Susan Hajkowski is presenting a seminar on behalf of ISTDP-UK on Friday 13 March where she will be discussing her research and the application of ISTDP within the NHS.

We are so looking forward to your seminar and thank you for taking the time for this interview.


How did you first become aware of or interested in ISTDP?

I first became interested in ways of shortening psychodynamic treatment during my initial training in traditional psychodynamic psychotherapy.  At this time I was aware of the rapidity with which other treatments claimed to work, particularly at that time CBT. I began to question, and became interested in whether it was possible to work more quickly with patients within the psychodynamic model, and if and how psychodynamic psychotherapy could be shortened and accelerated. This struck me as an essential goal, in order to help patients derive benefit from treatment in as short a time as possible.

I became aware of early developments in Short-Term Psychodynamic Psychotherapy. A critique of these developments was that they tended to focus, for the most part, on treatments for higher functioning patients. Working in secondary mental health services, I was increasingly working with patients presenting with longer-term, complex difficulties.  I attended the first Oxford conference in ISTDP in 2006 and was immediately struck by advances in techniques and applications, and how these might be used in my own practice.

Could you describe your training in ISTDP (courses, workshops etc.?)

Following the Oxford conference in 2006, I joined the first ISTDP core training group in the UK. Throughout, and following core training I have attended and participated in many conferences, workshops and immersion courses.

Have there been any ISTDP clinicians who have been a particular influence on your work?

Over the years I have benefited from the skill and talent of many trainers and students of ISTDP, and this has challenged me to learn about and understand different applications within the approach.

I am particularly fortunate to have discovered the work of David Malan early in my psychotherapy career. David and his work have had a profound effect on me and my practice, which in summary are: be ambitious in the aim of accelerating treatment – even with more complex and difficult to treat patient populations; be rigorous in treatment, collect outcomes and research the treatment process; be brave,  and do not be afraid to question and at times challenge orthodoxy from a positon of rigor and evidence; and finally, be generative, pass on knowledge in an endeavor to improve treatments  for patients.

In your presentation you are going to talk about application of ISTDP to complex client populations – could you explain briefly what you mean by this?

I have, for many years, been practicing short-term and accelerated treatments with patient populations within secondary mental health services. Increasingly patients referred into these services experience chronic debility with complex, and frequently co-morbid presentations including personality disorder, depression and anxiety. Unfortunately, for many of these patients past treatments have failed and they are often considered unsuitable for psychological therapies.

You’ve delivered research and clinical presentations both nationally and internationally including in Australia, North America and Europe – firstly this sounds very glamorous – is this part of the ISTDP lifestyle? And could you tell us a bit about how you made these international links?

I’ve been very fortunate as part of my work through the NHS to develop practice, teaching and research. In order to support this I’ve developed a number of important professional links, and sought professional routes that promote evidence based practice and research.  This includes important work with the Society for Psychotherapy Research (SPR) which brings together psychotherapy researchers internationally.

Would you say there are any particular challenges or obstacles to applying ISTDP within the NHS?

In some ways it may be easier to practice ISTDP within the NHS.  The real challenge, in my view, is in how we apply ethical, evidence based practice in all sectors of health and treatment provision. To this end, I believe the future of any practice is in the value of its outcomes to patients, and how we can rigorously demonstrate this.

In your experience, is ISTDP becoming more widely acknowledged or available within the NHS?

I think one of the challenges we have within the ISTDP community is to know about each other and where and what people are delivering in the UK. I am aware that some practitioners, and some services, currently deliver ISTDP in the NHS and have been for some time. However I am equally sure that I may not be aware of others. I think part of the value of ISTDP-UK is in bringing practitioners together and creating opportunities for collaborations in practice and research both within and outside of the NHS.

If you could have dinner with any psychotherapist/psychiatrist/psychologist, living or dead, who would you choose?

Freud, of course, in Vienna!

We look forward to Susan’s presentation and details and booking instructions are here: