Interpersonal Therapy For Depression
Interpersonal psychotherapy (IPT), or psychodynamic IPT, was first developed in the 1970s, when tricyclic antidepressants were normally the main treatment of depression. When interpersonal psychotherapy for depression was first introduced, the techniques were designed for use in research studies to determine the best combination and duration of tricyclic antidepressant treatment and psychotherapy. These psychological treatments gained popularity as it proved to be extremely effective in improving emotional maintenance and has sparked a growing interest in the field.
Now, interpersonal psychotherapy and cognitive behavioral therapy (CBT) are often recognized as the two most effective psychotherapeutic treatments for treating depression, affective disorders and other mental health concerns. When facilitated by an interpersonal therapist, it can be received in person or through online therapy services and either individually or as group interpersonal therapy. This mental health treatment can also be effective for anxiety, substance use disorder, bipolar disorder, persistent mild depression, binge eating disorder, and social phobia, helping to improve interpersonal skills and to prevent relapse.
Interpersonal psychotherapy definition
Interpersonal psychotherapy (IPT) is a clinical practice that usually considers your physical, mental, and social vulnerabilities, along with cultural and spiritual factors. IPT's focus is generally on social roles and relationships because these factors can be significant precursors to recurrent major depression and other mood disorders. It often focuses on improving problematic interpersonal relationships that the patient has with their friends, family members, coworkers, and the other people in their lives. Interpersonal therapy might help a person to recognize how their actions affect their personal relationships or learn to manage disputes effectively. This is typically a short term treatment undertaken over the course of several weeks.
Since its inception, interpersonal therapy has been adapted for use in a group setting as a group therapy option for disorders such as bulimia alongside medications.
A scientific treatment
IPT, supported by clinical training, is a scientific approach that often builds upon interpersonal theory and psychosocial research on depression. IPT, originally developed by Gerald L. Klerman and Myrna M. Weissman, was a depression collaborative research program under the International Society for Interpersonal Psychotherapy, an international umbrella organization. Over time, IPT became an empirically validated treatment backed by clinical trials that could be utilized beyond research clinics to treat mood disorders and recurrent depression.
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 and the American Psychiatric Press announced that IPT was officially being practiced by clinicians. In it, World Psychiatry described the process and how it could be used and may encourage additional spontaneous improvement when used alongside traditional treatments. 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 IPT different from CBT may be the concepts and techniques behind the treatment. First, unlike cognitive therapy, the patient is normally viewed as having a medical condition and the treatment is directly related to its symptoms. Therefore, their control over their mental illness may be limited. Depressive disorders, mood disorders like borderline personality disorder, anxiety disorders, posttraumatic stress disorder, and other psychological symptoms may happen to them, but may not be caused by their relationship with external stimuli.
Another unique feature of IPT may be that it can highlight the connection between the client's mood and disturbing life situations, specifically personal situations (such as grief for lost family members or loved ones, divorce, or losing a job) that may have caused or compounded their disorder.
Furthermore, IPT 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 to match the patient’s ability and needs.
Similarly, IPT and CBT are both considered to be effective maintenance therapies and provide acute treatment for those seeking mental health support in difficult times.
Treatment & therapy 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. The primary goals are usually to reduce psychiatric symptoms, work on relationships, and build a network of social support, all while teaching relationship skills and working on deficits.
Concepts behind interpersonal therapy
Several concepts, also called tactics, can make up the core of IPT. Aside from the biopsychosocial/cultural/spiritual basis already discussed, this generally assumes an Interpersonal Triad and makes use of an Interpersonal Inventory. The main treatment often takes place as you and your therapist discuss your problems and agree on goals for improving your coping skills.
The triad
Interpersonal psychotherapy theory suggests that depression, mood disorders, and other mental disorders may begin after an acute 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 (such as problematic relationships)
- Your own strengths and vulnerabilities (attachment style, personality, biopsychosocial/cultural/spiritual)
- Lack of social support
It may also factor in a current depressive episode or experiences of depression, instances of substance abuse (by the patient or their close associations), and any medications the person may be taking.
