International Federation for Psychotherapy 23rd World Congress of Psychotherapy
“Psychotherapy and World Mental Health 2023”
9-11 February 2023, Faculty of Medicine and Pharmacy, University Hassan II,
Casablanca, Morocco
Plenary Sessions
Afzal Javed (Pakistan)
Professor Afzal Javed was appointed President-Elect of the World Psychiatric Association at the 2017 World Congress of Psychiatry in Berlin. In 2020, he assumed the role of President and launched the WPA 2020-2023 Action Plan. As President, Professor Afzal Javed leads the work of the Executive Committee, ensuring the group remains focused on fulfilling the vision of WPA and on reaching its goals as outlined in its charter and in the current Action Plan. In addition to his roles as a Consultant Psychiatrist at the UK NHS, Honorary Clinical Associate Teacher at Warwick Medical School, University of Warwick UK and honorary Chairman of the Pakistan Psychiatric Research Centre, Fountain House, Lahore, Pakistan, Professor Afzal Javed also fulfils his role as WPA President by liaising with member societies across the globe, supporting their local endeavours, and sharing knowledge and information between them.
Plenary Address: Psychosocial Treatments and Public Health Needs
Thursday 9 February 1830-1900
Plenary Session Co-Chairs: Driss Moussaoui and César Alfonso
There is ample evidence that adverse psychosocial exposure is associated with several health problems including mental health consequences. This association may be causal, or it may reflect issues of reverse causation. Psychosocial factors such as stress, hostility, depression, hopelessness, and work-related difficulties may be associated with health problems and adverse risk profiles in terms of psychosocial factors seem to cluster with general social disadvantage. Psychosocial adversities can thus emerge as an important cause of health inequalities. Whereas unequal distribution of the social determinants of health, such as education, housing, and employment, drives inequalities in physical and mental health, there is also extensive evidence that psychosocial factors, such as work stress, may influence health and wellbeing in a big way. The amelioration of social inequalities in health should therefore be a priority for public health policy. This is more relevant and appropriate for many low resource countries. There have been calls for this goal to be realised through interventions targeting psychosocial risk factors. Thus, psychosocial intervention, is key to improving the health of the disadvantaged populations. This presentation highlights the current evidence that exists about the relationships between social determinants, psychosocial factors, and health outcomes. It also argues that for a conceptual framework that focuses on the psychosocial pathways between factors associated with social, economic, and environmental conditions and mental and physical health outcomes.
Norman Sartorius, M.D., Ph.D., F.R.C.Psych. (Croatia)
Professor N. Sartorius, previously the Director of the Mental Health Program of the World Health Organization, President of the World Psychiatric Association and of the European Psychiatric Association, now serves as President of the Association for the Improvement of Mental Health Programs, a non-governmental organization located in Geneva. Professor Sartorius holds several professorial positions in Europe, the USA and elsewhere. He has published more than 500 papers in peer-reviewed journals and authored, co-authored, edited, or co-edited more than 120 books. Professor Sartorius’ main areas of interest at present are the comorbidity of mental and physical disorders, the reduction of the stigma of mental disorders, and education of psychiatrists and other stakeholders in the field of mental health. In his previous positions he was the principal investigator of several international collaborative studies and projects dealing with schizophrenia and other major mental diseases, comorbidity of mental and physical illnesses, health service development, and education of different categories of staff.
Plenary Address: “Psychotherapy and Public Health”
Thursday 9 February 1900-1930
Plenary Session Co-Chairs: Driss Moussaoui and César Alfonso
The term “public health” refers to the effort to provide all people with health care which will prevent the occurrence of diseases and where this is not possible provide effective treatment of diseases with a minimal delay. Psychotherapy could be defined as the body of knowledge about human mental functioning coupled with the translation of this knowledge into specific techniques which can prevent the occurrence of mental disorder or provide care when this was not possible. Psychotherapy can and should contribute to the achievement of public health goals by preventing mental disorders or treating them. In addition, however psychotherapy can also play an important role in the organization of health care efforts and as a guide in the provision of non-specific aspects of treatment of all diseases. To play its roles effectively psychotherapy will rely on specialists who will decide what tasks they will handle and what can be done by others to ensure that the knowledge which psychotherapy offers finds an optimal use in promoting the public health of the populations. These tasks are not easy, and it is therefore of essential importance to ensure competence of future psychotherapists in the uses of psychotherapy in the public health sphere by an appropriate education of psychotherapists and by an adequate description of their duties.
