Výskum v oblasti intenzívnej krátkodobej dynamickej psychoterapie

Úvod: Dôkazy o účinnosti ISTDP 

Tento dokument skúma stav dôkazov na základe výsledkov a informácií o procese intenzívnej krátkodobej dynamickej psychoterapie (ISTDP) u širokého spektra klinických stavov a v rôznych settingoch.

Čo je intenzívna krátkodobá dynamická psychoterapia?

ISTDP, ktorú od 60. rokov 20. storočia do nedávnych rokov vyvíjal Dr. Habib Davanloo, je široko uplatniteľná cielená forma krátkodobej psychodynamickej psychoterapie, ktorá má modifikácie na liečbu vysoko rezistentných, depresívnych a disociatívnych klientov. Zdôrazňuje zameranie na telo, emocionálne prežívanie a zvládanie obrany. Sústreďuje sa na prácu tu a teraz, mobilizuje komplexné prenosové pocity a obrany ako prostriedok na získanie priameho prístupu k emóciám súvisiacim so vzťahovou väzbou. Prostredníctvom tejto práce v terapeutickom vzťahu sa mobilizujú a sprístupňujú spomienky a emócie súvisiace s traumou v procese pripútania v minulosti. U jedincov s represívnymi procesmi a disociatívnymi črtami so závažnejšími poruchami osobnosti tomuto prístupu predchádza fáza budovania kapacity, a preto môže byť u tejto skupiny liečba dlhšia. Metódu skúmal Dr. Davanloo a ďalší výskumníci prostredníctvom podrobných videozáznamov veľkých sérií prípadov, výskumu založeného na procese, spätnej väzby pacientov na videu, dlhodobého sledovania a následnej tabelácie výskumu výsledkov uskutočneného nezávislými centrami. Všetky školenia sú založené na demonštráciách videozáznamov skutočného kazuistického materiálu, podrobnej supervízie videozáznamov terapeutických sedení a vlastnom hodnotení týchto videozáznamov. 

Zhrnutie dôkazov výskumu

Celkovo je v nasledujúcich kategóriách zahrnutých viac ako 150 štúdií výsledkov s približne 75 randomizovanými kontrolovanými štúdiami:

• 25 štúdií u úzkostných porúch
• 30 nákladových štúdií
• 16 štúdií u depresívnych porúch
• 22 rôznych štúdií na variabilných skupinách obyvateľstva
• 19 štúdií u zmiešaných porúch
• 9 štúdií u porúch osobnosti
• 25 kvalitatívnych a procesných štúdií 
• 4 štúdie u závažných duševných porúch
• 53 štúdií u somatických ochorení
• 4 štúdie u poruchách užívania látok
• 38 štúdií u populácií refraktérnych na liečbu bez somatických ťažkostí 
• 5 štúdií probatórneho terapeutického rozhovoru
• 50 štúdií u somatických stavov

Replikácie

Existujú nezávislé replikácie randomizovaných kontrolovaných štúdií ISTDP pre depresiu rezistentnú na liečbu, veľkú depresiu, poruchy osobnosti, chronickú bolesť a sociálnu úzkostnú poruchu. Na základe toho metóda spĺňa kritériá empiricky podporovanej liečby.

Štúdie ISTDP u frekventantov tréningov a štúdie procesov učenia

Existuje malá séria štúdií, ktoré ukazujú, že liečba je účinná v rukách nových učiacich sa, že táto liečba môže priniesť štrukturálnu zmenu osobnosti, že liečba môže byť aj nákladovo efektívna a že množstvo tréningu koreluje s niektorými výslednými ukazovateľmi. V posledných rokoch svojho pedagogického pôsobenia Dr. Davanloo vyvinul metódu zážitkového učenia vo formáte malých skupín (Beeber, 2018).

Budúce smery výskumu

Celková aktualizovaná metaanalýza tohto výskumu výsledkov je v príprave. Existuje určitý výskum procesu učenia sa tejto metóde, ale ďalší výskum bude prínosný. Randomizované kontrolované štúdie by boli prospešné v prípade doplnkovej liečby u populácie so závažnými duševnými poruchami.

(Úplnú verziu pôvodného dokumentu nájdete na tomto odkaze.)

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