Mechanisms of Change in Intensive Short-Term Dynamic Psychotherapy: Systematized Review

Abstract

Objective: Despite increasing evidence for the effectiveness of intensive short-term dynamic psychotherapy (ISTDP), evidence supporting the purported mechanisms of change in ISTDP is lacking. This systematized review aimed to describe the major theorized mechanisms of change in ISTDP, critically evaluate the emerging literature pertaining to its purported mechanisms, and explore directions for future research.Methods: A systematized search of the literature was conducted by using online databases (PsychInfo, PubMed, EMBASE, and CINAHL).Results: Fourteen studies met inclusion criteria. The included studies explored at least one theorized ISTDP mechanism of change and attempted to operationalize or otherwise empirically examine the mechanism in relation to the therapeutic process. Examined mechanisms included "unlocking the unconscious" and specific therapist interventions. Conclusions:The current body of literature has several limitations, most notably the lack of a consensus definition for unlocking the unconscious. This difficulty in measuring mechanisms of change is common across therapeutic modalities and limits the validity and comparability of findings. Despite these limitations, the literature suggests a possible association between theorized mechanisms of change and positive therapy outcomes. Future research directions are discussed.

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

“…Consequently, there is no difference between the effectiveness of Intensive Short-Term Dynamic Psychotherapy and Acceptance and Commitment Therapy enriched with compassion on marital burnout in women seeking divorce. The research findings are consistent with previous studies on the effectiveness of ISTDP (Ahmadi et al, 2018;Aminifar et al, 2023;Balali Dehkordi & Fatehizade, 2022;Caldiroli et al, 2020;Caselli et al, 2023;Heshmati et al, 2021;Jahangasht Aghkand et al, 2021;Kashefi et al, 2023;Mami et al, 2021;Mehboodi et al, 2022;Moazzami Goudarzi et al, 2021;Mobassem, 2022;Parisuz et al, 2019;Pasbani Ardabili et al, 2018;Pejman Hoviatdoost et al, 2020;Qaziani & Arefi, 2017;Rosso et al, 2019;Salehian & Moradi, 2022;Sarafraz & Moradi, 2022;Taghavi et al, 2019;Town et al, 2017;Ziapour et al, 2023), Acceptance and Commitment Therapy (Aghili & Kashiri, 2022;Amidisimakani et al, 2018;Amini & Karami Nejad, 2021;Asadpour & Veisi, 2019;Mardani et al, 2023;Nazri et al, 2017;Rafiei Saviri et al, 2022;Sadeghi et al, 2022;Sadeghi, Naeimeh, & Alivandvafa, 2021), and compassion-based therapy (Amini & Karami Nejad, 2021;Aminifar et al, 2023;Ramezani et al, 2023;Saadati et al, 2021;…”

“…ISTDP assumes that early attachment experiences have a profound influence on the development and stability of attachment patterns in adulthood. Therefore, emotions and impulses that may harm attachment relationships and are unacceptable to the individual are repressed from consciousness (Caldiroli et al, 2020;Moazzami Goudarzi et al, 2021;Pejman Hoviatdoost et al, 2020). ISTDP suggests that many pathological symptoms are explained by the "triangle of conflict," with emotions at its core.…”