Allan Abbass

Dalhousie University | Dal · Department of Psychiatry

The approach of evidence-based medicine has been extended to psychotherapy. More than 20 years ago, criteria for empirically supported psychotherapeutic treatments (ESTs) were defined. Meanwhile a new model for empirically supported psychotherapeutic treatments has been proposed. While the empirical status of psychodynamic therapy (PDT) was assesse...

A variety of contemporary cognitive behavioral therapy (CBT) frameworks have collectively converged on acceptance of emotion as a therapeutic process central to producing positive outcomes. However, evidence shows that not all patients respond to these treatments, such as those with more severe and complicated symptomatology and more entrenched emo...

The purpose of this article was to raise awareness of an under-recognized but well-supported treatment for Functional Neurological Disorders (FND) termed Intensive Short-term Dynamic Psychotherapy (ISTDP). There has been significant interest in the role of psychological mechanisms in FND onset and maintenance with specific evidence for maladaptive...

Purpose: Intensive Short Term Psychodynamic Therapy (ISTDP) has demonstrated promising evidence for the treatment of several Functional Neurological Disorders (FND) including dissociative seizures. However, its implementation in secondary mental health and specialist services within the English National Health Service (NHS) is scarce. The aim of th...

Objective: A central tenet of psychodynamic theory of depression is the role of avoided anger. However empirical research has not yet addressed the question of for which patients and via hat pathways experiencing anger in sessions can help. The therapeutic alliance and acquisition of patient insight are important change processes in dynamic therapy...

Purpose: Medication has been a central part of treatment for severe mental disorders in Western medicine since the 1950s. In 2015, Norwegian Health Authorities decided that Norwegian health regions must have treatment units devoted to medication-free mental health treatment to enhance service users' freedom of choice. The need for these units has...

In this journal, Malhi et al. (2021) present the 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders While we applaud their efforts to develop a comprehensive treatment guideline, we call attention to several factual errors leading to erroneous conclusions and recommendations with regard to...

Homeschooling due to COVID-19 school closures is likely to increase conflict between work and family demands, potentially leading to adverse substance-use effects. We conducted a survey with 758 couples focusing on homeschooling, work–family conflict, and alcohol use (April 2020). The 211 homeschooling couples reported more work–family conflict tha...

This study examines the effectiveness of psychotherapy provided by novice therapists, in an attempt to clarify the controversial relationship between treatment effectiveness and therapist experience. To achieve this, we examined the short- and long-term effec�tiveness of intensive short-term dynamic psychotherapy (ISTDP) in the treatment of patient...

Introduction Cyberchondria involves excessive and uncontrollable online searching of information about a perceived illness. This behavior can cause or maintain distress. Objectives Little is known about cyberchondria during the COVID-19 pandemic or how cyberchondria in one individual may cause distress in their significant other if they are self-i...

Objective A recent meta-analysis of 17 randomized, controlled trials (RCTs) showed that Short-term Psychodynamic Psychotherapy (STPP) for functional somatic disorders (FSD) reduced somatic symptoms compared to wait list, minimal treatment, and treatment-as-usual controls. A clinically important yet unanswered question is how much improvement patien...

Intensive short‐term dynamic psychotherapy (ISTDP) was developed to manage treatment impasses preventing the experiencing of feelings related to childhood attachment interruptions, such as parental loss. According to ISTDP theory, certain categories of patients will exhibit habitual patterns of responding within the treatment relationship (called d...

In this article, Canadian psychotherapy researchers and teachers review the state of psychodynamic therapy (PDT) in Canada. We review the ways in which PDT has been implemented, developed and researched within the public and private sector, and how psychoanalytic and psychodynamic practitioners regionally have responded to the challenges of evidenc...

The coronavirus or COVID-19 crisis has forced counsellors and therapists around the globe to use online videoconference programs to provide psychotherapy treatment, teaching, and supervision. Some varieties of psychotherapy have historically used video technology for these purposes. Intensive short-term dynamic psychotherapy (ISTDP), one such metho...