Mark van Ommeren (Switzerland)
Mark van Ommeren, PhD, is Head of the Mental Health Unit within the WHO Department of Mental Health and Substance Use. The Unit covers a wide range of topics including advocacy, suicide prevention (following the LIVE LIFE approach), services across the life course (including integrated care and reorganization of services), essential medicines (including updating the WHO Model Lists of Essential Medicines), innovation and research in psychological interventions (eg EQUIP, PM+, SH+, Step-by-Step, EASE, STARS) and mental health in specific settings (e.g., leadership/country support/guidance in humanitarian emergencies; guidelines for the workplace). He coordinated the writing of the WHO (2022) World Mental Health Report: Transforming Mental Health for All. Much of Mark’s earlier work has focused on initiating and developing inter-agency mental health policy for humanitarian settings (eg Sphere standards, IASC guidelines) with linked implementation tools; developing, testing and disseminating a range of scalable psychological interventions; and “building back better” mental health services across different levels of the health system after major emergencies. As part of this work, he introduced the term “mental health and psychosocial support (MHPSS)” into the development of inter-agency humanitarian guidelines, which has resulted in improved collaboration across sectors in humanitarian settings around the world. He was born in the Netherlands and studied at the University of British Columbia in Vancouver (BSc in statistics (1992) and MA in (intercultural) counselling psychology (1995)) and received his doctorate (covering epidemiology among refugees in Nepal) from the Vrije Universiteit in Amsterdam (2000).
Plenary Address: “Towards the Effective Implementation of Psychological Interventions at Scale”
Friday 10 February 0800-0830
Plenary Session Co-Chairs: Aimee Nasser Karam and César A. Alfonso
Less than 1 in 3 people in the world with depression access care for depression. A recent review of treatment coverage for major depressive disorder found that minimally-adequate treatment ranged from 23% in high-income countries to 3% in low- and lower-middle-income countries. A wide range of psychotherapeutic interventions have been found effective for people suffering depression and anxiety. There has been substantial path-breaking research over last 20 years in low-, middle-, and high-income countries showing that a range of existing evidence-based interventions can be modified to enable to implement them at scale. Such modified versions include brief non-specialist-delivered individual and group versions of existing evidence-based psychological treatments (e.g., basic versions of interpersonal psychotherapy and cognitive-behavioural therapy); guided and unguided self-approaches materials drawing from evidence-based psychological treatment principles, delivered through recommended books or online programs. A range of open access psychological intervention manuals have been published by WHO in recent years (for adults: Individual and Group Problem Management Plus, Thinking Healthy, Self-Help Pus, Interpersonal Therapy; for young adolescents (forthcoming): EASE). In addition to much needed additional financial and human resources for health and social care systems to take up the responsibility for scale-up, it is essential to address the challenge of integrating psychological interventions in an agile manner in the health and social care system, requiring focused attention to clinical governance, that is ensuring that organizations are accountable for high quality standard of care. The WHO EQUIP project – which includes tools for evidence-based competency assessment – can play a key role.
Moussa Ba (Senegal)
Moussa Ba, a national from Senegal, totals more than 40 years of experience in the field of mental health. He has been the Chief of the Critical Incident Stress Management Unit (CISMU) of the Department of Safety and Security (DSS) of the United Nations (UN) since the creation of the Department in 2005 to the date of his retirement in December 2021. Prior to that he was appointed by UNICEF as a Program Officer in emergency countries in Western and Central Africa. He joined the United Nations Security Coordination Office (UNSECOORD) at the New York UNHQ in December 2002 as a Regional Stress Counsellor in charge for the West Africa region and DPKO Missions. Dr. Ba holds a M.D. from Cheikh Anta Diop University (Dakar Senegal), a Ph.D. in Psychiatry and Behavioral Sciences (Dakar University and Paris V France) and a Master’s degree in international health (Track Epidemiology in Complex Emergency Settings) from Tulane University (New Orleans, USA). Dr. Ba also holds the UK National Certification on Hostage Negotiation from the Scotland Yard Metropolitan Police Training Center in Hendon, UK.He has worked as an associate professor of psychiatry and behavioral sciences at the Cheick Anta Diop University of Dakar and cumulatively head of a Psychiatric Division at the Fann University Hospital Centre of Dakar for 15 years. He coordinated the Inter-University degree in Cognitive and Behavioral Therapy (between Paris V and Dakar University) and was also an Adjunct Professor of Disaster Mental Health in the inter-university linkage Dakar-Tulane (New Orleans)- and Morehouse (Atlanta). From 1988-1989 Moussa Ba worked as the Director of the Medical Research Department at the Ministry of Cooperation and Scientific Research in Senegal. From 1989-1994, he was appointed as the Advisor of the Minister of Children, Women Family in charge for all the cross sectoral coordination of all technical and administrative issues related to children and families nationwide. Dr. Ba is one of the 10 Experts of the task force that was hired by the UN Department of Social Affairs to design the World Plan of Action for Disabled People for the years 2000 and beyond (1992). In that committee he was the President of the Group in charge for Prevention. He received an award from President Chirac then Mayor of Paris for his work on Improving Mental Health at the International level (1994) and from President Clinton (1996) for his leadership on Improving Quality of Life in Africa.
