A typology for the interpersonal affective focus in dynamic interpersonal therapy based on a contemporary interpersonal approach.

Abstract

Dynamic Interpersonal Therapy (DIT) is a brief, time-limited psychodynamic individual therapy in which depressive and anxious symptoms are understood as responses to interpersonal difficulties. Problematic interpersonal representations of the self and others are conceptualized in DIT as the interpersonal affective focus (IPAF), a predominant and recurring interpersonal pattern that is connected to the symptoms and becomes the foundation of treatment. This article reports the development of a typology for classifying IPAFs, which characterizes the predominant style based on contemporary interpersonal approaches. If such a typology can be shown to have validity in a clinical setting, it could have multiple uses that would improve understanding of how DIT works and for whom it might be effective, for example, assisting the therapist in formulating the IPAF, allowing investigations of treatment outcome and process research, and informing training. An IPAF typology was developed by means of a hybrid method of qualitative analysis of transcriptions of audio recordings of DIT sessions using data from a randomized control and feasibility trial. Results revealed four themes, that is, patterns of relating, which could be described as hostile-dominant, hostile-submissive, friendly-dominant, or friendly-submissive. Limitations include the sample size and diversity, the impact of the inclusion and exclusion criteria of the pilot feasibility trial, and the clinical need to titrate the IPAF. Future research should focus on the reliability and validity of the typology and whether it can be employed in outcome and process research. Clinical Impact StatementQuestion: Can contemporary interpersonal approaches to depression provide a framework for classifying the interpersonal affective focus in Dynamic Interpersonal Therapy (DIT) to produce a tool for clinicians that might further outcome and process research? Findings: A qualitative analysis of DIT session transcripts revealed that the Inventory of Interpersonal Problems (IIP) provides a good basis for distinguishing four types of IPAFs: hostile-dominant, hostile-submissive, friendly-dominant, and friendly-submissive. Meaning: The focus of DIT can be categorized into four broad types, which may support clinicians in formulation and inform future research. Next Steps: Future research should examine the reliability and validity of the typology and its relationship with outcomes and processes in DIT.

Validation of the German version of the Comparative Psychotherapy Process Scale.

“…Future research could investigate which common or specific interventions are predictive of psychotherapy success and could provide differentiation and clarity to evidence-based integration efforts (e.g., Gaskell et al, 2023; McFarquhar et al, 2023; K. Owen et al, 2023).…”

Beliefs about emotions predict psychological stress related to somatic symptoms

“…In the psychotherapeutic process, three phases can be described to promote affective mentalization (Brockmann et al, 2022, pp. 105–114; Jurist, 2005; McFarquhar et al, 2023): (1) Identifying emotions, (2) Processing emotions and (3) Expressing emotions towards oneself and others. Especially in the identification of emotions, it seems to be important that the therapist adopts a “not‐knowing stance” so that the patient can develop their own language for their emotions.…”