Interpersonal Psychotherapy For Depression

Interpersonal Psychotherapy Definition

A Scientific Treatment

IPT, supported by clinical training, is a scientific approach that often builds upon interpersonal theory and psychosocial research on depression. In fact, interpersonal psychotherapy was originally developed as a research intervention under the International Society for Interpersonal Psychotherapy, an international umbrella organization. Over time, it became clear that IPT could be an effective treatment for depression and should be utilized beyond research clinics.

Because of this research success, mental health professionals were eager to try this technique for their clients. Therefore, in 2004, an article in World Psychiatry announced that IPT was officially being practiced by clinicians. Just two years earlier, the International Society of Interpersonal Psychotherapy was officially incorporated and created its own credentialing processes to ensure therapists were properly trained in this newer form of psychotherapy.

Are Mental Disorders In Our Biology?

What makes interpersonal psychotherapy different from CBT may be the concepts and techniques behind the treatment. First, the patient is normally viewed as having a medical condition. Therefore, their control over their mental illness may be limited. Depressive disorders, mood disorders, anxiety disorders, posttraumatic stress disorder, and others may happen to them, but may not be caused by their relationship with external stimuli.

Another unique feature of interpersonal psychotherapy may be that it can highlight the connection between the client's mood and disturbing life situations (such as grief, divorce, or losing a job) that may have caused or compounded their disorder. 

Furthermore, interpersonal psychotherapy is usually a short-term, present-focused treatment method that is based on attachment theory, communication theory, and the biopsychosocial/cultural/spiritual genesis of disorders. Therefore, it often incorporates multiple theories and ideas from multiple behavioral sciences.

Interpersonal Treatment Goals

Every type of therapy tends to have its own goals. For instance, CBT frequently has the goal of changing thoughts so that feelings and behaviors can also change. For interpersonal psychotherapy, the primary goals are usually to reduce psychiatric symptoms, work on relationships, and build a network of social support, all while teaching interpersonal skills and working on interpersonal deficits.

Concepts Behind Interpersonal Treatment

Several concepts, also called tactics, can make up the core of interpersonal psychotherapy. Aside from the biopsychosocial/cultural/spiritual basis of interpersonal psychotherapy already discussed, this generally assumes an Interpersonal Triad and makes use of an Interpersonal Inventory. The main treatment with this interpersonal triad and interpersonal inventory often takes place as you and your therapist discuss your problems and agree on goals for improving your coping skills.

Interpersonal Triad

Interpersonal psychotherapy theory suggests that depression, mood disorders, and other mental disorders may begin after an acute interpersonal crisis. This crisis may be somewhat relieved, or it might be exacerbated, depending on your attachment style and biopsychosocial/cultural/spiritual strengths and weaknesses. 

If you also have inadequate social support, the problem with depressive symptoms or major depressive disorder may be compounded further. The Interpersonal Triad is viewed as this combination of factors that may add up to cause your distress. The Triad includes:

• An acute interpersonal crisis
• Your own strengths and vulnerabilities (attachment style, personality, biopsychosocial/cultural/spiritual)
• Lack of social support

Three Phases Of IPT

Interpersonal psychotherapy is usually a highly structured treatment that can have three distinct phases. No matter what happens during the time-limited 45- to 60-minute weekly sessions, treatment generally continues along this path in standard interpersonal psychotherapy. The three phases are:

• Beginning Phase: This may be the assessment period that can include the Interpersonal Inventory, psychiatric history, etc. This phase is generally designed to take place in the first three time-limited sessions.
• Middle Phase: The middle phase can be considered the heart of the treatment. This is usually where the work of interpersonal psychotherapy is done. You may focus on resolving the problem area that you've set out to improve while your therapist practices supportive listening.
• Final Phase: In the last phase of treatment, the goal is generally to end the therapeutic relationship on a positive note, where the patient can continue to use the treatment after the sessions are done.

IPT: Inventory

If you begin interpersonal psychotherapy, you might begin by taking a test called the IP Inventory. This tool can help your therapist understand where you're getting or lacking social support, in whom you confide, and how healthy those relationships are. They’ll also usually learn about your romantic relationships, the status of your current relationships and past relationships, how you communicate with others in daily life, interpersonal issues or interpersonal disputes, and any problems in your relationship that might have led to your depressive episode.

This may be when a therapist might study references to your environment, previous or current mental illnesses, relationships, and medication history. The efficacy of this stage can be found through success in those working through trauma, finding new strategies to approach depressive episodes, and the principles at play.

Interpersonal Problem Areas

Since interpersonal psychotherapy is considered a scientific treatment, it usually has specific rules about how to proceed. The first step after the IP assessment is typically to identify the problem area on which to focus or any interpersonal deficits. In interpersonal psychotherapy, there are normally only four options from which to choose. They are:

• Grief - When a loved one has died
• Role Dispute - When a close personal relationship is marked by differences in role expectations
• Role Transition - When you're transitioning from one role to another, such as when you change jobs or move
• IP Deficits - When none of the other three options fits, and you've had ongoing problems with relationships for a significant period

Interpersonal Psychotherapy Techniques

Many of the techniques used in interpersonal psychotherapy are quite different from those used in cognitive-behavioral or other types of mental health treatment. The focus is usually on improving interpersonal relationships.

Interpersonal incidents can be various situations that may occur in a relationship. When you or your loved ones behave in ways that keep you from meeting your needs, you may have a crisis that could lead to symptoms of a mental disorder, such as depressive symptoms. As treatment progresses, your therapist works collaboratively and helps you examine and analyze these interpersonal relationships to find better ways of behaving within them while improving your interpersonal functioning and addressing any interpersonal deficits.

Role-Playing

Role-playing can be a common technique used in many different treatment modalities for interpersonal relationships. It can be especially helpful in interpersonal psychotherapy because it may give you the opportunity to explore the interpersonal situations you're in and work on your interpersonal skills.

Communication Analysis

Your therapist may do an exercise called communication analysis to help you identify problems in your interpersonal communication skills. You may begin by recalling an interaction that happened between you and another person. You may then write out the scene as if you were writing a play, including the setting and all the words and gestures of the "actors."

The therapist can then read your "movie script" and ask you questions about it. For example, they might ask you what you or the other person intended when they said or did something versus what was actually said or done. 

After you've analyzed this incident of interpersonal communication, it might proceed to a role-playing exercise in which the therapist helps you with better ways to handle such an incident. During the final sessions, you'll have an opportunity to practice and refine these improved communication strategies.

Finding A Therapist For Interpersonal Psychotherapy (IPT)

If you recognize that you're depressed, anxious, have mood disorder symptoms, or otherwise feel mentally unstable, you may realize that the problem lies in your communication and coping skills. If so, you might want to try interpersonal psychotherapy for emotional maintenance treatment and help in an interpersonal context. Treatment may progress with you, ensuring that interpersonal psychotherapy can help you through clinical treatment guidelines to accomplish your treatment goals.

Finding a therapist for interpersonal psychotherapy may be easy or difficult, depending on what your personal resources are and where you live. Transportation may be an issue for people who live in rural areas or must drive through heavy traffic to reach the therapist's office. If this is the case for you, you may benefit from trying online IPT. Online therapy can connect you with a licensed therapist from any location, as long as you have a stable internet connection. It generally eliminates the need to commute and can be more convenient than getting help in person.

As this study explains, online IPT can be effective in alleviating depressive symptoms.