Plenary Address: “Caring for the Caregivers in Challenging Situations– Lessons Learned from the United Nations”
Friday 10 February 0830-0900
Plenary Session Co-Chairs: César A. Alfonso and Aimee Nasser Karam
Abstract to follow
Driss Moussaoui, M.D. (Morocco)
Driss Moussaoui is Professor Emeritus at Faculty of Medicine in Casablanca, Morocco. He was the founder and Chair of the Ibn Rushd University Psychiatric Centre in Casablanca from 1979 to 2013. He was also Director of the Casablanca WHO Collaborating Centre in Mental Health from 1992 to 2013. Prof. Moussaoui was President of the Moroccan Society of Psychiatry and of the Arab Federation of Psychiatrists. He has edited or co-edited 12 books and published more than 200 papers in international journals. Prof. Moussaoui founded with the World Psychiatric Association (WPA) Executive Committee the Jean Delay Prize (1999). He is the scientific director of the WPA series « International Anthologies of Classic Psychiatric Texts » (French, German, Spanish, Italian, Greek and Russian, in press). Driss Moussaoui is Past President of the World Association of Social Psychiatry (WASP, 2010-2013) and member of the French Academy of Medicine. He is a WPA and WASP Honorary Member, and currently President of the International Federation for Psychotherapy (2018-2023).
Plenary Address: “Access to Psychotherapy: For a Better Mental Health in the 21st Century”
Friday 10 February 0900-0930
Plenary Session Co-Chairs: Aimee Nasser Karam and César A. Alfonso
Mental disorders are among the heaviest burdens on individuals and societies, all medical specialties included. Treatment of mental disorders necessitates for health workers a good relationship, an improvement of the environment of the patient, a psychotropic medication and/or a psychotherapy. The negative consequences of non-treatment are bad for the patient, for the family and for the society at large, from the human and from the economic points of view. Access to care for mental disorders remains scarce everywhere in the world, including in rich countries. Half of the people with schizophrenia receive no treatment in the USA and half of the people with depression in France are not even diagnosed. In some countries of Sub-Saharan Africa, Asia or Latin America, there is less than one psychiatrist for a million inhabitants. In such environments, access to mental health care in general and to psychotherapy in particular, are an inaccessible dream. During the past three years, International Federation for Psychotherapy launched a pilot project in Morocco on ‘Psychological Help in Rural Areas’. The results of this study will be presented, as well as experiences in various countries to overcome poor access to Psychotherapy.
Dinesh Bhugra (UK)
Dinesh Kumar Makhan Lal Bhugra CBE is a professor of mental health and diversity at the Institute of Psychiatry at King’s College London. He is an honorary consultant psychiatrist at the South London and Maudsley NHS Foundation Trust and is former president of the Royal College of Psychiatrists. He has been president of the World Psychiatric Association[ and the British Medical Association. He is a well-known commentator on mental health issues. He has contributed to The Guardian, The Daily Telegraph, The Times (UK), the Financial Times, The Observer, The Huffington Post, the BBC News Magazine, The Times of India, and The New York Times. His research interests include topics across social and public health psychiatry: cross-cultural psychiatry, migrant mental health, professionalism in psychiatry, depression, psychosexual medicine, service provision and decision-making. He has become an important authority on these issues, having published over 180 papers in peer-reviewed journals, 100 editorials and invited papers, 90 book chapters and authored or edited 30 books.
Plenary Address: The psychology of institutions
Friday 10 February 0930-1000
Plenary Session Co-Chairs: Aimee Nasser Karam and César A. Alfonso
Abstract to follow
Ulrich Schnyder, M.D. (Switzerland)
Ulrich Schnyder, M.D., is a psychiatrist and licensed psychotherapist. He is emeritus professor of psychiatry and psychotherapy at University of Zurich, Switzerland. Until 2018, he was head of the Department of Psychiatry and Psychotherapy at the University Hospital Zurich. His scientific activities are focused on various aspects of traumatic stress research, including epidemiology, neurobiology, psychotherapy and pharmacotherapy for PTSD, resilience to stress, and, more recently, refugee mental health, and the emotional, psychosocial and physical consequences of child maltreatment. Past President of the European Society for Traumatic Stress Studies (ESTSS), the International Federation for Psychotherapy (IFP), and the International Society for Traumatic Stress Studies (ISTSS). In 2013, he received the ESTSS Wolter de Loos Award for Distinguished Contribution to Psychotraumatology in Europe, and in 2016 the ISTSS Lifetime Achievement Award. Honorary Member, International Federation for Psychotherapy (IFP).
