Interpersonal Therapy for Depression
What Are the Ideas Behind Interpersonal Therapy for Depression? continued...
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.
What Kind of Adjustments Might Be Made Through IPT to Resolve Interpersonal Issues?
With issues involving interpersonal disputes, the therapist works with the patient to define how serious the issue has become in terms of how difficult it is to move beyond it. For instance, there might be a dispute between husband and wife that stems from the wife's attempts to be more independent. The therapist would lead the patient, in this case the husband, in an effort to discover the sources of misunderstanding. Then the therapist might use problem-solving approaches, communication training, or some other technique to enable the patient to resolve the conflict in a way that doesn't worsen the symptoms of depression.
In role transition issues, the therapist helps the patient determine the differences between the old and the new roles. Then together they would focus on identifying exactly what is causing the difficulties and work to find a solution for the problem.
For issues involving grief, the therapist facilitates the grieving process to help the patient move beyond it. Two important techniques used to do this are:
- Empathetic listening, which provides support and a safe outlet for the patient's feelings
- Clarification, which is a technique for helping the patient examine his or her own misconceptions about the situation