Short-Term Psychodynamic Psychotherapy and Cognitive Behaviour Therapy: Common and Specific Elements.

Journal of Psychiatry Reform vol. 11 #6, June 7, 2024


Author

Alan Eppel MB, MRCPsych, FRCPC

Author disclosures: Dr. Eppel receives royalties from sales of Short-Term Psychodynamic Psychotherapy.


Two of the most well-established psychotherapies are short-term psychodynamic psychotherapy and cognitive behavioural therapy. The purpose of this article is to describe the therapeutic interventions that are used in these therapies. The article identifies those interventions which are common to both of these therapies and those that are specific. This should assist in orientating students who are training in both of these modalities.

There is a long-standing debate in the psychotherapy literature as to whether the therapeutic benefits derive from the common elements or the specific elements. Each of these two therapies have a somewhat different focus on psychological processes and are are based on different theoretical conceptualizations. Both of these practices have evolved over decades and there has been some convergence in some specific areas of therapy practice.

Key Processes

The focus in STPP is on emotional processing and interpersonal relations. STPP is synonymous with  EDT, Experiential Dynamic Psychotherapy and Supportive Expressive Psychodynamic Psychotherapy.  It includes Intensive Short-Term Dynamic Psychotherapy and Accelerated Experiential Dynamic Psychotherapy.

The principle strategy in STPP is to facilitate the experiencing and processing of core affects by the patient within the context of a secure therapeutic relationship.

CBT  is skill-based with the goal of teaching the patient the skills needed to become their own therapist. Guided discovery using Socratic dialogue is one of the hallmarks in terms of therapist style and process of delivering the treatment

 

Interventions

# Therapy Process STPP CBT
1 therapeutic alliance. yes yes
2 explains rationale for process and method of therapy yes yes
3 agreement on goals and process of therapy yes yes
4 verbal or written treatment contract yes yes
5 fixed number of sessions yes yes
6 non-judgemental, respectful empathic stance. yes yes
7 comprehensive assessment & diagnosis yes yes
8 focus on developmental origins and relationships throughout life. yes no
9  Identifies attachment style. yes no
10 utilizes moment to moment tracking. yes no
11 deepens emotions and helps the patient to access associated memories. yes no
12 explores nonverbal communication yes no
13 works on defense mechanisms yes no
14  works with unconscious feelings and memories; works with transference & countertransference yes no
15  interpretation yes no
16 identifies recurrent interpersonal themes  related to past and present relationships yes no
17 encourages patient to try new ways of relating yes yes
18 processes meaning and emotions related to termination yes no
19 focuses on automatic thoughts &maladaptive behaviours no yes
20 sessions are structured and guided by an agenda no yes
21 uses thought records no yes
22 uses exposures to feared situations & response prevention no yes
23 between-session practice and behavioural experiments no yes
24 works on core beliefs no yes
25 use of rating scales & outcome measures yes yes
26 discusses discharge summary with patient yes yes
27 gives written discharge summary to patient yes no
28 relapse prevention & maintenance of gains at  end of treatment no yes

 

 

 

                                                      fig 1. Venn Diagram STPP and CBT

 

 

 

Conclusion

Identification of common and divergent therapeutic processes in STPP and CBT should be of assistance to trainees who are learning both methods of psychotherapy. This may also be of assistance to researchers identifying which interventions and processes result in the best therapeutic impacts.

Bibliography

Ablon JS, A. Levy RA, Katzenstein T. Beyond brand names of psychotherapy: identifying empirically supported change processes. Psychotherapy: Theory, Research, Practice, Training; 2006, V 43,  216 –231

Eppel A. Short-Term Psychodynamic Psychotherapy. Springer International 2018.

Leichsenring F, Ablon S ,  Barber JP. Developing a prototype for short-term psychodynamic (supportive expressive) therapy: An empirical study with the psychotherapy process Q-set. Psychotherapy Research, 2016 Vol. 26, No. 4, 500–510, http://dx.doi.org/10.1080/10503307.2015.1051160

McCarthy KS, Barber JP. The Multitheoretical list of therapeutic interventions (MULTI): initial report. Psychotherapy Research, January 2009; 19(1): 96113. DOI: 10.1080/10503300802524343.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Venn Diagram

Print Friendly, PDF & Email
Blog Attachment