Plenary Address: “Evidence-based Psychotherapies for PTSD: Differences, Commonalities, and Future Directions”
Friday 10 February 1000-1030
Plenary Session Co-Chairs: César A. Alfonso and Aimee Nasser Karam
This lecture gives an overview of the currently available empirically supported psychotherapies for PTSD. They each have their specific characteristics, but they also have a lot in common. In fact, the commonalities outweigh the differences by far: (1) Psychoeducation offers information on the nature and course of posttraumatic stress reactions, identifies ways to cope with trauma reminders, and discusses strategies to manage distress. (2) Emotion regulation and coping skills are frequently taught and trained in the beginning or first stages of treatment. This may also be seen as a treatment element that aims at promoting trauma survivors’ resilience. (3) Some form of imaginal exposure to the patients’ memory of their traumatic experiences can be found in virtually all evidence-based psychotherapies for trauma-related disorders. (4) Cognitive processing, restructuring and/or meaning making is another common element. (5) Emotions are targeted in all psychotherapies. Some predominantly tackle the patients’ fear network, others focus more on guilt and shame, anger, or grief and sadness. (6) Memory processes also play an important role in treating trauma-related disorders. The reorganization of memory functions and the creation of a coherent trauma narrative appear to be central goals of all trauma-focused treatments. Promising future developments may include, e.g., the combination of treatments to address comorbidities, “mini-interventions” for specific problems trans-diagnostically, and treatment elements aimed at enhancing resilience, such as mindfulness-based approaches. Furthermore, psychotherapists working with trauma survivors should develop their culture sensitivity.
Nadia Kadri (Morocco)
Nadia Kadri is a psychiatrist, cognitive-behavioural psychotherapist, and sexologist. She is also a Professor of Psychiatry at the Faculty of Medicine and Pharmacy at Hassan II University and head of teaching in medical psychology at the Ibn Rochd University Center in Casablanca. She is the coordinator of the university diploma in sexual health. Professor Kadri heads the IMTCC (Moroccan Institute of Behavioral and Cognitive Therapies) in Casablanca. She is the author of multiple peer-reviewed scientific articles and the following books: “Self-affirmation and mental health” (Le Fennec editions), “Sexual education manual” (Le Fennec editions), “Self-esteem” (Le Fennec editions), “Guide to the anxious” (Le Fennec editions).
Plenary Address: Aspects transculturels des therapies cognitives et comportementales
(N.B. This plenary address will be delivered in French)
Friday 10 February 1100-1130
Plenary Session Co-Chairs: Driss Moussaoui and Hachem Tyal
UNESCO has defined culture as the “set of distinctive spiritual, material, intellectual, and emotional features of society or a social group, and that it encompasses, in addition to art and literature, lifestyles, ways of living together, value systems, traditions and beliefs.”
In our daily clinical practice of psychotherapy, we notice that:
- patients from different cultures are sometimes closer by their personal specificities than patients from the same culture.
- the therapeutic relationship between patient and therapist transcends cultural specificities.
- the biological and psychological fundamentals transcend cultural particularities.
This presentation will address the following topics:
1. The components and specificities of Moroccan culture with clinical implications impacting healthcare delivery. Studies conducted in the field will be shared to illustrate these complexities.
2. CBT as an empirical, experimental model developed in Western countries and implemented throughout the world. This raises the following questions, especially in the non-Western world:
– What cultural factors require modification of techniques of CBT?
– What are the transcultural fundamental aspects of CBT?
– How do we integrate cultural factors in CBT?
3. To begin to formulate answers to these questions, I will present the results of a study carried out over consecutive years examining the CBT practice patterns of Moroccan psychotherapists.
Fiammetta Cosci, M.D., Ph.D. (Italy)
Prof. Dr. Fiammetta Cosci is Associate Professor in Clinical Psychology at the University of Florence, Italy, and Guest Associate Professor at the Department of Psychiatry & Neuropsychology, Maastricht University, the Netherlands. She is Editor in Chief of Psychotherapy and Psychosomatics (2021 IF: 25.617), the official journal of the International Federation for Psychotherapy. She is also Secretary General of the International Federation for Psychotherapy, Board Member of the European Association in Psychosomatic Medicine, and Co-opted Board Member of the International College of Psychosomatic Medicine. She received the EPA Research Prize, the Global Research Award for Nicotine Dependence, and the Y-Mind Center for Prevention of Mental Disorders Award. She published more than 110 papers in Web of Science international journals.
Plenary Address: “How to publish research and clinical articles on psychotherapy in high impact factor international journals”
Friday 10 February 1130-1200
Plenary Session Co-Chairs: Hachem Tyal and Driss Moussaoui
There is a growing need of enlarging the current knowledge in psychotherapy based on published clinical research in high impact factor international journals. The present intervention will overview the steps of the editorial process used in international journals publishing on psychotherapy articles and will give advice on how to select the proper journal and nicely prepare a manuscript. We expect that at the end of the intervention, participants are more familiar with the editorial process and with the steps to be followed. Psychotherapy must reach the scientific channel of communication to give a clinically useful contribution in research and in practice.
