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Interpersonal Therapy for Depression

Interpersonal therapy, or IPT, is a short-term, limited-focus treatment for depression. Studies have shown that IPT, which addresses interpersonal issues, may be at least as effective as short-term treatment with antidepressants for mild to moderate forms of clinical depression. Originally developed to treat depression in adults, it has been shown to be effective in treating adolescent depression and is commonly recommended as a treatment for depression in children.

Events surrounding interpersonal relationships do not cause depression. But depression occurs within an interpersonal context and affects relationships and the roles of people within those relationships. By addressing interpersonal issues, interpersonal therapy for depression puts emphasis on the way symptoms are related to a person's relationships, including family and peers.

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The immediate goals of treatment are rapid symptom reduction and improved social adjustment. The long-term goal is to enable people with depression to make their own needed adjustments. When they can do that, they are better able to cope with and reduce depressive symptoms.

What Are the Ideas Behind Interpersonal Therapy for Depression?

Interpersonal therapy is a manual-based treatment. That means the therapist strictly adheres to a treatment process whose effectiveness is supported by evidence.

According to the International Society for Interpersonal Therapy, there are three components to depression.

  • Symptom formation
  • Social functioning
  • Personality issues

IPT is a short-term treatment option that typically consists of 12 to 16 one-hour weekly sessions. Because it is so brief, IPT does not address personality issues. Instead, the therapist focuses on identifiable problems in how an individual interacts with or doesn't interact with others. When those problems are addressed, the patient realizes a benefit in his or her experience of symptoms.

Except to check on their severity and the effect of the various treatments, symptoms are not addressed in therapy sessions. Instead the therapist works collaboratively with the patient, either individually or in a group, to identify and then address one or two significant problems in his or her interactions. The number of problems addressed is deliberately limited to one or two for the whole course of treatment. The result is an intense focus on how to make the necessary adjustments in interpersonal situations that will help reduce symptoms of depression.

The types of problems addressed fall into four categories:

Interpersonal disputes or conflicts. These disputes occur in marital, family, social, school, or work settings. The disputes emerge from differing expectations of a situation. They become a problem that needs to be addressed when the conflicts that come from the expectations lead to significant distress.

Role transitions. Changing circumstances, whether they're developmental, stem from shifts in work or social settings, or result from a life event or end of a relationship, require adaptations from the individual. With depression, those changes are felt as losses and contribute to the depression.

Grief. In IPT, grief is the experience of loss through death. Grief becomes a problem when it is delayed or becomes excessive so that it lasts beyond the normal time for bereavement.

Interpersonal deficits. This refers to the patient reporting "impoverished" personal relationships either in number or in quality.

By focusing on issues from these categories, the therapist can help the person with depression learn how to make the adjustments that are needed to address the interpersonal issue and improve relationships.

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