Another ring of short psychotherapies developed by Hans Strupp and Jeffrey Binder is Hanna Levenson’s Time-Limited Dynamic Psychotherapy method.
Short-term or limited psychotherapy has taken its place in the psychiatry world as a frequently preferred psychotherapy method, especially due to its advantages in cost. The aim of short-term therapy is not to achieve the greatest possible change, but to achieve the maximum change that can be reached quickly with available resources.
Levenson’s dynamic psychotherapy is by no means a shortened version of open-ended therapy. Giving a certain amount of time to terminate the therapy creates some advantages in short therapies with limited duration. One of these is that clients’ fears about the addiction of therapy and their conflicting tendency to terminate therapy are minimized in this therapy method.
The most important feature of short-term dynamic psychotherapy approaches is that the treatment has a limited focus. The target must be determined and shot as soon as possible. It should not be forgotten that Yogi Berra said. “If you don’t know where you’re going, your road will end somewhere else.”
The maximum number of sessions in short-term therapies is 25. Many clinics apply therapy programs of 6-20 sessions. In other words, dynamic psychotherapy with limited duration has sensitivity to time and effective use of time. This lowers the total cost.
Short-term dynamic psychotherapy is also based on basic psychoanalytic concepts. These are childhood experiences, unconscious features, contradictions, transference, resistance, and repetitive behavior. Inferential concepts and metapsychological models such as the Oedipus complex are hardly emphasized. The therapy process is kept more factual by emphasizing the strengths of the patient. The client and the therapist focus on their relationship in the here and now.
The best response to psychotherapy comes from acute stress symptoms such as headache, restlessness, and easy crying. Chronic stress symptoms such as feelings of worthlessness, fragility and loneliness are the group with the fastest response. Psychotic symptoms, paranoid and hostile thoughts are the most difficult symptoms to respond to.
Short-term therapists advocate pragmatism, prefer the least radical intervention, emphasizing the patient’s strengths and resources, accept that many changes will occur after therapy, see being in the world more important than being in therapy, while long-term therapists favor the basic character without change, It gives less importance to its practice, wants serious changes to be experienced during therapy, and sees patients’ coming to therapy as the most important part of their lives.
Dynamic psychotherapy with limited duration is very effective in treating difficult patients. Its main use is for patients with interpersonal problems or personality disorders. The goal has been achieved when the client changes the dysfunctional interpersonal patterns to the way they relate to new functional experiences and understandings, that is, when the character structure is changed.
Time-limited dynamic psychotherapy uses the interpersonal therapy model. Object relations theory, which arises from the fact that we depend on others for a certain period to survive after birth, maintains its effect in this therapy method as well. Our first post-natal relationships create stereotypes about how we feel and treat others, which in turn generates harmony or conflict in interpersonal relationships.
Relationships with primary caregivers, particularly parents, at ages 0-2 can be a source of disturbance in adult relationships. The child whose basic needs are met and securely attached will be resistant to the negative effects of anxiety and will develop a solid psychological structure.
One of the most important differences of short dynamic psychotherapy is that the treatment focus is limited. Without looking at all clinical data, a certain point is focused. It is extremely important to detect this focus. It is one of the most important tasks of the therapist to correctly identify the interpersonal patterns that lead to the emergence and maintenance of functional relationships in the patient’s life. Often inflexible, self-deceiving expectations and self-negative evaluations create maladaptive interpersonal patterns.
5 main criteria for the client’s suitability for dynamic psychotherapy with limited duration.
1) Presence of emotional pain that will cause seeking treatment.
2) Willingness to come to the treatment and the confidence that he/she will get results from the treatment.
3) To be willing to think about the conflicts he/she experiences in interpersonal relationships.
4) To find the opportunity to work on them by getting away from their intense emotions.
5) To have the capacity to establish a meaningful relationship with the therapist.
If the patient has another pathology such as delirium, dementia, psychosis that makes it difficult to participate in the verbal shopping process, has a psychopathology such as bipolar disorder or specific phobia, or has a mental disorder that will make it difficult to tolerate the therapy process such as alcohol and drug use, impulse control disorder. If they have ailments, dynamic psychotherapy with limited duration should not be preferred.