Tobias Krieger, Ph.D. (Switzerland)
Tobias Krieger (*1981) completed his master’s degree in Psychology 2009 at the University of Bern, Switzerland. In 2013, he received his PhD from the University of Zurich, and, in 2020, he received the ‘venia docendi’ (Habilitation) from the Faculty of Human Sciences of the University of Bern. He is a trained and licensed psychotherapist in cognitive behavioral therapy with an interpersonal focus. As a practitioner he has worked with patients in various institutions. His research focuses on psychotherapy process and outcome research, internet-based interventions, depression treatment, and transdiagnostic factors. He is a consortium member of the Horizon 2020 ICare project, which focused on prevention of mental disorders via online interventions, and the European FP7 project E-COMPARED with a focus on blended treatment for depression. Currently, he works as a research group leader at the department of clinical psychology and psychotherapy at the University of Bern, and as a senior psychotherapist and clinical supervisor at the outpatient clinic of the University of Bern. His main research focus is on chronic loneliness with the support of a grant from the Swiss National Science Foundation (SNSF). He has (co-)authored nearly 100 research papers and book chapters and has recently co-authored a book on the psychotherapeutic treatment of loneliness.
Plenary Address: “Loneliness: the rediscovery of a relevant clinical phenomenon”
IFP Research Award
Friday 10 February 1200-1230
Plenary Session Chair: Chiara Rafanelli
Loneliness is a common phenomenon in the general population and clinical practice. It is a thoroughly subjective feeling that does not need to be correlated with social isolation: Some people can be alone without feeling lonely. In contrast, others feel lonely despite being among people. The ability to feel lonely may be an inherent part of being human and can be adaptive in order to take actions to improve existing or to create new relationships. However, chronic forms of loneliness are debilitating conditions. Many studies show that chronic loneliness is associated with various mental and physical health outcomes. Despite this knowledge, evidence-based interventions to effectively alleviate loneliness are still scarce. In addition, loneliness is highly stigmatized. Thus, low threshold scalable interventions that effectively address loneliness are needed. The present talk gives an overview of theoretical aspects of loneliness and the efficacy of existing interventions. Finally, preliminary results of a large three-arm randomized-controlled trial testing the efficacy of an internet-based self-help intervention for people suffering from loneliness are presented. These findings will then be discussed regarding their implications.
Jalil Bennani, M.D. (Morocco)
Jalil Bennani, M.D., is a psychiatrist and a psychoanalyst in Rabat, Morocco. He has written a number of books, notably: ‘The suspect body’ (Le corps suspect, 1980), ‘Psychoanalysis in Islamic territory’ (Psychanalyse en terre d’islam, 2008), ‘A psychoanalyst in the city’ (Un psychanalyste dans la cité, 2013, Grand Atlas Prize), ‘A such long journey’ (Un si long chemin – Paroles de réfugiés au Maroc, 2016), ‘From jinn to psychoanalysis’ (Des djinns à la psychanalyse, 2022). Jalil Bennani is an associate researcher in the CRPMS of the Paris University. He is entitled to lead research studies at the Nice University (Université de Nice Sophia Antipolis). He received in 2002 the «Sigmund Freud Prize of the City of Vienna» for significant contributions to the field of Psychoanalysis.
(N.B. This plenary address will be delivered in French)
Plenary Address: “For a New Approach of Traditional and Modern Practices”
Saturday 11 February 0800-0830
Plenary Session Co-Chairs: Ulrich Schnyder and Franz Caspar
Traditional practices are often at the crossroads of the comings and goings from one culture to another, from one language to another. We must take into account the movement of subjects and their symptoms, their desire to leave and retrieve. How can one integrate the non-Western knowledge with that of psychiatry and psychoanalysis? What is the epistemological break that takes place in theory? What are the effects on psychotherapeutic practices? I will address in this lecture the articulation of the discourse on beliefs to that on science, through the patient’s words, taken in its cultural diversity and its decentering.
Tom Jamieson- Craig, M.D., Ph.D., FRCPsych. (UK)
Tom Jamieson- Craig is Professor Emeritus of Social Psychiatry at the Institute of Psychiatry, Psychology and Neuroscience, King’s College, London. He qualified in medicine at the University of the West Indies in 1973 and trained in psychiatry in Nottingham UK. He was appointed as the first professor of Community Psychiatry in the UK in 1990 with clinical bases at St Thomas’ Hospital and later with the South London and Maudsley NHS Trust. His research closely followed his clinical interests including the evaluation of residential alternatives to the hospital asylum, controlled trials of early intervention services for first episode psychosis and in that role led several initiatives including the closure and community reprovision of a large hospital asylum, the introduction of early implementations of community mental health services including the implementation and evaluation of pan-London outreach for mentally ill homeless people, psychological interventions for ‘dual diagnosis’ and more latterly the use of digital (computer) enhancements to psychological therapies for psychosis He has published more than 300 papers in peer reviewed journals and book chapters. He is a past president of the World Association of Social Psychiatry (WASP, 2013-2016), Fellow of the European Society of Social Psychiatry and hon. Fellow of the WPA. He also served on several national health programmes including the MHRN research lead for the southeast of England, the mental health lead for the National Clinical Advisory service and with the Health Policy Commission.
