Dynamic interpersonal therapy

Domain I · Psychodynamic & depth psychology · Alessandra Lemma, Mary Target, Peter Fonagy · 2009 · UK

What it is

Dynamic Interpersonal Therapy (DIT) is a brief, manualised psychodynamic therapy for depression, and secondarily for anxiety. Developed by Alessandra Lemma, Mary Target and Peter Fonagy, it was built from the competences shared by evidence-based brief psychoanalytic and psychodynamic treatments,…

Format

• Format. 16 individual sessions, held weekly (the curriculum refers to weekly measure data). One trial delivered them over about 5 months. Session length is not stated in the sources; 50 minutes is the usual psychodynamic hour. PHQ-9 and GAD-7 are completed each session and the scores are discussed…
• Phase 1. Initial / engagement and assessment phase (sessions 1–4)

Who practises it, and how they are trained or regulated

• Version followed: Lemma, Target & Fonagy (2011), Brief Dynamic Interpersonal Therapy: A Clinician's Guide (OUP), the standard 16-session, three-phase model for depression, as operationalised in the competence framework of Lemma, Roth & Pilling and in the NHS (HEE) DIT curriculum, which states that it is built on the 2011 book (itself a revision of the 2009 UCL manual). Variants not followed here: a 2017 manual (2nd…

Evidence status, as the guide reports it

• Dynamic Interpersonal Therapy (DIT) is a brief, manualised psychodynamic therapy for depression, and secondarily for anxiety. Developed by Alessandra Lemma, Mary Target and Peter Fonagy, it was built from the competences shared by evidence-based brief psychoanalytic and psychodynamic treatments,…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• An idealised review with no disappointment voiced, especially in compliant IPAFs.
• Goals about other people changing; goals about symptoms only; goals far too large.
• Treating the measures as admin. Within the IPAF, the measures themselves carry meaning.
• You rushing to offer more sessions, which may enact a rescue; dismissing a real relapse.
• Acting on the pull, for example by rescuing or withdrawing, before you've thought about it.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.