Development of dynamic interpersonal therapy in complex care (DITCC): a pilot study

Abstract

The paper describes the development of Dynamic Interpersonal Therapy for use with complex depression (DITCC), and a pilot study testing DITCC’s effectiveness. The pilot found large pre-post improvements in well-being and distress; moderate rates of reliable improvement and clinically significant change; and curvilinear declines in depression and anxiety. Treatment completers and near-completers (N= 19) showed a significant curvilinear decline in symptoms of depression (PHQ-9) and anxiety (GAD-7). The results provide preliminary evidence that DITCC can be used as an effective treatment approach for complex depression. However, further research is needed to test its effectiveness in different settings with a larger sample size, using appropriate comparison groups under controlled conditions to further elaborate the short-term and long-term effects.

Keywords:

• dynamic interpersonal therapy
• effectiveness of therapy
• mentalization
• epistemic trust
• evaluation
• complex severe depression
• dynamic interpersonal therapy with complex depression
• psychodynamic therapy
• development of therapies
• routine outcome evaluation

Acknowledgements

We would like to acknowledge Jeremy Clarke, clinician in the pilot study and Dr Dudley Manns, East London Foundation Trust for supporting the setting out of the pilot.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. All clinicians taking part in the pilot were experienced therapists with a number of years of post qualification experience except one of the clinical psychologists who joined the team soon after qualifying.

2. The pilot study had ended, since the submission of the paper.

3. Complex depression defined as chronic, severe, co-morbid and disabling.

4. One patient did not have CORE-34 post-treatment data.

5. Number offered DITCC.