Plenary Address: “A therapist in your pocket? A role for digital technology in the delivery of psychological therapies”
Saturday 11 February 0830-0930
Plenary Session Co-Chairs: Ulrich Schnyder and Franz Caspar
Achieving sustained benefits from a psychological treatment depends on at least 3 things. First, access to a therapist, second that the therapy is provided with suitable competence and third that benefits are realised outside of the therapy room. For common mental disorders of depression and anxiety, the Improving Access to Psychological Therapies (IAPT) in the UK is a good example of upscaling therapy delivery with some 10,000 therapists seeing around 1 million people each year but with continuing concern about the longevity of benefit beyond the clinic. For those with psychotic conditions, achievements are more modest, reflecting in part greater skepticism about the efficacy of talking treatments for these conditions and even where a good evidence base exists, a shortage of specialised therapists to competently deliver the treatment. There is growing interest in the use of new ‘digital’ technologies to address some of the shortfall. These include self-help smart phone applications to treat specific symptoms as for example treatments of insomnia or ‘in vivo’ treatment for paranoid symptoms and the use of virtual reality as an adjunct to aspects of therapy delivery as in the replication of therapist-accompanied exposure to threatening environments or in an adaptation of relational therapies for hallucinated ‘voices’. Much of this work is still experimental and will face considerable challenges upscaling to routine health care, but some are already achieving this upscaling and with more mobile phones in use worldwide today than there are toothbrushes the expansion of these novel therapies is certain to follow.
Etheldreda Nakimuli-Mpungu, M.D., Ph.D. (Uganda)
Etheldreda Nakimuli-Mpungu M.D., Ph.D., an Associate Professor of Psychiatry at Makerere University in Uganda, works toward making psychotherapy more culturally appropriate, particularly for people living with HIV and depression. She has developed a highly cost-effective group support psychotherapy program that can be delivered by lay health workers and which has been shown to dramatically reduce depression symptoms and improve anti-viral medication adherence and viral suppression in those affected. Her research earned her the 2016 Elsevier Foundation Award, and a Presidential National Independence Medal of Honor on 8 March 2016 – International Women’s Day. Recently, she was listed among the BBC 100 most inspiring and influential Women in 2020. Dr. Nakimuli-Mpungu completed her medical degree, and Master of Medicine in Psychiatry at Makerere University in 1998 and 2006 respectively. In 2012, she attained a doctoral degree in psychiatric epidemiology from Johns Hopkins University, USA. Her work has been published in the Lancet HIV and Lancet Global Health. Dr Nakimuli-Mpungi has received funding from MQ: Transforming Mental Health, Grand Challenges Canada, the United Nations Programme on HIV/AIDS, United States Agency for International Development (Development Innovation Ventures), and the Child Relief International Foundation.
Plenary Session: Long-term Effect of Group Supportive Psychotherapy in Uganda on Depression and HIV Treatment Outcomes
Saturday February 11 0900-0930
Plenary Session Co-Chairs: Ulrich Schnyder and Franz Caspar
The presenter will describe a study that examined the effect of supportive group psychotherapy compared to group psychoeducation on depression and HIV treatment outcomes. Her team investigated the mediating role of depression and anti-retroviral therapy adherence in the relationship between supportive group psychotherapy and viral load suppression. Patients from thirty HIV clinics across three districts in Uganda were randomly assigned to receive either group psychotherapy or psychoeducation for depression. Depression, optimal (≥95%) ART adherence, and HIV viral loads were assessed at baseline, 6-, 12-, 18-, and 24-months post-treatment. Multilevel mixed effects regression models and generalized structural equation modeling were used to estimate outcomes and mediation effects. 1140 people living with HIV entered the study. 578 (51%) received supportive group psychotherapy and 562 (49%) received psychoeducation. Fewer group psychotherapy than psychoeducation participants met criteria for depression at 24 months post treatment [1% versus 25%; adjusted odds ratio (aOR) =0·002, 95% CI 0·0002-0·018]. More group psychotherapy than psychoeducation participants reported optimal (≥95%) ART adherence [96% versus 88%; aOR =20.88, 95% CI 5.78- 75.33] and improved viral suppression [96% versus 88%; aOR =3.38, 95% CI 1.02- 11.02]. The indirect effects of supportive group psychotherapy through sequential reduction in depression and improvement in HIV medication adherence at 12 months may partially explain the higher viral suppression rates at 24 months. In settings where the HIV epidemic persists, depression treatment with group supportive group psychotherapy may be critical for optimal HIV treatment outcomes.
