Dynamic Interpersonal Therapy

Dynamic interpersonal therapy (DIT) is a simple, 16-session individual therapy protocol for mood disorder.

About Dynamic Interpersonal Therapy (DIT)

The protocol draws on the work of the Expert Reference Group on clinical competencies, which identified key components of manualised psychoanalytic/ psychodynamic therapies. DIT is an easy to acquire, semi-structured treatment protocol. There are plans to roll DIT out nationally within the NHS Talking Therapies programme for work with depressed patients. DIT training is therefore NHS Talking Therapies supported.

Find out more about DIT.

Background to the development of DIT

DIT was explicitly developed out of the psychoanalytic/psychodynamic competences (Lemma et al., 2008) that provided the basis for the It is drawn from the psychoanalytic/psychodynamic approaches that have the strongest evidence for efficacy, based on the outcome of controlled trials. It is specifically designed to address symptoms of depression and anxiety.

DIT and NHS Talking Therapies

DIT is the brief psychodynamic therapy model now offered at Step 3 within NHS Talking Therapies. The National Institute for Health and Clinical Excellence (NICE) guidelines for depression state that brief psychodynamic therapy is one option that can be considered for depressed patients, either when the patient has not responded to cognitive behavioural therapy interventions, or where the patient actively opts for a psychodynamic approach.

