[Table], Figure 7-2: Brief Psychodynamic Therapy - Brief Interventions and Brief Therapies for Substance Abuse

Figure 7-2 Brief Psychodynamic Therapy
Therapy (Theorist)	Length of Treatment	Focus	Major Techniques
Time-Limited Psychotherapy (Mann)	12 sessions	Central issue related to conflict about loss (lifelong source of pain, attempts to master it, and conclusions drawn from it regarding the client's self-image)	Formulation, presentation, and interpretations of the central issue Interpretation around earlier losses Termination
Short-Term Anxiety-Provoking Psychotherapy (Nielsen and Barth)	Usually 12 to 15 sessions	Unresolved conflict defined during the evaluation	Early transference interpretation Confrontation/clarification/interpretations
Intensive Short-Term Dynamic Psychotherapy (Laikin, Winston, and McCullough)	5 to 30 sessions; up to 40 sessions for severe personality disorders	Experiencing and linking interpersonal conflicts with impulses, feelings, defenses, and anxiety	Relentless confrontation of defenses Early transference interpretation Analysis of character defenses
SE Therapy (Luborsky and Mark)	16 for major depression, 36 for cocaine dependence	Focus on the core conflictual relationship theme	Supportive: creating therapeutic alliance through sympathetic listening Expressive: formulating and interpreting the CCRT; relating symptoms to the CCRT and explaining them as coping attempts
Vanderbilt Time-Limited Dynamic Psychotherapy (Binder and Strupp)	25 to 30 sessions	Change in interpersonal functioning, especially change in cyclical maladaptive patterns	Transference analysis within an interpersonal framework Recognition, interpretation of the cyclical maladaptive pattern and fantasies associated with it
Brief Adaptive Psychotherapy (Pollack, Flegenheimer, and Winston)	Up to 40 sessions	Maladaptive and inflexible personality traits and emotions and cognitive functioning, especially in the interpersonal domain	Maintenance of focus Interpretation of the transference Recognition, challenge, interpretations, and resolution of early resistance High level of therapist activity
Dynamic Supportive Psychotherapy (Pinsker, Rosenthal, and McCullough)	Up to 40 sessions	Increase self-esteem, adaptive skills, and ego functions	Self-esteem boosters: reassurance, praise, encouragement Reduction of anxiety Respect adaptive defenses, challenge maladaptive ones Clarifications, reflections, interpretations Rationalizations, reframing, advice Modeling, anticipation, and rehearsal
Self Psychology (Baker)	12 to 30 sessions, not rigidly adhered to	Change intrapsychic patterns. Incorporate more diverse representations of others and changes in information processing	Analysis of the mirroring, idealizing, and merger transferences Supportive, empathic
Interpersonal Psychotherapy (Klerman)	Time limited; for substance abuse, the trials have been 3 and 6 months	Eliminating or reducing the primary symptom; improvement in handling current interpersonal problem areas, particularly those associated with substance abuse	Exploration, clarification, encouragement of affect, analysis of communication, use of the therapeutic relationship and behavior-change techniques
Sources: Crits-Christoph and Barber, 1991; Klerman and Weissman, 1993; Rounsaville and Carroll, 1993.

Figure 7-2
Brief Psychodynamic Therapy

Therapy (Theorist)

Length of Treatment

Focus

Major Techniques

Time-Limited Psychotherapy (Mann)

12 sessions

Central issue related to conflict about loss (lifelong source of pain, attempts to master it, and conclusions drawn from it regarding the client's self-image)

Formulation, presentation, and interpretations of the central issue
Interpretation around earlier losses
Termination

Short-Term Anxiety-Provoking Psychotherapy (Nielsen and Barth)

Usually 12 to 15 sessions

Unresolved conflict defined during the evaluation

Early transference interpretation
Confrontation/clarification/interpretations

Intensive Short-Term Dynamic Psychotherapy (Laikin, Winston, and McCullough)

5 to 30 sessions; up to 40 sessions for severe personality disorders

Experiencing and linking interpersonal conflicts with impulses, feelings, defenses, and anxiety

Relentless confrontation of defenses
Early transference interpretation
Analysis of character defenses

SE Therapy (Luborsky and Mark)

16 for major depression, 36 for cocaine dependence

Focus on the core conflictual relationship theme

Supportive: creating therapeutic alliance through sympathetic listening
Expressive: formulating and interpreting the CCRT; relating symptoms to the CCRT and explaining them as coping attempts

Vanderbilt Time-Limited Dynamic Psychotherapy (Binder and Strupp)

25 to 30 sessions

Change in interpersonal functioning, especially change in cyclical maladaptive patterns

Transference analysis within an interpersonal framework
Recognition, interpretation of the cyclical maladaptive pattern and fantasies associated with it

Brief Adaptive Psychotherapy (Pollack, Flegenheimer, and Winston)

Up to 40 sessions

Maladaptive and inflexible personality traits and emotions and cognitive functioning, especially in the interpersonal domain

Maintenance of focus
Interpretation of the transference
Recognition, challenge, interpretations, and resolution of early resistance
High level of therapist activity

Dynamic Supportive Psychotherapy (Pinsker, Rosenthal, and McCullough)

Up to 40 sessions

Increase self-esteem, adaptive skills, and ego functions

Self-esteem boosters: reassurance, praise, encouragement
Reduction of anxiety
Respect adaptive defenses, challenge maladaptive ones
Clarifications, reflections, interpretations
Rationalizations, reframing, advice
Modeling, anticipation, and rehearsal

Self Psychology (Baker)

12 to 30 sessions, not rigidly adhered to

Change intrapsychic patterns. Incorporate more diverse representations of others and changes in information processing

Analysis of the mirroring, idealizing, and merger transferences
Supportive, empathic

Interpersonal Psychotherapy (Klerman)

Time limited; for substance abuse, the trials have been 3 and 6 months

Eliminating or reducing the primary symptom; improvement in handling current interpersonal problem areas, particularly those associated with substance abuse

Exploration, clarification, encouragement of affect, analysis of communication, use of the therapeutic relationship and behavior-change techniques

Sources: Crits-Christoph and Barber, 1991; Klerman and Weissman, 1993; Rounsaville and Carroll, 1993.

From: Chapter 7—Brief Psychodynamic Therapy

Brief Interventions and Brief Therapies for Substance Abuse.

Treatment Improvement Protocol (TIP) Series, No. 34.

Center for Substance Abuse Treatment.

Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1999.

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