Three phases of interpersonal therapy
Relationships and IPT phases
IPT 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 of three psychological treatments. 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 therapist works with the patient. You may focus on resolving the problem area that you've set out to improve while your therapist practices supportive listening. This might include exercises such as played-out role transitions or scenarios.
- 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.
Inventory
If you begin IPT, 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, relationship issues or 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.
Problem areas
Since IPT 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 deficits. In IPT, there are normally only four categories or 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
IPT techniques
Many of the techniques used in interpersonal psychotherapy are quite different from those used in cognitive-behavioral or other types of therapy. The focus is usually on improving relationships.
Interpersonal incidents can be various situations that may occur in a relationship. When someone's loved ones behave in ways that keep them from meeting their needs, they may have a crisis that could lead to symptoms of a mental disorder, such as depressive symptoms. As treatment progresses, depressed patients will work in collaboration with therapists to examine and analyze these relationships to find better ways of behaving within them while improving their functioning and addressing any deficits.
Role-playing
Role-playing can be a common technique used in many different treatment modalities for relationships. This interpersonal psychotherapy adapted therapy can be especially effective because it may give you the opportunity to explore the situations you're in and work on your interpersonal skills. Also, Social Rhythm Therapy is another form of IPT that can help people maintain regular social rhythms despite the appearance of stress in their lives from relationships, work, and other events.
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 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 practitioner for interpersonal psychotherapy
If you recognize that you're depressed or anxious, have mood disorder symptoms, or are experiencing significant life challenges, you may realize that the problem lies in your communication and coping skills. If so, you might want to try psychotherapy for emotional maintenance treatment and help in an interpersonal context. Treatment may progress with you, ensuring that interpersonal therapy can help you through clinical treatment guidelines to accomplish your treatment goals. Also, randomized controlled trials have shown that IPT is an effective therapy for depressed adolescents, if you want to support your loved ones through treatment.
Online support options
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.
Takeaway
Interpersonal psychotherapy often looks at a person’s mental, social, and physical vulnerabilities, as well as cultural and spiritual factors. It often considers interpersonal relationships and social roles and the ways these factors can affect mental health disorders. Interpersonal psychotherapy frequently uses role-playing and communication analysis to help clients. A therapist may support a variety of people living with mental disorders by using interpersonal psychotherapy to treat eating disorders, mental disorders, mood disorders, postpartum depression, and bipolar disorder.
If you’re interested in interpersonal psychotherapy but don’t feel comfortable with traditional in-person therapy at this time, you may benefit from online therapy. An online therapist can serve as a guide to interpersonal psychotherapy and any other therapeutic approaches that interest you. With BetterHelp, you can be matched with a therapist who has experience providing treatment for depression, including through interpersonal psychotherapy or cognitive behavioral therapy. Take the first step toward getting help with depression and contact BetterHelp today.
Frequently Asked Questions
What Are Focuses Of IPT?
Unlike other types of therapy, interpersonal psychotherapy is usually a time-limited and evidence-based approach to improving the quality of a client's relationships, as well as social functioning, to reduce distress. Interpersonal psychotherapy focuses on four key areas: addressing deficits, managing unresolved grief, handling difficult life decisions, and coping with disputes stemming from conflict.
Which Technique Is Used In IPT?
IPT uses a variety of techniques, such as role-playing and communication analysis.
IPT is typically used to discuss and analyze relational problems, role transitions, or even new business interests. It can also help with a variety of mental health disorders.
What Are Differences Between CBT And IPT?
CBT typically focuses on modifying biased information processing and dysfunctional beliefs that arise from social anxiety or mood disorders. Conversely, IPT generally focuses on resolving behavioral patterns that may play a large role in maintenance of a major depressive disorder or anxiety. The goals of both types of therapy are usually to better a client’s life and outlook on situations, but the exact method of achieving this goal through maintenance treatment can vary.
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