The 20-Day DIT Programme provides counsellors and psychologists working in NHS Talking Therapies with a structure to conduct a time-limited manualised psychodynamic therapy. It is a postgraduate certificate-level training for NHS Talking Therapies employees who do not meet psychodynamic competencies. You will become a DIT practitioner on successful completion of the full training.
The 5-Day DIT Training provides psychoanalytically/dynamically trained practitioners with a structure to conduct a time-limited, manualised psychodynamic therapy. It is intended as a CPD course to hone the skills of established psychodynamic practitioners, to enable them to deliver an effective brief psychodynamic intervention to treat depression. To become a DIT practitioner, you are required to attend the five-day training, pass the role-play, successfully complete supervision and pass a case study. This course is accredited by the British Psychoanalytic Council.
DIT practitioners can avail themselves of a unique opportunity provided by the Anna Freud Centre to enhance their professional development by becoming a qualified DIT supervisor.
DIT for Complex Care is a two-day advanced training that supports qualified DIT practitioners to apply the model to a complex patient group in secondary care. The training assumes existing knowledge of working with the 16-session DIT model and that clinicians have the requisite competence. DIT for Complex Care modifies and extends the model and emphasises skills like mentalizing, developing epistemic trust, stabilisation techniques and risk management. The adapted DIT complex care model is a 28-session approach that is based on the published results of a pilot study carried out in Newham (Journal of Psychoanalytic Psychotherapy, 33(7) 1-22; August 2019.
We also offer annual courses such as DIT Refresher and DIT and Mentalization.
View all live DIT trainings.
Recommended reading for Dynamic Interpersonal Therapy short course (the papers in bold are directly related to DIT).
Bateman, A. & Fonagy, P. (2006) Mentalisation-based Treatment for Borderline Personality Disorder. Oxford: Oxford University Press
Bateman, A, Brown, D and Pedder, J. (2000) Introduction to Psychotherapy: An outline of psychodynamic principles and practice (3rd edition) London: Routledge
Blatt, S and Luyten, P. (2009) ‘A structural–developmental psychodynamic approach to psychopathology: Two polarities of experience across the life span.’ Development and Psychopathology 21, 793–814
Bowlby, J. (1958). ‘The nature of the child’s tie to his mother.’ Int. J. Psycho-Anal., 39: 350-373
Douglas, A., Ablett-Tate, N. and Chad, N. ‘Dynamic interpersonal therapy in an NHS tertiary level specialist psychotherapy service’ Psychoanalytic Psychotherapy: Applications, Theory and Research, 30(3), 223-229
Fonagy, P. (2001) Attachment Theory and Psychoanalysis. London: Karnac
Fonagy, P., Gergely, G., Jurist, G., & Target, M. (2002). Affect Regulation, Mentalization and the Development of the Self (London: Other Press).
Fonagy, P. (2010). The changing shape of clinical practice: A comprehensive narrative review. Psychoanalytic Psychotherapy, 24(1)
Gelman, T., McKay, A., Marks, L. (2010). Dynamic Interpersonal Therapy: Providing a focus for time-limited psychodynamic work within the NHS, Psychoanalytic Psychotherapy: Applications, Theory and Research, 24(4): 347-361
Guthrie, E. (2010). Psychodynamic Interpersonal Therapy: Advances in Psychiatric Treatment. London: Sage.
Gomez, L. (1997) An Introduction to Object Relations. London: Free Association Books
Greenson, R. R. (1967) The technique and practice of psychoanalysis Vol. I. New York: International Universities Press
Kernberg, O. (1985). Internal World and External Reality: Object Relations Theory Applied. New York: Aronson.
King, P. (1978) "Affective Response of the Analyst to the Patient's Communications", Int. J. Psychoanal., 59: 329-334
Lemma, A., Target, M., Fonagy, P. (2011) Brief Dynamic Interpersonal Therapy. Oxford: OUP.
Lemma, A. (2003) Introduction to the Practice of Psychoanalytic Psychotherapy. Chichester: Wiley, particularly the chapter ‘Working with Endings’.
Lemma, A., Roth, A., Pilling, S. (2008) The competences required to deliver effective psychoanalytic/ psychodynamic therapy. www.ucl.ac.uk/CORE
Lemma, A., Target, M., Fonagy, P. (2011) The development of a brief psychodynamic intervention (Dynamic Interpersonal Therapy) and its application to depression: a pilot study. Psychiatry: Biological and Interpersonal Processes,74 (1): 41-48
Lemma, A., Target, M., Fonagy, P. (2010) The Development of a Brief Psychodynamic Protocol for Depression: Dynamic Interpersonal Therapy. Psychoanalytic Psychotherapy: Applications, Theory and Research, 24(4): 329-346
Lemma, A. & Patrick, M. (2010). ‘Introduction: Contemporary psychoanalytic applications: development and vicissitudes’ in Off the coach: Contemporary psychoanalytic approaches. London: Routledge.
Leonidaki, V., Lemma, A. & Hobbis, I. ‘Clients’ experiences of dynamic interpersonal therapy (DIT): opportunities and challenges for brief, manualised psychodynamic therapy in the NHS’. Psychoanalytic Psychotherapy: Applications, Theory and Research : 30(1), 42-61
Luborsky, L. & Crits-Christoph, P. (1990). Understanding transference: The core conflictual relationship theme method. New York: Basic Books.
Luyten, P., Fonagy, P., Lowyck, B., & Vermote, R. (2012). ‘The assessment of mentalization’ In A. Bateman & P. Fonagy (Eds.), Handbook of mentalizing in mental health practice (pp. 43-65). Washington, DC: American Psychiatric Association
Luyten, P., Fonagy, P., Lemma, A., Target, M. (in press) Mentalising and depression. In: A. Bateman and P. Fonagy (eds.) Mentalising in Mental Health Practice. Washington: APA
Ogden, T.H. (1992). The Primitive Edge of Experience. London: Karnac.
Perry, H.S. (1982) Psychiatrist of America: The Life of Harry Stack Sullivan. New York: Norton
For those based in the UK
1. Prospective trainer must be an accredited DIT Practitioner and Supervisor.
2. Prospective trainer shadows the 5-Day DIT Programme run at the Centre or at least 10 days on the 20-Day DIT Training run at the Centre.
3. Prospective trainers delivers a 5-day training at the Centre or at least 10 days of the 20-day DIT training as a support trainer.
4. If approved by the DIT Programme Director, prospective trainers gains AFC Trainer status.
5. The Centre can approach the trainer to deliver paid teaching for the Centre.
Maintenance:
- The trainer must attend a yearly CPD event for trainers and supervisors.
- The trainer is required to maintain their DIT Practitioner status by seeing at least one patient a year. This should include one hour of DIT supervision for every 12 hours of DIT therapy work for the first year of work as a DIT Practitioner and using peer supervision beyond the first year.
For those based outside of the UK
Step 1 - Initial Accreditation
1. The Training Provider must be based outside of the UK and intending to train teams based outside of the UK and in the agreed countries identified in the licensing agreement.
2. The Training Provider must employ at least one DIT trainer who:
  1. Has completed the 5-day or the 20-day DIT Training run by the Centre
  2. Is a registered DIT Practitioner and Supervisor
  3. Has shadowed the full 5-day DIT training or at least 10 days of the 20-day DIT training
3. The training Provider must have at least two DIT trainers within 2 years of accreditation (any training exceeding 20 participants must be run by 2 trainers).
4. The organisation or Training Provider must be currently involved with providing DIT treatments and supervision, or that its proposed trainers are providing DIT treatments.
5. The organisation or Training Provider will have demonstrated relevant involvement in academic, research and practice settings involved addressing the social, emotional and mental well-being of adults.
6. The organisation must provide a satisfactory plan for delivery of training and other associated services (e.g., supervision).
Once the above requirements have been demonstrated, Training Provider to pay a £1,000 initial accreditation fee.
Step 2 – Completion of one initial 5-day DIT training organised by the Training Provider, co-delivered with a Centre approved trainer (£5,500 fee plus tutor expenses, incl. travel, accommodation and subsistence).
Step 3 – Maintaining accreditation
- Training provider to pay £1,000 annual accreditation fee
- Training provider to attend minimum of 6 hours of supervision on training and delivery of DIT, within 1 year of the first training delivery, with an AFC trainer (ideally the trainer who co-delivered the first training)– at £200/hr (£1,200 fee)
- Training provider is required to maintain their DIT Practitioner status by seeing at least one patient a year. This should include one hour of DIT supervision for every 12 hours of DIT therapy work for the first year of work as a DIT Practitioner and using peer supervision beyond the first year.
- Training provider to submit regular training and supervision records, including the list of those who successfully complete the training.
- Training provider to share learning, including arranging for their trainers to attend at least one accredited DIT training Centre network event (online) annually to share learning across the community Sharing Learning.