Interpersonal Psychotherapy (IPT)
Interpersonal Psychotherapy (IPT) is a time-limited, diagnosis-targeted, well studied, manualized treatment for major depression and other psychiatric disorders. Therapists help patients to solve an interpersonal crisis as a way of both improving their lives and relieving their symptoms. IPT helps patients to understand their emotions as social signals, to use this understanding to improve interpersonal situations, and to mobilize social supports. Its success in a series of research studies has led to its inclusion in numerous national and international treatment guidelines.
IPT typically is scheduled as a 12-16 week, once weekly therapy for acute major depression. It has demonstrated efficacy as an acute and as a maintenance treatment for major depression, and for patients from adolescence to old age; with adaptation, as an adjunct to medication for bipolar disorder; for bulimia and binge-eating disorders; and, with less research support, for posttraumatic stress disorder (PTSD) and anxiety disorders.
IPT uses the medical model as a conceptual framework for patients’ mood symptoms. In the context of initiating IPT, the therapist conducts a psychiatric history and diagnoses a current episode of major depression according to DSM 5 criteria. The IPT therapist likens the depressive episode to other medical illnesses (“no different than asthma or diabetes or pneumonia”) and further explains that the patient has an inherited, biologic vulnerability to depression. Using the medical model as a framework, the IPT therapist stresses that it is not the patient’s “fault” for developing depression–any more than it is someone’s “fault” for developing pneumonia. Using a stress-diathesis model to explain the interaction between biological vulnerability and stressful life events, IPT further posits (and makes explicit to patients) that although individuals are not to blame for their illness, they are in an excellent position to help themselves recover from depression by attending to the interpersonal factors that may serve as triggers for the underlying biologic illness.
IPT builds on empirical evidence demonstrating reciprocal relationships between mood symptoms and interpersonal relationships. Its basic principles assume that helping patients to improve problematic interpersonal relationships or circumstances that are directly associated with the current mood episode will result in symptom reduction. Iteratively, improvement in mood will lead to additional spontaneous improvement in interpersonal functioning which, in turn, will lead to further reductions in mood symptoms. Thus, the primary goals of IPT treatment are symptom remission and improved interpersonal functioning.
The late Gerald L. Klerman, M.D., Myrna M. Weissman, Ph.D. and colleagues published the first randomized IPT trial in 1974. They found in initial studies that IPT was more effective than a placebo; that in combination with medication it fared better than either treatment alone; and that on one-year follow-up, IPT helped patients to build social skills, which medication did not. Since 1974 there have been more than 250 randomized controlled studies of IPT published by research groups around the world.
Content reference: Overview of IPT | International Society of Interpersonal Psychotherapy – ISIPT. (2020). Retrieved 28 December 2020, from https://interpersonalpsychotherapy.org/ipt-basics/overview-of-ipt/
Video graphic reference: Smart CBT (https://www.youtube.com/watch?v=Qn5BuEKUTzw)