Joel M Town

Joel M Town
Dalhousie University | Dal · Department of Psychiatry

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58
Publications
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Introduction
Skills and Expertise

Publications

Publications (58)
Preprint
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...
Article
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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...
Article
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...
Article
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...
Article
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...
Article
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...
Book
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...
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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...
Article
Objective: Although self-monitoring is an important part of eating disorder treatment, non-adherence is commonly observed among patients asked to maintain paper food records. This study aims to compare the efficacy and acceptability of electronic self-monitoring via Recovery Record to self-monitoring via traditional paper records, in an intensive...
Article
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...
Article
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...
Article
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...
Article
Received: January 23, 2018 Accepted: February 11, 2018 Published online: April 10, 2018 Issue release date: August 2018
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Full-text available
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...
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Full-text available
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...
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Full-text available
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...
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Full-text available
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...
Article
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...
Article
Affect experiencing (AE), defined as the facilitation of client in-session bodily arousal and visceral experiencing of affect, is a distinct theoretical process presumed to contribute to therapeutic improvement. This study examined the role of AE in the treatment of major depressive disorder by exploring its association to client distress and thera...
Article
This prospective pilot study examined the relationship between self-efficacy and treatment outcome in an adult outpatient eating disorder program. Data from 59 eating disorder outpatients were collected, including measures of self-efficacy, eating disorder symptom severity, negative emotions (depression, anxiety, and stress), body mass index, and d...
Article
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...
Article
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...
Article
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...
Article
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...
Article
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...
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Full-text available
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...
Article
The aim of this pilot study was to evaluate the changes in symptom severity and long-term health care cost after intensive short-term dynamic psychotherapy (ISTDP) individually tailored and administered to patients with psychotic disorders undergoing standard psychiatric care. Eleven therapists with different levels of expertise delivered an averag...
Article
To evaluate whether a mixed population of patients treated with Intensive Short-term Dynamic Psychotherapy (ISTDP) would exhibit reduced healthcare costs in long-term follow-up. A quasi-experimental design was employed in which data on pre- and post-treatment healthcare cost were compared for all ISTDP cases treated in a tertiary care service over...
Article
Full-text available
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 rise in complex...
Article
Background: Since the mid-1970s, short-term psychodynamic psychotherapies (STPP) for a broad range of psychological and somatic disorders have been developed and studied. Early published meta-analyses of STPP, using different methods and samples, have yielded conflicting results, although some meta-analyses have consistently supported an empirical...
Article
CME EducationaL Objectives 1. Review the outcome evidence of prior meta-analytic reviews of intensive short-term dynamic psychotherapy (ISTDP). 2. Provide an additional meta-analysis of ISTDP for the treatment of personality and somatic disorders. 3. Suggest areas for future study in the use of psychodynamic psychotherapy for personality and somati...
Article
Acute care psychiatric inpatient admissions are frequently precipitated by psychosocial stress including interruptions in key relationships due to a move, separation or other transition. The emotions triggered by these events often induce depression, anxiety, psychotic phenomena and acting-out behavior. Electroconvulsive therapy (ECT) may be an eff...
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Full-text available
Davanloo's Intensive Short-term Dynamic Psychotherapy (ISTDP), while derived from traditional psychoanalytic theory, is a modified brief treatment with growing empirical support for its effectiveness with clients with psychoneurotic disorders and character pathology. This model describes key empirically derived processes that can bring ready access...
Article
Based on over forty years of videotaped case-based research, Habib Davanloo of McGill University, Canada, discovered some of the core ingredients that can enable direct and rapid access to the unconscious in resistant3 patients, patients with func-tional disorders, and patients with fragile character structure. We will describe here some of the mai...
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Full-text available
More than 20 years ago Habib Davanloo coined the term unlocking of the unconscious to describe how the psychodynamic concept of the human unconscious can become accessible using the technique of Intensive Short-Term Dynamic Psychotherapy (ISTDP). According to Davanloo, the possibility that unconscious material will be revealed is greatly increased...
Article
Based on over forty years of videotaped case-based research, Habib Davanloo of McGill University, Canada, discovered some of the core ingredients that can enable direct and rapid access to the unconscious in resistant3 patients, patients with functional disorders, and patients with fragile character structure. We will describe here some of the main...
Article
The aim of this research was to examine the extent to which the use of research-specific procedures in psychodynamic psychotherapy impacts upon treatment effectiveness and which variables moderate this potential relationship. Effects of audio/video recording of sessions, use of treatment manuals, and checks of treatment fidelity were examined. A me...
Article
Habib Davanloo has spent his career developing and teaching methods to accelerate dynamic psychotherapy, including his technique of intensive short-term dynamic psychotherapy (ISTDP). Over the past 20 years, outcome studies using this treatment have been conducted and published. We performed a systematic review of the literature to obtain studies p...
Article
This paper describes the profile of verbal response modes utilised in the expert application of Short-Term Dynamic Psychotherapy (STDP). One hundred and fifteen randomly selected segments from six treatments of STDP were analysed. Trained raters used a verbal response mode coding system to examine the individual speaking turns of an expert therapis...
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Full-text available
The aim of this research was to examine the relationship between therapist interventions and patient affect responses in Short-Term Dynamic Psychotherapy (STDP). The Affect Experiencing subscale from the Achievement of Therapeutic Objectives Scale (ATOS) was adapted to measure individual immediate affect experiencing (I-AES) responses in relation t...
Article
The research evidence for Short-Term Psychodynamic Psychotherapy (STPP) in the treatment of personality disorders (PD) was examined through consideration of studies utilizing randomized controlled designs. An extensive literature search revealed eight published Randomized Controlled Trials (RCT) of moderate study quality. A critical review of this...
Article
The presence of comorbid personality disorder (PD) is one of the factors that can make the treatment of depression unsuccessful. Short-term Psychodynamic Psychotherapy (STPP) has been shown efficacious in the treatment of personality and depressive disorders (DD). However, the efficacy of STPP for comorbid DD and PD has not been systematically eval...
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Full-text available
To test whether the presence of indolyl-3-acryloylglycine (IAG) is associated with autism, we analyzed urine from population-based, blinded cohorts. All children in York, UK with autism spectrum disorders (ASDs), diagnosed using ICD-10 research diagnostic criteria, were invited to participate. Fifty-six children on the autism spectrum (mean age 9y...
Article
To test whether the presence of indolyl-3-acryloylglycine (IAG) is associated with autism, we analyzed urine from population-based, blinded cohorts. All children in York, UK with autism spectrum disorders (ASDs), diagnosed using ICD-10 research diagnostic criteria, were invited to participate. Fifty-six children on the autism spectrum (mean age 9y...

Projects

Projects (3)
Archived project
Project
The aim of this project is to examine which patients benefit specifically from short-term psychoanalytic psychotherapy (STPP) for depression when compared to other patients (prognostic factors or predictors), and which patients benefit specifically from STPP when compared to other treatments (prescriptive factors or moderators). The goal of the proposed project is to collect the primary data of 63 studies examining the efficacy of STPP for depression that were identified by a thorough literature search for a recent ‘conventional’ meta-analysis (Driessen et al., 2015), and to combine these datasets in order to conduct ‘individual patient data (IPD)’ meta-analyses.