Objectives Intensive short‐term dynamic psychotherapy (ISTDP) requires the technique of challenge to defenses when treating resistant patients. As the technique of challenge is difficult for some therapists to practice, it leads us to question whether challenge can be replaced by clarification of defenses without losing treatment effectiveness. Thi...

Introduction: Functionalsomatic disorders (FSD) are common and costly, thereby driving the need for the development of effective brief treatment options. Short-term psychodynamic psychotherapy (STPP) is one candidate treatment method. Objective: To review and meta-analyze, where possible, randomized controlled trials (RCTs) of STPP for FSD. Met...

Background : Depressed patients with chronic and complex health issues commonly relapse; therefore, examining longer-term outcomes is an important consideration. For treatment resistant depression (TRD), the post-treatment efficacy of time-limited Intensive Short-Term Dynamic Psychotherapy (ISTDP) has been demonstrated but longer-term outcomes and...

Background Intensive Short-Term Dynamic Psychotherapy (ISTDP) is an intervention introduced by Davanloo in order to treat affective and somatic symptoms, and personality disorders. It is a brief intervention aimed to reach awareness of painful or forbidden emotions and consequently to override symptoms and self-destructive tendencies. In this revie...

Originally published as a special issue of Psychoanalytic Psychotherapy, this collection was timed to coincide with the publication of the new NICE guideline for the treatment of depression, which will shape the context of NHS talking therapy services for the next decade. In 2005, Professor Lord Layard demonstrated for the first time that mental h...

Objective: To assess the clinical- and cost-effectiveness of Intensive Short-Term Dynamic Psychotherapy (ISTDP) for patients with chronic pain. Method: A sample of 228 pain patients were drawn from a larger naturalistic study of ISTDP. They received an average of 6.1 sessions delivered by 31 therapists. Psychiatric symptoms and interpersonal probl...

This research examined the efficacy of intensive short-term dynamic psychotherapy (ISTDP) in the treatment of social anxiety disorder (SAD) and compared the therapeutic outcomes of ISTDP when feeling focus or defense work is emphasized. A three-group randomized design with 6-month follow-up was used. Forty-one subjects were selected among volunteer...

What to conclude from a non-randomized clinical trial comparing dialectical behavior therapy and mentalization-based treatment in patients with borderline personality disorder? - Patrick Luyten, Falk Leichsenring, Allan Abbass, Mark Hilsenroth, Sven Rabung, Christiane Steinert

In this article, we review Davanloo's metapsychology of the unconscious and how it can contribute to the current psychodynamic understanding and treatment of psychosis. In this framework, current attachment and emotions become connected with unconscious conflict-laden feelings about early attachment trauma at the core of the unconscious conflict. T...

Introduction Posttraumatic stress disorder (PTSD) is associated with significant psychiatric morbidity and high healthcare costs. Objective The aim of this pilot study was to evaluate changes in healthcare costs and general psychiatric symptom severity in patients with PTSD following intensive short-term dynamic psychotherapy (ISTDP). Method Heal...

Addiction programs are plagued with high dropout and relapse rates. A large proportion of patients suffering from addiction also suffer from personality disorders. Aim: A 30-day inpatient program based on intensive short-term dynamic psychotherapy was developed to address features of personality disorders such as anxiety regulation, emotion recogni...

Why the concept of distinct psychotherapeutic approaches is indispensable - and why the tool box concept of psychotherapy cannot workBackground: In Germany, the official psychotherapy guidelines are oriented towards the model of distinct psychotherapeutic approaches. Within the German health care system this also applies to the training in psychoth...

Objectives: Physical pain is prevalent among psychiatric outpatients, yet there has been little research regarding the types of pain reported. The purpose of this study was to survey outpatients seeking psychotherapy regarding pain locations and to examine associations between number of pain locations and psychiatric distress and alexithymia. Metho...

Objective: Background regarding a recent debate between Cuijpers et al. (2019a, b) and the authors (Munder et al. 2019) about the efficacy of psychotherapy for depression is given. Method: A main reason for the discrepancy in Cuijpers et al.'s and our conclusions is discussed. Results: In our view the discrepancy is due, among other things, to a bl...

