ISTDP Treatment

We offer help to adults and adolescents using ISTDP-based treatment

We help adults and adolescents with issues such as:

    Depression
    Anxiety
    Eating Disorders
    Relationship Issues
    Postraumatic Stress Disorders (PTSD)
    Personality Disorders
    Marital Difficulties
    Grief and Loss
    Work Stress
    Life Stresses
    Self-Esteem
    Assertiveness
    Anger Management
    Parenting Difficulties
    Bipolar Disorder
    Trauma and Impact of Abuse
    Bullying
    Sleep Problems
    Behavioural Problems
    Self-Harm Behaviour
    Medically Unexplained Symptoms
    Chronic Pain

Individual ISTDP Treatment

At the Melbourne Centre for ISTDP we conduct an initial 120 minute assessment interview ("Trial Therapy") to complete a thorough assessment of your problems and to determine together whether ISTDP could be effective in helping you resolve your problems.

ISTDP is based upon psychodynamic principles: that symptoms arise as a result of the defensive ways in which we (ego) have learnt to manage the conflicting demands of our emotions (id), our sense of ‘right and wrong’ (super-ego) and the environment in which we live (external reality). The goal of any experiential dynamic psychotherapy is for the patient to become conscious of the unconscious ways that they ward off emotional conflicts. They are then encouraged to work through those emotional conflicts experientially in the present moment, at a pace that does not evoke excessive anxiety. Thus, the patterns that were formed in childhood which are being repeated in the current are undone in the here-and-now of the therapy room, in favour of healthy emotional connection and expression.

Fundamentally, Malan (2010) observed that an ISTDP approach to this therapeutic task differs from the traditional psychoanalytic one in this crucial respect: “Instead of allowing the client’s defences to operate and then offering interpretations at a time when the client is receptive, an ISTDP practitioner seeks to help the client confront and disown their defences as they are activated, facilitating the here-and-now experiencing of the emotions which they repress.”

Dr Habib Davanloo, the founder of ISTDP, found that when the therapist takes this active and involved stance two things become apparent: defences are not as impenetrable as first thought and the therapeutic alliance between therapist and patient is more powerful than first thought. In fact, the therapist can foster an ‘internal crisis’ whereby the patients healthy longings and desire for change eventually overpowers their defences, leading not only to symptom relief but enduring, robust character change within a much shorter timeframe.

What is the empirical evidence for ISTDP?

Beyond a 2006 Cochrane Review for Short-Term Dynamic Psychotherapy in general, evidence for ISTDP’s particular effectiveness has accumulated over the last three decades, and in the following areas:

  • Personality disorders
  • Treatment resistant depression
  • Anxiety disorders
  • Eating Disorders
  • Medically unexplained symptoms (Somatic disorders)
  • Chronic pain
  • Mixed samples
  • Clinical and cost effectiveness

Abbass et al.’s (2013) meta-analysis of 13 studies found large improvements for general psychopathology, depression, anxiety and interpersonal functioning before and after therapy. These improvements were maintained at follow-up, which was between six months and ten years. In terms of cost effectiveness, eight studies found that a course of ISTDP led to significant savings through reduced use of health services and medication, less disability claims and increased return to work. The authors conclude that “ISTDP is a systematic set of approaches to treat a very broad range of complex and resistant patients” (p.13).

References

Abbass A.A., Hancock J.T., Henderson J., Kisely S.R. (2006) Short-term psychodynamic psychotherapies for common mental disorders. Cochrane Database of Systematic Reviews 2006, Issue 4.

Abbass, A.A., Town, J.T., Driessen, E. (2013). Intensive Short-Term Dynamic Psychotherapy: A Review of the Treatment Method and Empirical Basis. Research in Psychotherapy: Psychopathology, Process and Outcome, 16(1), 6 – 15

Malan, D.H. “Introduction to ISTDP.” The Third Oxford Conference on Experiential Dynamic Therapy, ISTDP-UK. St. John’s College, Oxford, UK. 20th May 2010. Keynote Address.

Formats of Treatment

Treatment is usually conducted on a weekly to fortnightly basis with sessions lasting for 55 minutes.

Block therapy is also available for people who aren’t able to attend on a weekly/fortnightly basis. In block therapy, treatment is provided in “blocks”, where a number of 120-minute sessions may occur on the same day or in the same week (usually consecutive days), followed by a length of time (e.g., a few months) where no treatment is provided. Block treatment is typically undertaken by people from interstate or overseas and needs to be booked and paid for in advance.

Appointment Costs

Fees will be provided by each practitioner prior to booking an appointment. Concession rates may be available for elgibile health care card holders.

Medicare Rebates

With a referral and Mental Health Care Plan from your GP, or a referral from a Psychiatrist, you may be eligible to claim a rebate from Medicare for up to 10 individual sessions per calendar year. The current rebate for 2017 has been set at $124.50 by Medicare.