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What is Dynamic Interpersonal Therapy?

Dynamic interpersonal therapy (DIT) is a short-term, highly structured form of psychotherapy that is used to treat depression and anxiety. A usual course of DIT consists of sixteen weekly sessions.

DIT’s focus is on relationships, and helping clients understand the link between their low moods and the ways they are interacting with others.

The idea is that if an individual can understand how the patterns of relating he or she developed while growing up are affecting the way they behave around others in the present, and then learn to deal with relationships in more positive and useful ways, stress lowers and emotional health improves.

DIT was developed from Psychodynamic therapy. It uses evidence-based (proven by studies to work) elements of the psychodynamic framework, packaged in a time-limited, more tightly structured format. To be licensed as a DIT practitioner, therapists must also have at least 150 hours of practice as a psychodynamic practitioner.

What psychological issues is Dynamic interpersonal therapy recommended for?

anxiety

depression

relationship issues

What are the goals of dynamic interpersonal therapy?

Dynamic interpersonal therapy seeks to help clients achieve the following:

more able to reflect on thoughts and feelings

clearer understanding of self and others

able to recognise and take responsibility for behaviour around others

more confident with relating to others and managing relationship difficulties

more able to sustain intimacy with others

better moods and less anxiety

ability to see options and make better choices

What other therapies is dynamic interpersonal therapy comparable to?

Psychodynamic psychotherapy – DIT is a ‘child’ of Psychodynamic therapy, created from it’s framework and in a sense a sort of shorter, more focused and structured version.

Psychoanalytical psychotherapy – Psychodynamic psychotherapy stems from Psychoanalytic psychotherapy, so DIT also shares main concepts with psychoanalytic thought.

An example of DIT

A typical IPAF could be: the patient describes a childhood with parents who were neglectful both emotionally and physically. She presents with difficulties with her husband who she says takes no interest in her wishes or needs. Her sense of others is that they are untrustworthy and self-interested and that she is powerless and insignificant. This provokes anger and frustration, but she cuts off so then perpetuates the pattern rather than voicing her needs. Her less conscious aspect of the conflict is the deep terror of losing her sense of identity.

The middle phase (sessions 5-12) works on this pattern to encourage a shift and understand resistance to change.  The end phase from sessions 13-16 involves closing the work and giving of a goodbye letter. The letter, borrowed from cognitive analytic therapy, describes the work and reflects on what was experienced in the relationship. There are obvious connotations of being a ‘transitional object’ and no doubt there is something powerful about writing in this intimate way, holding them in mind during this process and for the patient receiving a letter that reflects how much has been heard and understood.

Dynamic Interpersonal Therapy

This webpage gives you some brief background information (which helps to put the framework in context), and background documents for both clinicians and commissioners.

It is a good idea to read the background information and documentation, as this will help you to implement the framework to best effect. 

Background information

Couples counselling – Couples counselling also focuses on relationships. But it’s very different than DIT. Couples counselling has the aim of helping a relationship improve. DIT has the aim of improving all of an individual’s relationships, and their style of interacting, in order to improve their moods.

What are the theories behind Dynamic Interpersonal Theory?

Like many sorts of psychotherapy and counselling, Dynamic Interpersonal therapy is based on the idea that what happened to someone in the past can be affecting the way they think, feel, and act in the present.

DIT sees depression as resulting from confused thinking and understanding around ‘attachment’ in relationships. Attachment is the way someone allows him or herself to trust and depend on others.

If an individual has unclear or unhelpful ideas about attachment within his or her relationships, then it leads to distorted thinking – thoughts that are more based on negative beliefs then what is actually happening. And distorted thinking leads to low moods and depression.

If an individual can identify the core ‘pattern’ of relating they are using, which will be something unconscious and repetitive, he or she can then understand why their relationships are going wrong and causing them to feel unhappy.

They can then start to make choices that move them away from this pattern, and choose other behaviours that lead to better relationships.

And better functioning, healthy relationships, allow an individual to feel better about themselves and the world, thus their depression lifts.

How might sessions of DIT therapy work?

The first few sessions of Dynamic interpersonal therapy involve a therapist asking about a client’s moods and their main relationships.

Listening carefully to the client, the therapist will notice details they then reflect back to help the client understand how he or she both impacts and responds to others. This helps the client not only understand more about themselves and others, but also allows them to see links between their low moods and their relationships.

Together the therapist and client work to identify the pattern that is being repeated in the client’s relationships that is causing difficulty and stress. This pattern might, for example, be something like, ‘if someone gets to close it’s best to push them away so they can’t hurt you”. They will then look at other choices the client could make instead of their habitual pattern.

A DIT therapist will not just use what a client shares as a platform for exploration, but also the therapist and client relationship. The way an individual interacts with his or her therapist can act like a mirror for the way they also act with others. Using the example above of an individual who pushes people away, the therapist might note that as soon as the client started to trust the therapist he or she then suddenly pulled away. Together the therapist and client can explore this interaction, and look at alternative ways of thinking and behaving.

Dynamic interpersonal therapy does not involve homework, but progress is usually tracked. This allows both the client and therapist to see the improvement on a weekly basis.

References:

https://www.ucl.ac.uk/pals/research/clinical-educational-and-health-psychology/research-groups/core/competence-frameworks-3

https://welldoing.org/article/what-is-dynamic-interpersonal-therapy