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IPT for Depression

Interpersonal Psychotherapy (IPT) was developed initially as an individual treatment for adult patients with major depressive disorder but later adapted for dysthymia, depressed adolescents and older patients, depression during pregnancy and postpartum period, as group treatment for depression and in brief formats for depression and distress. Designed for administration by experienced and trained mental health professionals, it can also be taught clinically to less trained persons. IPT has been used with and without medication for depression.

IPT is based on the idea that whatever the cause of depression, genes, inflammation, environment, it does not arise in a vacuum. The onset of depression is usually associated with something going on in the patient’s current personal life, usually in association with people they feel close to. Some common events are: a marriage breaks up, a dispute threatens an important relationship, a spouse loses interest and has an affair, a job is lost or in jeopardy, a move to a new neighborhood takes place, a loved one dies, a promotion or demotion occurs, a person retires, or a medical illness is diagnosed. IPT identifies and helps the patient learn how to deal with those personal problems and to understand their relationship to the onset of symptoms.

IPT views depression as having three parts:

Symptoms. The emotional, cognitive, and physical symptoms including depressed and anxious mood, difficulty concentrating, indecisiveness, pessimistic outlook, guilt, sleeping and eating disturbances, loss of interest and pleasure in life, fatigue, and suicidality.

Social and Interpersonal Life. Close attachments and relationships

Personality. Enduring patterns of behavior, for handling anger, self-esteem, assertiveness etc.

IPT does not treat personality and notes that many behaviors that appear enduring may be a reflection of the depression itself.

The elements of IPT, regardless of adaptation, include:

  • Medical Model

You are a person with an illness, distress, symptoms, etc. It’s not your fault

  • Sick Role

Take care of yourself. Who can help you?

  • Interpersonal Inventory

Who is in your life now?

  • Link symptoms to onset of problems. (Grief, Disputes, Transitions, Loneliness)
  • Target symptom reduction and improved social functioning, not personality
  • Set time limits
  • Focus on current life and not the past

For details of the efficacy data, see Cuijpers, 2017. For the latest review of elements and adaptations, see Weissman, Markowitz & Klerman, 2018.

 

References

Cuijpers P. Four decades of outcome research on psychotherapies for adult depression: An overview of a series of meta-analyses. Canadian Psychology 2017; 58:7-19.

Weissman MM, Markowitz JM, Klerman GL. The Guide to Interpersonal Psychotherapy. Oxford Press 2018.