GC 201
May 7, 2022
Interpersonal
Interpersonal Therapy
Therapy
(IPT)
(IPT)
Presented by: Faye Abegail L. Torralba
GC 201
Contents
1 What is IPT? 4 Focal Problem Areas
2 Brief History 5 Termination and Maintenance
3 General Goals of IPT
What is IPT?
Interpersonal Therapy is a time- limited, specified
psychotherapy developed initially for patients
with major depressive disorder (MDD) and later
adapted for other disorders as well.
Ge ra ld
Interpersonal psychotherapy was developed by Gerald Klerman
(1929–1992) with contributions by his wife, Myrna Weissman, My r na
and other colleagues.
Brief History
Influenced of both early theorists and research on depression
• In developing a brief therapeutic approach to the treatment of depression, Klerman studied psychological research
on depression to determine which factors played a role in the onset of depression.
• Klerman identified four major problem areas that interpersonal therapy should be able to address and treat:
1 2 3 4
Grief Interpersonal Role Transitions Interpersonal
Disputes Deficits
History
General Goals of IPT Goals
• Reduce symptoms of depression
To improve mood, sleep, appetite, energy, and general outlook on life.
• Help the patient deal better with the people and life situations associated with the onset of symptoms
The IPT therapist focuses, within a time- limited treatment, on:
• current problems
• people who are important in the patient’s current life
• linking interpersonal problems to symptom onset
• the patient’s affect (both positive and negative feelings)
• helping patients to master present problems by recognizing their emotional responses to those
situations; understanding these responses as helpful rather than “bad” feelings; and finding ways to
effectively express them to address crises, gather social support, and develop friendships and
relationships.
Focal Problem Areas
Depression was the result of a variety of interpersonal issues
• Although grief is considered a normal emotion, not a psychiatric disorder, it can provide difficulties for
1 people in mourning, particularly when the reaction is severe and continues over a long period of time.
Grief • Grief may present a particularly difficult problem when individuals experience the loss of more than one
person who is close to them.
• Some individuals are more prone to becoming depressed after losing a close friend or family member
than are others.
• Complicated Bereavement - painful emotions are so long lasting and severe, one has trouble recovering
from the loss and resuming their own life; when grief is severe and the severe phase lasts longer than two
months, or when a loved one has died and the patient has not experienced the normal mourning process.
Problem Areas
Grief
GOALS IN TREATING A GRIEF REACTION
1 • To facilitate mourning (catharsis)
Grief Facilitate the mourning process by encouraging the patient to think and feel about the loss in detail, and
by discussing the sequence and consequences of events prior to, during, in the immediate aftermath of, and
since the death.
• To (re)establish interests and relationships
that can to some degree substitute for the person and the relationship that have been lost. The death has
often left a vacuum in the patient’s life, a loss of relationship
and of direction that the patient may not feel capable of filling.
Problem Areas
Grief
OVERALL STRATEGIES
1 IPT provides three strategies for working with patients with complicated grief:
Grief
• Educate about grief and depression.
• Facilitate catharsis through letting the patient experience her feelings about the loss. Elicit the feelings
through detailed discussions about the deceased, the death, and the relationship.
• Find new activities and relationships to substitute for the loss and provide a direction forward in life.
Problem Areas
Focal Problem Areas
Depression was the result of a variety of interpersonal issues
• Struggles, arguments, or disagreements with others, particularly on a continuing basis, can lead to
2
depression.
Inter-
personal • Disputes between family members, co-workers, boss, friends, associates, community organizations
Disputes
(church) is a contributing factor to depression.
!@#$%^
@#$%^!
Problem Areas
Interpersonal Disputes
GOALS OF TREATMENT
2 • For a role dispute, the goals of treatment are to help the patient identify the disagreement, choose a plan
Inter- of action, and modify communication or expectations or both to resolve the difference of opinion.
personal • When the relationship cannot be successfully renegotiated, examining the options also helps the patient to
Disputes
decide whether staying in the troubled relationship is the best alternative.
• Even if attempts to resolve the dispute prove unsuccessful, the patient will have learned to better
communicate her feelings during a disagreement.
Problem Areas
Interpersonal Disputes
STAGE OF DISPUTE
Renegotiation
2 • the parties are in active contact about their differences
Inter- • Sometimes it emerges that the patient simply needs to express their needs and lacks the social skills to do
personal
Disputes so.
• Once the patient has accepted their desire as reasonable, they may benefit from role play in order to
express their need to another person.
Impasse
• An impasse exists when discussion between the patient and the other person has stopped.
• There is smoldering, low- level resentment and hopeless resignation but no attempt to renegotiate the
relationship. The individuals involved may deal with each other using the “silent treatment”.
Problem Areas
Interpersonal Disputes
STAGE OF DISPUTE
2 Dissolution
Inter-
• Dissolution may be appropriate when the relationship is irretrievably disrupted by the dispute and one or
personal both parties actively strive to terminate it through divorce or separation, by leaving an intolerable
Disputes
marriage or work situation, or by ending a soured friendship.
• A dissolution triggers a role transition, In this role transition, the patient must mourn the loss of the
relationship and recognize opportunities in the new role.
Problem Areas
Interpersonal Disputes
MANAGING ROLE DISPUTES
2 • IPT therapists validate these feelings as normal responses to interpersonal situations
- Elicit the patient’s feelings in her description of an interpersonal encounter: “What were you
Inter-
personal feeling?
