Stuart Andrews, Ph.D. - Psychotherapy


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When conducting psychotherapy I most often work in the Intensive Short-term Dynamic Psychotherapy (ISTDP) model of treatment. I spent over a decade collaborating with Dr. Leigh McCullough, a pioneer researcher and theoretician in the field who conducted two large-scale research studies on ISTDP demonstrating the effectiveness of this treatment and attempting to identify the critical change factors in psychotherapy (e.g., Winston, Pollack, Samstag, McCullough, & Muran, 1994).1

Research studies have demonstrated ISTDP to be an effective treatment for a wide range of clinical disorders, including mood disorders, anxiety disorders, somatic disorders, and personality disorders (Abbass, et al., 2014).2 In close collaboration with the patient, the ISTDP therapist takes a very active approach in addressing the blocks or stuck points that people may have in accessing their true potential. ISTDP is based on the premise that many of the problems patients come to therapy to address, such as depression, anxiety, self esteem, and relationship difficulties, are rooted in the ways people have learned to fear and avoid feelings. Dr. McCullough described this common fear of feelings as an "affect phobia" (McCullough Vaillant, 1997).3 Just as people with phobias about bridges or airplanes will avoid these external stimuli to minimize anxiety, people will avoid certain feelings or "internal phobias" to minimize anxiety. The goal of ISTDP is to help people understand and recognize the overlearned mechanisms they may use to avoid certain feelings, and by doing so gain greater access to the healthy experience and expression of their emotions.

Consistent with research on ISTDP, I have found that many of my patients experience significant symptom relief in as little as 1-3 hours of trial therapy (Abbass, Joffres & Ogrodniczuk, 2009). 4 While treatment length varies based on individual patient capacity and the goals of therapy, the average treatment length for ISTDP therapy is around 20 sessions (Abbass, Town & Driessen, 2012). 5 Moreover, research shows that patients in ISTDP therapy tend to continue making improvements in the years following termination. ISTDP is also one of the only models shown to be effective for treatment-resistant cases in which multiple other therapies have failed (Johansson, Town, & Abbass, 2014). 6

What to Expect
Therapy in this model begins with an initial evaluation, which is usually 60 minutes, but can be up to 3 hours in length. The goal of this therapy is to provide meaningful and lasting change in as few sessions as possible. To ensure that you have the best outcome possible, I will ask you to fill out a very brief outcome measure before and after each session. The feedback from these measures will help guide our work together

1Winston, A., Pollack, J., Samstag, J., McCullough, L. & Muran, C. (1994). Short-term psychotherapy for personality disorders. Journal of Nervous and Mental Disease, 179(4), 188-193.
2Abbass, A., Kisely, S.R., Town, J.M., Leichsenring, F., Drissen, E., De Maat, S., Gerber, A., Dekker, J., Rabung S. Russalovska, S., Crowe, E. (2014). Short-term psychodynamic psychotherapies for common mental disorders (Review). The Cochrane Collaboration. New York: John Wiley & Sons.
3McCullough Vaillant, L. (1997). Changing Character. New York: Basic Books.
4Abbass, A. Joffres & Ogrodniczuk (2009). A Naturalistic Study of Intensive Short-term Dynamic Psychotherapy Trial Therapy. Brief Treatment and Crisis Intervention, 8, 164-170.
5Abbass, Town & Driessen (2012). Intensive Short-term Dynamic Psychotherapy: A Systematic Review and Meta-analysis of Outcome Research. Harvard Review of Psychiatry, 20, 97-108.
6Johansson, Town, & Abbass (2014). Davanloo's Intensive Short-term Dynamic Psychotherapy in a Tertiary Psychotherapy Service: Overall Effectiveness and Association between Unlocking the Unconscious and Outcome. PeerJ 2:e548; DOI 10.771/peerj.548.