Dynamic Interpersonal Therapy (DIT): Providing a focus for time-limited psychodynamic work in the National Health Service

Abstract

In this paper we outline the experience of our involvement as clinicians in a pilot feasibility study of a new brief psychoanalytically-based protocol – Dynamic Interpersonal Therapy [DIT] (see also Lemma, Target, & Fonagy, this issue). We discuss how the DIT model has helped us to integrate more coherently the brief psychoanalytically-based work we have been doing in the London Borough of Tower Hamlets, an area of ethnic diversity and high levels of deprivation. We describe the experience of using standardized outcome measures in a brief psychoanalytic therapy. We also include some case studies of clinical work undertaken using the DIT model.

Keywords:

• brief therapy
• psychodynamic
• DIT
• IAPT
• research in clinical practice

Acknowledgements

We would like to acknowledge our colleagues, Jane Gibbons and Pauline O'Halloran, who were part of the team undertaking the DIT pilot study. We would also like to thank Alessandra Lemma for her inspirational supervision and for sharing with us the exciting project of putting DIT on the map of psychological therapies in the NHS.

Notes

1. The cognitive behavioural evidence base underlying IAPT is based upon randomized controlled trials (RCT) in which the patient sample to be studied is carefully chosen to exclude the complicating variables which are so familiar to clinicians in a public health care setting. This introduces the debate of whether the result a therapy achieves in a clinical trial can adequately predict the result a therapy achieves in routine clinical practice (the effectiveness/efficacy debate) (Roth & Fonagy, 2005). This debate and its implications are beyond the scope of this paper. It is included here to introduce recognition of critiques of RCTs as the only way to indicate that a particular therapy approach is clinically useful and effective.

2. This paper provides a deliberately brief description of DIT, as the model is fully described in the paper by Lemma, Target, and Fonagy (in this issue).

3. All clinical case material has been anonymized and identifying information disguised and/or consent has been granted to use anonymized case material.