients who receive ISTDP on average show large and clinically significant changes, research into ‘how therapy works’, indicates that the focus on experiencing emotion in ISTDP is central to good outcomes.

6080 Young Street, Suite 301, Halifax, Nova Scotia  B3K 5L2

Phone: (902) 444-3443
Fax: (902) 444-3104