Plenary Sessions; International Federation for Psychotherapy
23rd World Congress of Psychotherapy; 9-11 February 2023; Casablanca, Morocco
Norman Sartorius, M.D., Ph.D., F.R.C.Psych.
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.
Psychotherapy and Public Health
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.
Driss Moussaoui, M.D.
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).
Access to psychotherapy: For a better mental health in the 21st century
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.
Tom Jamieson- Craig, M.D., Ph.D., FRCPsych.
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.
A therapist in your pocket? A role for digital technology in the delivery of psychological therapies
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.
César A. Alfonso, M.D.
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. 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.
Childhood adversity, epigenetics, and psychotherapy as a biological treatment
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.
Jalil Bennani, M.D.
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.
For a new approach of traditional and modern practices
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.
Ulrich Schnyder, M.D.
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).
Evidence-based psychotherapies for PTSD: Differences, commonalities, and future directions
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.
Moussa Ba (Senegal)
Helping the helpers in disaster situations
Afzal Javed (Pakistan)
Martin Bohus (Germany)
Vincenzo di Nicola (Canada)
Mark van Ommeren (Switzerland)