Interpersonal Psychotherapy

Interpersonal Psychotherapy (IPT) is a time-limited psychotherapy that focuses on the interpersonal context and on building interpersonal skills. IPT is based on the belief that interpersonal factors may contribute heavily to psychological problems. It is commonly distinguished from other forms of therapy in its emphasis on interpersonal processes rather than intra-psychic processes. IPT aims to change the person's interpersonal behavior by fostering adaptation to current interpersonal roles and situations. IPT is one of the short term therapies that have been proven to be effective for the treatment of depression. Short term usually involves up to 20 sessions and maintains a focus on 1-2 key issues that seem to be most closely related to the depression.

The main idea of this therapy is to look at the social functioning in one of 4 possible areas of life:

» Interpersonal Disputes = conflicts
» Role transitions = marked changes in life
» Grief (e.g. loss of a loved person)
» Interpersonal deficits

Interpersonal psychotherapy offers two possible treatment plans for persons with depressive symptoms. The first plan treats the acute episode of depression by getting rid of the current depressive symptoms. This approach requires intervening while the person is in the midst of a depression. The acute phase of treatment typically lasts two to four months with weekly sessions. Many clients terminate treatment at that point, after their symptoms have subsided. Maintenance treatment is the second treatment plan and is much less commonly utilized than acute treatment. This is a longer-term therapy based on the principles of interpersonal therapy but with the aim of preventing and reducing the frequency of depressive symptoms in the future. Clients who engage in both phases may be in therapy for at least two years.

Interpersonal therapy is a descendant of psychodynamic therapy, itself derived from psychoanalysis, with its emphasis on the unconscious and childhood experiences. Symptoms and personal difficulties are regarded as arising from deep, unresolved personality or character problems. Psychodynamic psychotherapy is a long-term method of treatment, with in-depth exploration of past family relationships as they were perceived during the client's infancy, childhood, and adolescence.

There are seven types of interventions that are commonly used in IPT, many of which reflect the influence of psychodynamic psychotherapy: a focus on clients' emotions; an exploration of clients' resistance to treatment; discussion of patterns in clients' relationships and experiences; taking a detailed past history; an emphasis on clients' current interpersonal experiences; exploration of the therapist/client relationship; and the identification of clients' wishes and fantasies. IPT is, however, distinctive for its brevity and its treatment focus. IPT emphasizes the ways in which a person's current relationships and social context cause or maintain symptoms rather than exploring the deep-seated sources of the symptoms. Its goals are rapid symptom reduction and improved social adjustment. A frequent byproduct of IPT treatment is more satisfying relationships in the present.

IPT has the following goals in the treatment of depression: to diagnose depression explicitly; to educate the client about depression, its causes, and the various treatments available for it; to identify the interpersonal context of depression as it relates to symptom development; and to develop strategies for the client to follow in coping with the depression. Because interpersonal therapy is a short-term approach, the therapist addresses only one or two problem areas in the client's current functioning. In the early sessions, the therapist and client determine which areas would be most helpful in reducing the client's symptoms.

The remaining sessions are then organized toward resolving these agreed-upon problem areas. This time-limited framework distinguishes IPT from therapies that are open-ended in their exploration. The targeted approach of IPT has demonstrated rapid improvement for patients with problems ranging from mild situational depression to severe depression with a recent history of suicide attempts. Thus, it can truly be said that Interpersonal Psychotherapy has a good evidence-base for the effective treatment of depression.