Disputes
- Validate and normalize them (except, for example, inappropriate guilt, which can be identified as
a symptom): “Is it reasonable that you were feeling angry?”
- Explore options: “Looking back, what could you have done in that situation? What might you do
when it arises again? Have you expressed those feelings to your spouse?”
- Then role play to help the patient put those feelings into a statement and tone of voice in order to
communicate it to the other person.
Problem Areas
Focal Problem Areas
Depression was the result of a variety of interpersonal issues
• Depression associated with transitions occurs when a person has difficulty coping with a life change that
3
affects their mood and requires different behavior or modifications in one or more close relationships.
Role
Transitions • The aims of treating depression associated with a role transition are to under stand what it means to the
patient: what the patient has lost, what the new situation demands, what might be gained, what
expectations the person and others have in relation to that change, and how capable the person feels of
meeting them.
• The depressed patient is likely to recall the time before the change as idyllic, the change itself as
traumatic, and the aftermath— the present and anticipated future— as dreadful, painful, and chaotic.
Problem Areas
Role Transitions
GOALS AND STRATEGIES
3 Five tasks help the patient manage transition problems:
• Giving up the old role
Role
Transitions • Mourning the old role: expressing sadness, guilt, anger, powerlessness, and fears about the loss.
• Acquiring new skills, exploring opportunities for growth due to the change
• Developing new attachments and support groups
• Recognizing the positive aspects of the new role.
These tasks often overlap and the patient may achieve them only gradually.
Problem Areas
Focal Problem Areas
Depression was the result of a variety of interpersonal issues
• Some individuals may be socially isolated or have few social skills
4
• Individuals who have few friends, “loners,” may have difficulty making or sustaining relationships.
Interpersonal
Deficits • This can be a default category for patients who do not fit the other categories; when individuals do not
report recent events that may have caused depression, this category is often used.
• Individuals falling into this category are more likely to have personality disorders than are those in the
others.
• This area implies lack of social skills and continuing interpersonal problems, it can be a more difficult
area to treat than the other three.
Problem Areas
Interpersonal Deficits
GOALS AND STRATEGIES
4 The major task in this problem area is to:
Interpersonal
Deficits • reduce social isolation by improving the patient’s skills in tolerating social anxiety
• spending time with and talking to people
• increasing the patient’s self- confidence
• strengthening the patient’s current relationships and activities
• helping them to find new relationships and activities
The goal is to modestly extend social functioning and build social supports.
Problem Areas
Interpersonal Deficits
GOALS AND STRATEGIES
• The purpose of the tasks is to help the patient understand their problems in relationships and to practice
4
forming new relationships. Since IPT is a time-limited therapy, the work within the therapeutic
Interpersonal
Deficits relationship is a temporary step toward better social functioning in outside relationships.
Tasks:
• To review past significant relationships, both good and bad
• To explore patterns of strengths and difficulties in these relationships
• To discuss the patient’s feelings— positive and negative— about any current relationships (including
possibly that with the therapist)
Problem Areas
Interpersonal Deficits
GOALS AND STRATEGIES
4 • The goal is to reduce social isolation and improve current relationships by improving skills in
communicating and increasing the patient’s social competence and confidence.
Interpersonal
Deficits • Patients treated for interpersonal deficits in IPT may have poorer outcomes than patients in other
categories and might do better in an alternative treatment such as CBT or might require long- term
treatment.
• Therapists should consider alternatives to IPT, such as a different psychotherapy or IPT plus medication
for these patients, if the initial IPT treatment does not result in symptomatic improvement.
Problem Areas
Focal Problem Areas
Depression was the result of a variety of interpersonal issues
1 2 3 4
Grief Interpersonal Role Transitions Interpersonal
Disputes Deficits
• As the description of these four problem areas shows, the focus of interpersonal therapy is on current
problems that deal with relationships.
• When assessing patient problems, the therapist finds out which ones of the four categories fit the patient’s
problems.
Problem Areas
Termination and Maintenance Treatment
• IPT is a time- limited, not an open- ended, treatment. The time selected can vary: in IPT studies, the
interval has been as brief as three to six weekly sessions and as long as thirty- six monthly sessions.
• The termination phase begins with an open discussion about the end of the treatment, and reviews
what has been accomplished and what remains to be done. The patient is encouraged to discuss any
feelings, positive or negative, about ending the therapy.
• The patient– therapist relationship is a temporary one meant to enhance the patient’s health, not to
substitute for real- world relationships.
Termination and Maintenance Treatment
Goals of the Termination Phase
• To conclude acute treatment with the recognition that separations are role transitions, and hence may
be bittersweet, but that the sadness of separation is not the same thing as depression
• To bolster the patient’s sense of independence and competence, if treatment is to end, and to
underscore new interpersonal skills the patient has developed.
• To relieve guilt and self- blame if the treatment has not been successful, and to explore treatment
options.
• To discuss the options of continuation or maintenance treatment if IPT has been acutely successful
but the patient faces a high risk for relapse or recurrence.
Thank you!
Sources
Weissman, M. M., Markowitz, J. C., & Klerman, G. L. (2018). The guide to interpersonal
psychotherapy, Updated and expanded ed. Oxford University Press.
Sharf, R. S. (2011). Theories of psychotherapy and counseling: concepts and cases, 5th
ed. Pacific Grove: Brooks/Cole Pub. Co.
