Paolo Migone Replies

I thank Allan Abbass, Peter Lilliengren, and Joel Town—well-known psychotherapy researchers and experts in Habib Davanloo's intensive short-term dynamic psychotherapy (ISTDP)—for their letter. They seem to agree with the main argument of my paper, but say that the way I describe Davanloo's technique does not reflect recent developments in the model. They usefully clarify that today, depending on patients' psychopathology, there are diversified techniques within Davanloo's

approach, and these techniques are well described in their letter. I thank them for this clarification.

Davanloo's technique, however, represents only a peripheral aspect of my paper; as I state there, “the topic of brief therapy is taken only as an opportunity to reflect on psychoanalytic technique in general” (p. 647; see also p. 653). I want to take this opportunity to clarify my main argument, which is actually reinforced by Abbass, Lilliengren, and Town's letter. In fact, they emphasize that ISTDP, despite the “short-term” in its name, is not time-limited and can in some cases be medium-term or even long-term in duration. This statement, which seems an oxymoron, highlights one of the several self-contradictions I pointed out within the brief psychotherapy movement: namely, that brevity itself is irrelevant to the identity of the technique. Hence, the term should be dropped, as it leads to misunderstandings. As Abbass, Lilliengren, and Town describe very well, the model's identity lies in the technique itself. Unfortunately, they do not discuss why in this technique the word “short-term” is retained (other techniques have indeed abandoned it and now use descriptors like “dynamic-experiential”). As I argue in my paper, if this technique is efficacious it is not clear why it should not be used also by “long-term” therapists. Incidentally, the expressions “long-term” and “short-term” are both misleading, since the length of treatment is not an a priori or independent variable, but depends on the