Aimee Nasser Karam, Ph. D. (Lebanon)
Dr. Aimee Nasser Karam received her Ph.D. in Clinical Psychology from St. Joseph University in Beirut, Lebanon. She completed her training in Cognitive Behavioral Therapy at the Beck Institute for Cognitive and Behavioral Therapy in Pennsylvania, (USA) and has a Postgraduate Diploma in Advanced Cognitive Therapy Studies from the Oxford Cognitive Therapy Center, Oxford University (UK). She is a certified Diplomat in Cognitive Behavioral Therapy and a member of the Academy for Cognitive Therapy. She is the first specialist in the field of cognitive and behavioral therapy (CBT) in Lebanon (practice, teaching, and supervision). Dr. Karam is Head of Clinical Psychology at the Medical Institute for Neuropsychological Disorders (MIND) in the Department of Psychiatry and Clinical Psychology at St George Hospital University Medical Center in Beirut. She is a founding member of the Institute for Development, Research and Applied Care, a non-profit, non-governmental organization dedicated to mental health, research, community service and education in Lebanon and the Arab World. She is a Professor at Balamand University, school of Medicine and author of several publications. She served as President of the Lebanese Psychological Association from 2017-2019. Dr Karam has participated in international conferences and seminars in the field of clinical psychology and has represented Lebanon in conferences and seminars on Cognitive Behavioral Therapy and practicing it as a first line psychological treatment. Dr. Karam founded the Lebanese Association for Behavioral and Cognitive Therapy, the first associate member of the European Association for Behavioral and Cognitive Therapy (EABCT).
Plenary Address: Becoming a More Effective Therapist, Understanding and Targeting the Cognitive Vulnerability of Depression
Saturday 11 February 0930-1000
Plenary Session Co-Chairs: Ulrich Schnyder and Franz Caspar
Several components of vulnerability for depression have been proposed during recent years and have attracted empirical attention. Increased levels of rumination, maladaptive schema, negative attributional style, impaired self-perception, among other indicators may place individuals at risk for major depression. Although evidence supporting each of these models has emerged, conceptual challenges remain, and no single model is enough to embrace all aspects of vulnerability to depression.
Using empirical findings on the process and outcomes of CBT for Depression will help getting the specifics and the most out of effective interventions in the cognitive work and their long-term impact. Targeting the key factors that account for achieving change and maintaining the therapeutic gains for depression on the short and long term will be discussed, in particular how to do it, conceptually and skillfully.
Gisele Apter , M.D. (France)
Professor Gisèle Apter is both a Child and Adolescent and Perinatal Psychiatrist. She is Professor of Child Psychiatry at University Rouen Normandy and directs Child Psychiatry at Le Havre Hospital in Normandy as well as a Research Unit in Perinatal and Infant Psychiatry and Psychopathology She is currently the President of SIP: Société de l’Information Psychiatrique, which is the Society of Public Psychiatrists in France. After having been the Founding Chair of the World Psychiatric Association (WPA) Section on Perinatal and Infant Mental Health, she is now the WPA Western Europe Zonal Representative. She is particularly interested in the perinatal period and infancy, the impact of parental mental disorders on pregnancy and newborns and has extensively published in this field.
Plenary Address: Psychotherapy in Perinatal and Child Psychiatry: An Inescapable Necessity?
Saturday 11 February 1030-1100
Plenary Session Co-Chairs: Dilip Jeste and François Ferrero
Infant and Child psychiatry have yet to be considered as major subjects in psychiatry and in mental health. It is now well known that the majority of severe mental illnesses start before the age of 25 and more than half in childhood and adolescence. In addition, history of abuse and neglect in early childhood pave the way for adverse mental health. However, acknowledgement has been rare. Furthermore, major public health policies especially in countries where most of the planet’s children are born are even rarer. Even if we still need to know more on how mental illness will unfold, we should be advocating for more prevention and care. Therefore, focus on early intervention in childhood should be first and foremost on our agenda. Up until recently it was surmised that psychotherapy “cost” more and was more difficult to implement than treatment of full-blown episodes requiring state of the art care (such as hospitalization and pharmacotherapeutic treatment). However, this is a myth. Secondary and tertiary care are more difficult to implement and costly than generic psychotherapeutic treatments and should only concern a smaller fraction of the population. Training for manualized interactive and or psychoeducational interventions and therapy are cost-effective. And they can be implemented locally, in a culturally and sociologically sensitive manner. In young children and in wide public health settings, psychotherapeutic education and generic knowledge of psychotherapeutic non-stigmatizing supportive interactive care during the peripartum and childhood is an opportunity that should be considered too good to turn down.
Vincenzo Di Nicola, M.Phil., M.D., Ph.D., F.R.C.P.C., F.C.A.H.S. (Canada)
Vincenzo Di Nicola is an interdisciplinary scholar who trained as a psychologist, child psychiatrist, psychotherapist, and philosopher. Di Nicola practices and teaches in Montreal, Quebec, and consults internationally in the areas of child and family psychiatry, trauma, and social and cultural psychiatry. Di Nicola’s appointments include Tenured Professor of Psychiatry, University of Montreal, Canada; Clinical Professor of Psychiatry, George Washington University, USA; Honorary Professor of Psychology & Law, FADOM, Brazil; Honorary Chair & Professor of Social Psychiatry, Milan School of Medicine, Ambrosiana University, Italy. He is Founder & President, Canadian Association of Social Psychiatry, and President-Elect, World Association of Social Psychiatry. Di Nicola is Co-Founder & Past Chair, American Psychiatric Association Caucus on Global Mental Health & Psychiatry; Co-Founder & Co-Chair, APA Caucus on Medical Humanities in Psychiatry; and Past President, APA Quebec & Eastern Canada District Branch. Di Nicola’s recent international fellowships and awards include APA’s Distinguished Service Award; Distinguished International Member, Bulgarian Association of Sciences & Arts; Distinguished Fellow, American and Canadian Psychiatric Associations; Psychiatric Fellow, American Academy of Psychodynamic Psychiatry & Psychoanalysis; and Fellow, Canadian Academy of Health Sciences. His research ranges from behavioural psychology to child psychopharmacology and psychiatric epidemiology, focused on children’s eating and mood disorders, migrant families, and trauma. His most recent volume with Drozdstoj Stoyanov is Psychiatry in Crisis: At the Crossroads of Social Sciences, the Humanities, and Neuroscience (2021).
