Interpersonal psychotherapy

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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 intrapsychic processes. IPT aims to change the person's interpersonal behavior by fostering adaptation to current interpersonal roles and situations.

History

Interpersonal psychotherapy largely stems from the interpersonal psychoanalysis work of Harry Stack Sullivan, who, although coming from a psychodynamic background, was strongly influenced by ideas in sociology and social psychology.[1] Sullivan thought that the most significant factors in triggering emotional reactions in individuals were the interpersonal behaviors of others.[2]

Interpersonal therapy was first developed as a theoretical placebo for the use in psychotherapy research by Gerald Klerman, et al. IPT was, however, found to be quite effective in the treatment of several psychological problems. IPT was later developed in the 1970s and 80s as an outpatient treatment for adults who were diagnosed with moderate or severe non-delusional clinical depression.[3]

IPT takes structure from psychodynamic psychotherapy, but also from contemporary cognitive behavioral approaches in that it is time-limited and employs homework, structured interviews, and assessment tools.[4]

Applications

Although originally developed as an individual therapy for adults, IPT has been modified for use with adolescents and older adults.[5]

Medical indications

Stages

Interpersonal psychotherapy typically proceeds in several stages. In the initial stages, therapeutic goals typically include diagnosis, completing the requisite inventories, identifying the patient's major problem areas, and creating a treatment contract.

In the intermediate stages, the patient and therapist, focusing on the present, work on the major problem areas identified. Four major problem areas are commonplace in IPT. The first is grief, and patients typically present with delayed or distorted grief reactions. Treatment aims include facilitating the grieving process, the client's acceptance of difficult emotions, and their replacement of lost relationships. The second major problem area is role dispute, in which a client is experiencing nonreciprocal expectations about a relationship with someone else. Here, treatment focuses on understanding the nature of the dispute, the current communication difficulties, and works to modify the client's communication strategies while remaining in accord with their core values. A third major problem area is role transition, in which an individual gives up an old role and takes on a new one. In this case, treatment attempts to facilitate the client's giving up of the old role, expressing emotions about this loss, and acquiring skills and support in the new role they must take on. A final problem area commonly broached with IPT is interpersonal deficits. Clients presenting interpersonal deficits commonly engage in an analysis of their communication patterns, participate in role playing exercises with the therapist, and work to reduce their overall isolation, if applicable. [8]

In the end stages of IPT, the therapist works to consolidate the client's gains, discuss areas which still require work, talk about relapse prevention, and process any emotions related to termination of therapy.

See also


References

  1. Sundberg, N. (2001). Clinical Psychology: Evolving Theory, Practice, and Research. Englewood Cliffs, NJ: Prentice Hall.
  2. Weissman, MM (2006), A Brief History of Interpersonal Psychotherapy, Psychiatric Annals (PDF) http://www.psychiatry.wisc.edu/mridepressionstudy/briefhistoryIPT.pdf
  3. Swartz, H. (1999). Interpersonal therapy. In M. Hersen and A. S. Bellack (Eds). Handbook of Comparative Interventions for Adult Disorders, 2nd ed. (pp. 139 – 159). New York: John Wiley & Sons, Inc.
  4. Weissman, M. M, Markowitz, J. C., & Klerman, G. L. (2007). Clinician's quick guide to interpersonal psychotherapy. New York: Oxford University Press.
  5. 5.0 5.1 5.2 5.3 5.4 Weissman, M. M. & Markowitz, J. C. (1998). An Overview of Interpersonal Psychotherapy. In J. Markowitz, Interpersonal Psychotherapy (pp. 1 – 33).Washington D.C.: American Psychiatric Press.
  6. Joiner, T. E., Brown, J. S., & Kistner, J. (2006). The interpersonal, cognitive, and social nature of depression. Mahwah, N.J.: Lawrence Erlbaum Associates.
  7. Markowitz, 1999
  8. Interpersonal Psychotherapy By Ellen Frank, PhD and Jessica C. Levenson, MS [1]