Review
Review
ISTDP for the Treatment of Somatization Complaints
An Article Review
Abbass, A., Campbell, S., Magee, K., & Tarzwell, R. (2009). Intensive short-term dynamic psychotherapy to reduce rates of emergency department return visits for patients with medically unexplained symptoms: Preliminary evidence from a pre-post intervention study. CJEM, 11, 529-534.
Find the original article here.
Summary
Abbass et al. (2009) examined the preliminary efficacy of intensive short-term dynamic psychotherapy (ISTDP) in the treatment of patients with medically unexplained symptoms (i.e., somatization complaints) presenting to the emergency department (ED). ISTDP is a brief, although not time-restricted, approach that targets the unconscious emotional processes underlying patient’s manifest symptomatology (e.g., panic, back pain, headache). Using a pre-post intervention design, the researchers found that patients (n = 50) who received ISTDP following an ED visit evidenced a mean reduction of 3.2 (69%) ED visits in the following year compared to the year prior to the intervention. This reduction rate outperformed several benchmark comparison groups. Furthermore, patients evidenced significant favorable change in global symptom ratings following ISTDP. Although the study had limitations (e.g., lack of randomized control group), the findings provide preliminary evidence for the efficacy of a brief, dynamically oriented approach to somatization complaints.
Clinical Implications
The evidence, albeit preliminary, suggests that ED clinicians should consider helping patients to explore and to tolerate the emotional process connected to their manifest physical symptoms. Doing so might not only reduce ED subsequent visits, but also promote direct symptom reduction.
Michael J. Constantino, Ph.D.
Dr. Michael J. Constantino received his BA in Psychology from the State University of New York (SUNY) at Buffalo, and his MS and PhD from the Pennsylvania State University. He completed a predoctoral clinical internship at SUNY Upstate Medical University, and a postdoctoral fellowship at the Stanford University Medical Center. He then joined the Clinical Psychology faculty at the University of Massachusetts Amherst (UMass), where is a Professor of Psychological and Brain Sciences (PBS). At UMass, he directs the Psychotherapy Research Lab, teaches graduate and undergraduate courses on psychotherapy, supervises clinicians-in-training, and is the PBS Graduate Program Director. Among other professional positions, Dr. Constantino is Past- President of the North American Society for Psychotherapy Research and APA Division 29 (Society for the Advancement of Psychotherapy). Dr. Constantino’s professional and research interests center on patient, therapist, and dyadic characteristics/processes influencing psychosocial treatments; pantheoretical principles of clinical change (i.e., common factors); and measurement-based care.President of the North American Society for Psychotherapy Research, and current President of APA Division 29 (Society for the Advancement of Psychotherapy). Dr. Constantino’s professional and research interests center on patient, therapist, and dyadic characteristics/processes influencing psychosocial treatments; pantheoretical principles of clinical change (i.e., common factors); and measurement-based care.http://www.umass.edu/pbs/people/michael-constantino https://sites.google.com/site/constantinotherapyresearchlab/home
Cite This Article
Constantino, M. J., & Magnavita, J. J. (2010, March). ISTDP for the treatment of somatization complaints: An article review [Web article] [Review of the article Intensive short-term dynamic psychotherapy to reduce rates of emergency department return visits for patients with medically unexplained symptoms: preliminary evidence from a pre-post intervention study, by A. Abbass, S. Campbell, K. Magee, & R. Tarzwell]. Retreived from https://societyforpsychotherapy.org/ebpp-treatment-review-2/
References
Abbass, A., Campbell, S., Magee, K., & Tarzwell, R. (2009). Intensive short-term dynamic psychotherapy to reduce rates of emergency department return visits for patients with medically unexplained symptoms: Preliminary evidence from a pre-post intervention study. CJEM, 11, 529-534.
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