The aim of this study was to evaluate changes in long-term health care costs and symptom severity after adjunctive intensive short-term dynamic psychotherapy (ISTDP) individually tailored and administered to patients with bipolar disorder undergoing standard psychiatric care. Eleven therapists with different levels of expertise delivered an average...

Equivalence testing: reversed hypotheses, margins, and the need for controlling researcher allegiance - Volume 49 Issue 5 - Falk Leichsenring, Allan Abbass, Mark Hilsenroth, Patrick Luyten, Sven Rabung, Christiane Steinert

Jurisdictions in Canada, notably in Ontario and Quebec, are proposing a laudable goal of increasing publicly funded access to psychotherapy. Ontario and Quebec will likely follow the lead of the Increasing Access to Psychotherapy (IAPT) program in the United Kingdom and train psychotherapists to provide cognitive–behavioural therapy. Results from I...

To the Editor We are pleased to see JAMA Internal Medicine focus on psychotherapy for chronic pain in the recent article by Niknejad and colleagues.¹ We write to further the conversation by raising 2 points.

Aims The aim of this study was to reanalyse the data from Cuijpers et al. 's (2018) meta-analysis, to examine Eysenck's claim that psychotherapy is not effective. Cuijpers et al ., after correcting for bias, concluded that the effect of psychotherapy for depression was small (standardised mean difference, SMD, between 0.20 and 0.30), providing evid...

Aim: This research examined the experiences of patients with Medically Unexplained Symptoms (MUS) treated with Intensive Short-Term Dynamic Psychotherapy (ISTDP) within a family practice setting. Methods: Patients who had attended the MUS service were sent a semi-structured qualitative questionnaire about their symp�toms, and their relationship w...

Background: Medically unexplained symptoms (MUS) are associated with frequent visits to health care providers, high costs, and frustration for patients and providers. Objective: To assess the impact of an Intensive Short-Term Dynamic Psychotherapy (ISTDP) service on physician attitudes and perspectives in two family practices. Design: Descriptiv...

Equivalence and non-inferiority testing in psychotherapy research - Falk Leichsenring, Allan Abbass, Ellen Driessen, Mark Hilsenroth, Patrick Luyten, Sven Rabung, Christiane Steinert

Received: January 23, 2018 Accepted: February 11, 2018 Published online: April 10, 2018 Issue release date: August 2018

The UK draft NICE guideline on depression in adults was sent out for stakeholder consultation between July and September 2017. The final guideline publication date currently remains ‘to be confirmed’. This paper sets out key concerns with the methodology employed in the guideline and its impact on recommendations for psychodynamic psychotherapies f...

For psychotherapy of mental disorders, presently several approaches are available, such as interpersonal, humanistic, systemic, psychodynamic or cognitive behavior therapy (CBT). Pointing to the available evidence, proponents of CBT claim that CBT is the gold standard. Some authors even argue for an integrated CBT-based form of psychotherapy as the...

The authors wish to make the following corrections to this paper [1].[...]

Introduction Short-term psychodynamic psychotherapy (STPP) is an empirically supported treatment that is often used to treat depression. However, it is largely unclear if certain subgroups of depressed patients can benefit specifically from this treatment method. We describe the protocol for a systematic review and meta-analysis of individual parti...

This study investigated the relationship between alexithymia and physical complaints among psychiatric outpatients, and whether sex moderated this relationship. Participants (N = 185) completed measures of physical complaints (bodily symptom burden, pain severity, pain interference), alexithymia, current symptom (depression, anxiety) distress, and...

The objective of this study was to evaluate the clinical- and cost-effectiveness of Intensive Short-Term Dynamic Psychotherapy (ISTDP) for generalized anxiety disorder (GAD). We further aimed to examine if a key clinical process within the ISTDP framework, termed the level of mobilization of unprocessed complex emotions (MUCE), was related to outco...

Medically unexplained symptoms (MUS) are known to be costly, complex to manage and inadequately addressed in primary care settings. In many cases, there are unresolved psychological and emotional processes underlying these symptoms, leaving traditional medical approaches insufficient. This paper details the implementation of an evidence-based, emot...

Although psychodynamic therapy (PDT) is an evidence-based intervention for a broad spectrum of psychiatric conditions, there is often notable bias in the way PDT is depicted both in the popular media and in the scientific literature. This has contributed to a negative view of PDT, which hampers both patient access to this treatment and researcher a...

