Interpersonal Therapy (IPT)

Interpersonal therapists focus on the patient's disturbed personal relationships that both cause and exacerbate (or increase) the depression.

Interpersonal Psychotherapy (IPT) is one of the short term therapies that have been proven to be effective for the treatment of depression. Short term psychotherapy usually involves up to 20 sessions (usually weekly meetings, 1 hour per session) and maintains a focus on 1-2 key issues that seem to be most closely related to the depression.

Interpersonal psychotherapy

The treatment is highly structured. The number and content of treatment sessions are planned carefully. The initial assessment period lasts 1 to 2 sessions. Interpersonal problems are considered under 4 heading:

bereavement and other loss
role disputes
role transitions
interpersonal deficits such as loneliness

Problems are considered by reference to specific situations and alternative ways of coping are evaluated. Clear goals are set and progress towards them is monitored. New coping strategies are tried out in homework assignments.

Fairburn (1997) described IPT like this: "Interpersonal Psychotherapy (IPT) is a short term focal psychotherapy in which the goal is to help patients identify and modify current interpersonal problems. It was developed in the late 1960s as a treatment for clinical depression, the premise being that since interpersonal difficulties contribute to the onset and maintenance of depression, their resolution is likely to hasten recovery".

It's based on the idea that depression is often linked to things like a fight with your partner or a problem with a workmate. Sometimes the event triggers your depression. But sometimes the depression comes first, and your mood makes fights or work problems more likely. Either way, during interpersonal therapy, your therapist encourages you to learn new and better ways of relating to people.

In trials at Oxford University IPT has been found to be an effective short term alternative to CBT (Cognitive Behavioural Therapy) in Bulimia. IPT for Bulimia such as that practised in the Oxford trials is similar to IPT for depression: it is a non interpretative, non prescriptive therapy, and works through a number of phases.

In the first phase of IPT, the therapist and client identify which problems in the clients interpersonal relationships need exploration. This phase is led by the therapist, who builds a "history" of the client in order to help the client identify interpersonal problems. The next phase is driven by the client; the therapist helps maintain focus and encourages change. Finally, in the last phase, both the therapist and client explore what has been achieved and what has not, and focus on the future and what changes the client can make to promote continuing improvement.

Although IPT is a programmed treatment, it is flexible enough to address patients' individual problems and situations. Treatment begins by taking a history of the problem. The therapist then suggests which of the four problem areas is most relevant and then asks the patient what he or she wishes to accomplish. Since IPT is time-limited (usually only 16 session long), Ms. Clougherty emphasized working on no more than two problems.

The IPT therapist begins each session by asking, "how have you been since our last visit?" Patients usually answer by describing recent dysphoric moods or recent upsetting events. The therapist attempts to link moods to recent events in the problem area.

One very interesting point about IPT is that this model works from the assumption that patients suffer from chronic (mental) illness. At the beginning of treatment, the therapist may tell a patient he or she is too "sick" to accomplish certain tasks, although later the therapist will strongly encourage the patient to take on the same or other tasks.

Since depression is a recurrent illness, it is recommended that successful short term treatment be combined with ongoing, maintenance therapy. Maintenance IPT (IPT-M) can be administered once per month following termination of the short term phase. Preliminary results from ongoing studies suggest that IPT-M may prolong time to recurrence of depression.