Interpersonal psychotherapy is a short-term therapy of up to 20 sessions primarily for the treatment of acute depression. The treatment is divided into three sections and focuses on developing interpersonal relationships that may be triggers for depression. During the sessions, the focus is on the patient learning to deal with the particular current difficulties in a practical, emotional and communicative way.
What is interpersonal psychotherapy?
Interpersonal psychotherapy (IPT) is a short-term therapy used primarily to treat acute depression. The therapeutic approaches, which focus on short-term, practical benefits for the patient, are based on the interpersonal theories of U.S. psychotherapist Harry Stack Sullivan, which he postulated in the 1930s. Likewise, IPT incorporated insights from British psychotherapist John Bowlby, whose post-1940 attachment theory was guided by the recognition that current attachments and relationships have a more important influence on behavior than early childhood experiences. IPT was substantially developed in the 1960s by U.S. psychiatrist Gerald Klerman and his wife, Myrna Weissman. The authors did not intend to create a new method of treatment in psychotherapy, but it was more a summary of the methods of work that had been common until then, in order to create a possibility of comparison with drug treatment in the treatment of depression. However, it then turned out that IPT was particularly effective in the treatment of acute depression. Further developments to the current forms of therapy then took place successively in the 1970s and 1980s. Based on the assumption that acute depression always develops in an interpersonal context, therapeutic work focuses on practical assistance for the patient. Interpersonal techniques such as communication analysis, emotion updates, and also role-playing are used. Inspired by practical therapeutic successes, IPT has also been further developed for the treatment of adolescents and for couples counseling, and has been modified accordingly. At some clinics, interpersonal psychotherapy has been further developed into an inpatient treatment method and is also used as group therapy.
Function, effect, and goals
The main area of application of IPT is in the short-term treatment of acute depression in adults. Typical applications also include postpartum depression, bulimia, and bipolar disorder, in which the patient alternates between euphoria and depression in rapid but unpredictable succession. IPT always conceives of depression as a multifactorial disease whose individual triggers must be considered in therapy. The treatment is divided into three phases, the initial, the middle and the termination phase, and extends over 12 to a maximum of 20 sessions of 50 minutes each. In the initial phase, which consists of one to three sessions, a detailed anamnesis is taken and the patient is informed about the treatment method. The initial phase also includes the definition of the therapy goals together with the patient. The concrete goals are laid down and specified in the treatment contract, and the patient’s depressive period is already placed in an interpersonal context. The middle phase is the actual work phase, in which an adaptation to the social conditions that are considered to be the trigger for the depression or other psychological problems is “trained” together with the patient. The patient learns how to deal with the current interpersonal conflicts, and new bonds and relationships are established. The patient’s emotions and social classification are always the focus of consideration. In the termination phase, which comprises one to a maximum of three sessions, after a summary of the new and modified way of dealing with the triggering social conflicts learned so far and the patient’s own role, an outlook on the future is worked out. IPT can be accompanied by drug treatment if certain indications are present, on the recommendation of the therapist. The therapeutic approach lies more in coping with the here and now than in coming to terms with possible past psychological traumas.This means that the therapy makes a very direct reference to the current conflicts in the current social environment. In practical implementation, solution-oriented conversation and role-playing techniques are used to enable the patient to identify and resolve personal conflicts within his or her current social network. The core focus of evidence-based IPT always remains the development and establishment of existing and new social relationships in the context of the patient’s individual personality. A distinctive feature is that patients are encouraged to actively participate. They are given “homework”, for example, to consolidate what they have learned, and they can be asked to work on certain topics independently as part of the therapy. The methods and working techniques of interpersonal psychotherapy are scientifically recognized in Germany and in many other countries in Europe, Asia, Africa and Australia. Health insurance companies usually cover the costs incurred. The study of IPT working methods has been included in the further training and specialization to become a specialist in psychiatry and psychotherapy at some university hospitals.
Risks, side effects, and hazards
Psychotherapies are fundamentally fraught with the risk that the goals of therapy will not be achieved and that treatment will not be successful. In addition, there is a risk that the treated symptomatology may even worsen for a variety of reasons. For example, unexpected complications may occur, the therapist may make serious therapeutic errors, or the physical course of the disease may worsen for other reasons. Such risks are minimized in interpersonal psychotherapy because many involve role-playing and hands-on exercises that provide the therapist with constant feedback on treatment progress.
