Topics of interest · Therapy
A therapy that works with the feelings underneath.
Intensive Short-Term Dynamic Psychotherapy (ISTDP) in plain language: what it is, who it can help, the evidence, and what to expect.
Sometimes a difficulty keeps returning no matter how well we understand it. ISTDP is a way of working with the emotions beneath the surface, where some of those patterns are held.
This page explains Intensive Short-Term Dynamic Psychotherapy in everyday terms. It is one of several approaches we offer; you can see the full range on our therapy service page. Whether ISTDP is a good fit is something we work out with you, and we are always honest if another approach would suit you better. At the clinic, ISTDP is provided by a clinician who has trained specifically in the approach.
What it is
What ISTDP is
ISTDP is an emotion-focused, experiential talking therapy. It pays close attention to feelings as they arise in the session, and to the ways we have learned to keep difficult feelings at bay.
All of us develop protective habits, ways of avoiding, minimising or holding back feelings that once felt too much to bear. These protections make sense, and they often helped at the time. Over the years, though, the same habits can keep us anxious, stuck, or distant from the people we care about, often without our realising it.
In ISTDP, the therapist gently helps you notice these patterns as they happen, and to turn towards the underlying feelings safely, at a pace you can manage. The aim is to ease the anxiety and the avoidance that keep a difficulty going, so that feeling, thinking and relating become freer. The approach was developed by the psychiatrist Habib Davanloo from the 1960s onwards, and has been refined and studied by clinicians and researchers since.
The word "intensive" refers to the close, active focus on emotion within each session, not to long or frequent appointments. Sessions are a usual length, and the work is collaborative throughout.
Who it helps
Who it can help
ISTDP has been used across a broad range of difficulties, particularly where emotions and relationships are closely involved, and where other approaches have not fully helped.
- Depression and low mood, including difficulties that have proven hard to shift
- Anxiety and panic, where worry, tension or avoidance have taken hold
- Long-standing relationship and interpersonal patterns that keep repeating
- Physical symptoms with a strong emotional component (sometimes called functional or somatic symptoms), where investigations have not found a medical cause
- The effects of difficult or painful past experiences
- Difficulties where a person feels emotionally stuck or shut down, or senses a pattern they cannot quite name
ISTDP is not the right fit for everyone or for every situation. Part of the first stage of the work is checking, together, whether it suits you and your goals. If it does not, we will say so and suggest an approach that does.
“The protections that once helped us can be the very things that keep us stuck.”
The evidence
What the research shows
ISTDP has a growing research base. As with much of psychotherapy research, the quality of studies varies, so the findings are best read as encouraging rather than the final word.
A systematic review and meta-analysis by Abbass and colleagues brought together trials of ISTDP across mood, anxiety, personality and somatic difficulties. It reported meaningful improvements that were generally maintained at follow-up, and several studies suggested the therapy was cost-effective, including through reduced use of other health services. Later reviews have looked specifically at functional and somatic symptoms, with broadly supportive results.
We read this evidence carefully and conservatively. It supports ISTDP as a reasonable, evidence-informed option for a range of difficulties, particularly where emotions and relationships are central, while recognising that no single therapy suits everyone and that more high-quality research is always welcome.
What to expect
What to expect
A clear, collaborative process, paced to what you can manage.
- Getting to know your situation. The first appointments are about understanding you, your concerns and what you hope for, and beginning to notice together the patterns that may be keeping a difficulty going.
- Working with emotion, safely and at your pace. As the work develops, the therapist helps you turn towards underlying feelings while keeping anxiety manageable. You stay in control; nothing is forced.
- Reviewing progress together. We check how things are going and adjust as needed. The number of sessions varies with the person and the goal. The approach is often briefer than longer-term therapies, though that depends on the situation, and we will be honest with you about it.
Sessions are usually around 50 minutes, though an initial or occasional session may run longer where that is clinically useful and agreed in advance. We will always be clear with you about timing and fees beforehand.
Funding and rebates
What you can claim
With a Mental Health Treatment Plan from your GP, the Better Access initiative provides Medicare rebates for a number of individual sessions each calendar year. A referral is not needed to see us privately; a referral and plan are needed to claim Medicare rebates. We also work with the Department of Veterans' Affairs, WorkCover Queensland and other schemes. Current fees and rebate details are on our Fees and Policies page.
Wondering if it might suit you?
If something keeps returning and you would like to understand it differently, request an appointment or call 0452 452 262. We will talk it through and work out the right approach together. You do not need a referral for a private appointment.
Request an appointmentSources: Abbass AA, Town J, Driessen E, Intensive Short-Term Dynamic Psychotherapy: a systematic review and meta-analysis of outcome research, Harvard Review of Psychiatry, 2012. Abbass A, et al., reviews of ISTDP method and empirical basis, and meta-analysis of short-term psychodynamic psychotherapy for functional somatic disorders. Davanloo H, foundational work on Intensive Short-Term Dynamic Psychotherapy (1960s onward). Background: ISTDP UK research summary (istdp.org.uk). This page is general information, not a substitute for individual clinical advice.