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Overview of IPT

Basic Principles.  Interpersonal Psychotherapy (IPT) is a time-limited, focused psychotherapy for the treatment of depression .  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.

 

Theoretical Rationale. IPT’s development was influenced by the interpersonal school of psychology and its leaders such as Harry Stack Sullivan and Adolf Meyer.  Sullivan argued that psychopathology arose in the context of conflict between an individual and his primary social unit.  Meyer extended Sullivan’s argument, drawing the distinction between the psychoanalytic focus on intra-psychic conflict as a primary locus of psychopathology versus an emphasis on interpersonal conflicts as the genesis of psychophathology in the interpersonal school.  IPT also draws on the work of Frieda Fromm-Reichmann who emphasized the social roots of depression, Jerome Frank who articulated a sociocultural definition of psychotherapy, and attachment theorists such as John Bowlby.

 

Medical Model. 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.