This study examined the effects of trial therapy interviews using intensive short-term dynamic psychotherapy with 500 mixed sample, tertiary center patients. Furthermore, we investigated whether the effect of trial therapy was larger for patients who had a major unlocking of the unconscious during the interview compared with those who did not. Outc...

Objectives: Evidence of the contribution of emotional processes to the emergence, maintenance, and experience of medically unexplained symptoms (MUS) suggests that clinical approaches which target these processes could be beneficial. In this study, qualitative methods were used to examine patients' perspectives and subjective experiences of emotio...

Background While short-term psychodynamic psychotherapies have been shown effective for major depression, it is unclear if this could be a treatment of choice for depressed patients who have not sufficiently responded to existing treatments and commonly have chronic and complex health issues. Method This superiority trial used a single blind random...

Reviews the book, Transference Focused Psychotherapy for Borderline Personality Disorder: A Clinical Guide by Frank E. Yeomans, John F. Clarkin, and Otto F. Kernberg (see record 2015-18407-000). Borne out of over a century of combined clinical experience Yeomans, Clarkin, and Kernberg provide simply a treasure trove of theoretically informed, empir...

Replicability of findings is an essential prerequisite of research. For both basic and clinical research, however, low replicability of findings has recently been reported. Replicability may be affected by research biases not sufficiently controlled for by the existing research standards. Several biases such as researcher allegiance or selective re...

Background: Kenny has proposed that severe music performance anxiety that is unresponsive to usual treatments such as cognitive-behaviour therapy may be one manifestation of unresolved attachment ruptures in early life. Intensive Short-Term Dynamic Psychotherapy specifically targets early relationship trauma. Accordingly, a trial of Intensive Short...

Purpose: The purpose of this study was to examine preliminary evidence of intensive short-term dynamic psychotherapy (ISTDP) as a treatment option for psychogenic nonepileptic seizures (PNES) in terms of impact on healthcare costs, emotional wellbeing, and somatic symptoms. Method: Drawn from a sample of patients treated in a tertiary psychiatri...

Among other points, the study by Connolly Gibbons and colleagues raises the ongoing challenge facing all psychiatrists using pharmacotherapy and psychotherapy: how to improve rates of remission in real-world clinical samples. The study found that more than 80% of all participants did not respond to treatment (22% of patients receiving CBT and 16% o...

Background Intensive short-term dynamic psychotherapy (ISTDP), as developed by Habib Davanloo, is an intensive emotion-focused psychodynamic therapy with an explicit focus on handling resistance in treatment. A core assumption in ISTDP is that psychotherapeutic effects are dependent on in-session emotional processing in the form of an increase in c...

Intensive short-term dynamic psychotherapy (ISTDP) was developed out of the need for relatively short psychodynamic psychotherapeutic treatment approaches to complex and resistant patient populations so common in public health systems. Based on extensive study of video recordings, Habib Davanloo discovered, and other researchers have validated, som...

This study examined the efficacy of intensive short-term dynamic psychotherapy (ISTDP) on depressive symptoms and executive functioning in patients with major depression. We examined pretest, posttest, and follow-up depression scores as well as pretest-posttest executive functioning scores between 16 participants receiving ISTDP and 16 allocated to...

Ongoing advances in videoconference technology present increasingly affordable and accessible means of obtaining supervision, consultation, and advanced training in psychotherapy. This chapter provides a practical guide and description of how one can use this technology to conduct small-group training in advanced psychotherapy with group members lo...

Objective: The study investigated the effectiveness of an 8-week intensive residential treatment programme based on principles from intensive short-term dynamic psychotherapy for patients with known treatment-resistant anxiety- and/or depressive disorders (mainly with comorbid personality disorders). Methods: Patients (N=95) with prior repeated...

The authors regret that one of the institutional affiliations of the first author was omitted in the published paper.The affiliation that also should be credited is Drammen District Psychiatric Centre, Division for Mental Health and Addiction, Vestre Viken Health Trust, Norway. The authors would like to apologise for any inconvenience caused.