ISTDP for generalized anxiety disorder: A pilot effectiveness and process-outcome study.

Clinical Implications & Learning Points

• Focus on MUCE:

  • Routinely assess and facilitate deep emotional experiences (e.g., grief, anger) rather than relying solely on cognitive techniques or support.

  • Track MUCE via session notes or simple ratings to predict and enhance treatment response.

• Brief, Intensive Work

  • Even a small “dose” of ISTDP (under 10 sessions) can yield significant gains—plan for shorter, targeted courses rather than open-ended therapy.

• Therapist Stance

  • Adopt a deliberately active, emotion-focused stance: challenge defenses early, press for emotional engagement, and contain patient anxiety safely.

• Economic Value

  • Present ISTDP not only as clinically efficacious but also cost-saving—valuable for justifying its use in managed care settings and to stakeholders.

• Training & Supervision

  • Supervise therapists with a focus on recognizing MUCE and maintaining technical fidelity to the ISTDP model. Video-review sessions to fine-tune interventions.