Toward a DMM based Dynamic Psychotherapy (DMM-DP).

The innovations introduced by the Dynamic-Maturational Model of attachment and adaptation (DMM) are extremely useful for the comprehension of the clinical process and particularly compatible with the psychodynamic approach to psychotherapy. Therefore, the possibility of a DMM based Dynamic Psychotherapy (DMM-DP) can be considered (Baldoni 2011, 2012). DMM analyzes clinical problems in terms of attachment strategies in relation with the environment, considering patient’s and therapist’s attachment pattern and their interactions. Attachment assessment techniques in the DMM, especially the AAI, are relational experiences. They offer not only information, but also the possibility of insight and change for the patient and they assume an implicit therapeutic value fostering the working alliance. Some of these assessment techniques can be used as part of a DMM based Parent Training (DMM-PT) which integrates psychodynamic and psycho-educational interventions (including the use of the CARE-Index as a video-feedback). DMM is a precious guide to verbal interventions (questions, observations, reformulations, interpretations, self-disclosure) in brief and long-term dynamic psychotherapy. However, DMM treatment for the most severe patients - rather than focusing only on verbal intervention and following recent psychodynamic research - underlines the importance of the analysis of countertransference, relational dynamics, mentalization processes, expression and regulation of emotions, setting variations and non-verbal communication. DMM follows a biopsychosocial approach - inserting people and problems into systems, subsystems and different levels of systems - and integrating different techniques (psychoanalytic, cognitive, behavioral, psycho-educational, systemic). As a consequence, the therapist tends to be more active than in a classical psychoanalytic approach. Different techniques can be used by the same therapist or by different therapists, in an integrated protocol. The goal is to offer a tailored cure based on the patient’s needs. Therapist training is important and implies a constant follow-up and Randomized Controlled Trials for assessing treatment efficacy in an evidence-based perspective.