Plenary Address: “Take Your Time: Seven Lessons for Young Therapists”
Saturday 11 February 1100-1130
Plenary Session Co-Chairs: Dilip Jeste and François Ferrero
In these seven lessons for young therapists, a practising psychiatrist and psychotherapist with more than 40 years’ experience surveys what therapy is about and how it works, from behaviour therapy and family therapy to psychodynamic psychotherapy. Ranging from what to read and how to begin therapy, the lessons cover therapeutic temperaments and technique, the myth of independence and individual psychology, the nature of change, the evolution of therapy, the search for meaning and relational ethics, and finally, when therapy is over.
- People come into therapy in order not to change – When does therapy begin?
- Therapeutic temperaments – Who conducts therapy and why?
- The family as a unique culture – Relational psychology and relational therapy.
- Changing the subject – How does therapy work?
- One hundred years of invisibility – The evolution of therapy from the 19th-century era of the symptom through the 20th-century era of therapy to the 21st-century era of change.
- Making meaning – Making sense, technique, and doing good: Relational ethics.
- “And on the seventh day, the Lord rested …” – When therapy is over: The myth of closure, flow, and slowness in therapy.
This plenary address integrates the author’s model of working with families across cultures presented in A Stranger in the Family: Families, Culture, and Therapy (Norton, 1997) and elaborated in his Letters to a Young Therapist (Atropos, 2011) with his more recent work on trauma in Trauma and Transcendence (Fordham, 2018), and “Take Your Time,” his Slow thought manifesto (Aeon, 2019).
César A. Alfonso, M.D. (USA)
César A. Alfonso, M.D., is Clinical Professor of Psychiatry at Columbia University, Adjunct Professor at the University of Indonesia, and Visiting Professor at the National University of Malaysia and at Prince of Songkla University in Thailand. Born in Cuba in 1961, he spent formative years in Spain and Puerto Rico before pursuing undergraduate studies at Yale University, and graduate and postgraduate studies in medicine, psychiatry, psychosomatic medicine, and psychoanalysis in New York. Dr. Alfonso served as President of the American Academy of Psychodynamic Psychiatry and Psychoanalysis (AAPDPP) in 2010-2012, as Chair of the Psychotherapy Section of the World Psychiatric Association for six years and presently serves on the Council of the International Federation for Psychotherapy. His recent work includes the study of the psychodynamic determinants of treatment adherence, biopsychosocial and cultural aspects of suicide, the clinical care of visually impaired persons, and the design and implementation of psychotherapy training programs worldwide. Dr. Alfonso is a Distinguished Fellow of the American Psychiatric Association and a Fellow of the New York Academy of Medicine, the Academy of Consultation-Liaison Psychiatry, and of the AAPDPP. He has over 100 publications, including three books with Guilford Press and Springer Nature. Dr. Alfonso practices in New York and is Chief Psychiatrist at the Lighthouse Guild Clinic. He is Editor in Chief of Psychodynamic Psychiatry.
Plenary Address: “Childhood Adversity, Epigenetics, and Psychotherapy as a Biological Treatment”
Saturday 11 February 1130-1200
Plenary Session Co-Chairs: Dilip Jeste and François Ferrero
Psychotherapy results in improved mentalization and reflective functioning, effective adaptation, and symptomatic reduction. It results in increased levels of functioning at work, within the family unit, and in social settings. Psychotherapy not only alters brain chemistry and function, but also effects change at the level of the DNA. Understanding gene-environment interactions is relevant to clinical practice of psychotherapy. Traumatic events, in particular during the sensitive periods of brain development in early childhood and adolescence, may trigger enduring epigenetic changes. The speaker will review how epigenetics may be an important underlying mechanism for the pathogenesis of mental disorders. Epigenetic mechanisms that have been widely studied include DNA methylation, histone modifications and non-coding RNA interference and silencing. Professor Alfonso will summarize data showing that psychosocial interventions, including brief psychotherapy interventions, may reverse epigenetic changes associated with major depression, PTSD and stressor related disorders, decreasing suicide risk and improving overall health and quality of life. Psychotherapy, thus, could be conceptualized as an effective biological treatment.
