Workshop: An Overview of Psychodynamic-Interpersonal Therapy

Prof Else Guthrie

This one day workshop provides an overview of psychodynamic interpersonal therapy. This model of therapy, also referred to as Conversational Model Therapy, was developed by Dr Robert Hobson during the 1970s and gradually refined and developed over the last 40 years. It is one of the view non-CBT therapies to have a strong evidence base and can be easily learnt and practised by individuals with relatively little psychotherapy experience. It is jargon free, accessible, simple but profound!

The workshop will be as follows:

The Basic Model: Components and Practice

The basic components of the model will be described using videotapes and the PIT manual. Participants will have the chance to practice the different aspects of the model in pairs.

Research Base The main research evidence regarding the model will be presented including evidence for its efficacy in depression, self harm, medically unexplained symptoms (MUS) and borderline personality disorder.

Adaptation of the model for working with people with medically unexplained symptoms.

This part of the workshop will focus on using the model with people who present with conditions such as irritable bowel syndrome and functional dyspepsia: so-called functional somatic syndromes. This session will be interactive with many opportunities for participant involvement. We cover engagement, working with symptoms, listening and goodbye letters.

Evidence of Efficacy for Depression

  1. Prescriptive v. Exploratory Psychotherapy – Outcome of the Sheffield Psychotherapy Project. Shapiro D, Firth J. British Journal of Psychiatry, 1987; 151: 790-799.
  2. Effects of Treatment Duration and Severity of Depression on the Maintenance of Gains after Cognitive-Behavioural and Psychodynamic-Interpersonal Psychotherapy. Shapiro D, Rees A, Barkham M, Hardy G. Journal of Consulting and Clinical Psychology, 1995; 63 (3): 378-387.
  3. Barkham M, Rees A, Shapiro DA, Stiles WB et al Outcome of time-limited psychotherapy in applied settings: replicating the Second Sheffield Psychotherapy Project. Journal of Consult and Clin Psychol 1996:64: 1079-1085.
  4. Shapiro DA, Rees A, Barkham M Hardy G et al Effects of treatment duration and severity of depression on the maintenance of gains following cognitive-behavioural therapy and psychodynamic-interpersonal therapy. J Con Clin Psychol 1994, 63, 378-387.
  5. *Cost-effectiveness of Brief Psychodynamic-Interpersonal Therapy in High Utilizers of Psychiatric Services. Guthrie E, Moorey J, Margison F, Barker H, Palmer S, McGrath G, Tomenson B, Creed F. Archives of General Psychiatry June 1999: 56; 519-526.
Evidence of Efficacy for MUS/Somatisation
  1. A controlled Trial of Psychological Treatment for the Irritable Bowel Syndrome. Guthrie E, Creed F, Dawson D, Tomenson B. Gastroenterology 1991: 100: 450-457.
  2. *A Randomised Controlled Trial of Psychotherapy in Patients with Chronic Functional Dyspepsia. Hamilton J, Guthrie E, Creed F, Thompson D, Tomenson B, Bennett R, Moriarty K, Stephens W, Liston R. Gastroenterology 2000; 119: 661-669
  3. *The cost-effectiveness of psychotherapy and paroxetine for severe irritable bowel syndrome. Creed F. Fernandes L. Guthrie E. Palmer S. Ratcliffe J. Read N. Rigby C. Thompson D. Tomenson B. North of England IBS Research Group. Gastroenterology. 2003; 124(2):303-17
  4. *Reported sexual abuse predicts impaired functioning but a good response to psychological treatments in patients with severe irritable bowel syndrome. Psychosomatic Medicine 2005; 67:490-499
  5. Outcome in severe irritable bowel syndrome with and without accompanying depressive, panic and neurasthenic disorders. Creed F, Ratcliffe J, Fernandes L, Palmer S, Rigby C, Tomenson B, Guthrie E, Read N, Thompson D. British Journal of Psychiatry 2005; 186: 507-15
  6. *Does psychological treatment help only those patients with severe irritable bowel syndrome who also have concurrent psychiatric disorder? Creed F, Guthrie E, Ratcliffe J, Fernandes L, Rigby C, Tomenson B, Read N, Thompson DG. Australian and New Zealand Journal of Psychiatry 2005; 39:807-815
  7. The relationship between somatisation and outcome in patients with severe irritable bowel syndrome. Creed F, Tomenson B, Guthrie E, Ratcliffe J, Fernandes L, Read N, Palmer S, Thompson DG. J Psychosom Res. 2008; 64 (6): 613-20
  8. *Psychodynamic interpersonal therapy and improvement in interpersonal difficulties in people with severe irritable bowel syndrome. Hyphantis T, Guthrie E, Tomenson B, Creed F. Pain. 145; 196-203, 2009
Evidence of Efficacy for Self Harm
  1. *Randomised Controlled Trial of Brief Psychological Intervention After Deliberate Self-Poisoning. Guthrie E, Kapur N, Mackway-Jones K, Chew-Graham C, Moorey J, Mendel E, Marino-Francis F, Sanderson S, Turpin C, Boddy G, Tomenson B. British Medical Journal 2001; 323: 135-138
  2. *Predictors of outcome following brief psychodynamic-interpersonal therapy for deliberate self-poisoning. Guthrie E, Kapur N, Mackway-Jones K, Chew-Graham C, Moorey J, Mendel E, Marino-Francis F, Sanderson S, Turpin C, Boddy G. Australian and New Zealand Journal of Psychiatry. 2003; 37:532-536
Evidence that PIT can be used by relatively inexperienced therapists, and that it can be taught easily and quickly to practitioners with some previous experience of counseling/psychotherapy techniques.
  1. Psychodynamic interpersonal therapy by inexperienced therapists in a naturalistic setting: A pilot study. Shaw, C. M; Margison, F. R; Guthrie, E. A; Tomenson, B. European Journal of Psychotherapy, Counselling & Health. Vol 4(1) Apr 2001, 87-101
  2. Counsellors’ experiences of changing their practice. Mackay HC, West W, Moorey CJ, Guthrie E, Margison. F. Journal of Counselling and Psychotherapy Research 2001:1:33-37
  3. Effectiveness of psychodynamic interpersonal therapy training for primary care counsellors. Guthrie E, Margison F, Mackay H, Chew-Graham C, Moorey J and Sibbald B. Psychotherapy Research 14(2) 161–175, 2004
Descriptive Papers which discuss the model
  1. *Psychodynamic Interpersonal Therapy. Elspeth Guthrie. Advances in Psychiatric Treatment, 1999; 5: 135-145.
  2. Persons and experience: essential aspects of psychodynamic interpersonal therapy . Moorey J, Guthrie E. Psychodynamic Practice 2003:9:547-564
Russell Meares’ Work
  1. Stevenson J, Meares R. An outcome study of psychotherapy for patients with borderline personality disorder. Am J Psych 1992: 149:358-62.
  2. Meares R, Stevenson J, Comerford A. Psychotherapy with borderline patients: I. A comparison between treated and untreated cohorts. Australian and New Zealand Journal of Psychiatry 1999: 33: 467-472.
  3. Korner A, Gerull F, Meares R et al Borderline personality disorder treated with the conversational model: a replication study Comprehensive Psychiatry, 2006: 47: 406-411
Books
  1. Hobson, Robert. Forms of Feeling: The Heart of Psychotherapy.
  2. Meares, Russell (2005). The Metaphor of Play: Origin and Breakdown of Personal Being. Brunner-Routledge.
  3. Meares, Russell (2001). Intimacy and Alienation: Memory, Trauma, and Personal Being. Brunner-Routledge.