Interpersonal Psychotherapy (IPT) for depressed adults: Specific interventions and techniques
- Holly A Swartz, MD
Holly A Swartz, MD
- Professor of Psychiatry
- University of Pittsburgh School of Medicine
Interpersonal Psychotherapy (IPT) is a time-limited psychotherapy for treating depression [1,2]. The therapy focuses upon improving problematic interpersonal relationships or circumstances that are directly related to the current depressive episode. Interpersonal relationships and depressive symptoms appear to affect each other in a reciprocal manner [3-7]. Improvement of interpersonal functioning reduces symptoms, which leads to additional spontaneous improvement of interpersonal functioning, which in turn reduces depressive symptoms further.
IPT was developed in the 1970s as a treatment for depression and for many years was used only by investigators in clinical trials . Demonstrated success in multiple studies eventually led clinicians to conclude that IPT is a practical, user-friendly treatment for many different types of depressed patients, including pregnant, postpartum, or primary care patients .
Neuroimaging studies using sequential single photon emission computed tomography (SPECT) and positron emission tomography (PET) suggest that successful treatment of major depression with IPT leads to changes in brain function [10,11]. Many of these changes overlap with changes in brain function seen in patients treated with an antidepressant, including regional brain metabolic abnormalities that tended to normalize with treatment.
Clinical guidelines suggest IPT monotherapy for treatment of mild to moderate depression [9,12,13]. In addition, IPT is used to treat other psychiatric illnesses, including bipolar disorder, eating disorders, and anxiety disorders .
This topic will review specific IPT interventions and techniques for treating depressed adults. The indications, theoretical foundation, general concepts, and efficacy of IPT are discussed separately, as are other treatments of depression. See (See "Interpersonal Psychotherapy (IPT) for depressed adults: Indications, theoretical foundation, general concepts, and efficacy" and "Unipolar major depression in adults: Choosing initial treatment" and "Unipolar depression in adults: Treatment of resistant depression".)
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- THERAPEUTIC STRATEGIES
- Principles of IPT
- Common therapeutic factors
- Combining IPT with pharmacotherapy
- DELIVERING INTERPERSONAL PSYCHOTHERAPY
- Individual versus group format
- Face to face versus online format
- Duration of therapy
- Stages of treatment
- - Initial phase
- Diagnose major depression
- Give the patient the sick role
- Take an interpersonal inventory
- Establish the depression timeline
- Select interpersonal problem area and formulate the case
- Provide hope
- Discuss treatment contract
- - Middle phase
- Interventions for each interpersonal problem area
- - Grief (bereavement)
- - Role dispute
- - Role transition
- - Interpersonal deficits
- Interventions for any interpersonal problem area
- - Termination
- EVIDENCE OF EFFICACY
- OTHER RESOURCES