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Interpersonal Psychotherapy (IPT)

Interpersonal Psychotherapy (IPT) is a highly structured and time-limited form of psychotherapy that was originally developed for treating Major Depression. It is based on the premise that Depression is often triggered by interpersonal stresses and that mental health problems tend to occur within an interpersonal context.

In particular, IPT identifies four areas of interpersonal functioning that could potentially be related to an individual's mental health symptoms. These areas include Interpersonal Disputes, Role Transitions, Grief, and Interpersonal Deficits, and are described in further detail below.

The first two sessions of the therapy are dedicated to gathering information from the patient and reviewing their symptoms and experiences in order to determine which of these four areas of interpersonal functioning is most affected and best accounts for their symptoms. In this initial phase, an "interpersonal inventory" is performed, which is essentially a register of all the key relationships in the individual's life, categorized according to the four areas mentioned above. Then, in sessions 3-14, the main work of the therapy takes place, where the therapist helps the client work through their difficulties in the given area of interpersonal functioning upon which they chose to focus. The last two sessions are used to consolidate the lessons and gains that the client has acquired as well as to deal with any feelings of loss in view of the end of the therapy.

The four areas of interpersonal functioning that can lead to psychological distress are described by IPT as follows:

    Interpersonal Disputes: These include disputes or conflicts with any one of the important people in one's life, be it a spouse, partner, family member, or someone in one's social or work settings. These conflicts, by definition, are ones that lead to a significant amount of ongoing stress for the client. The aim of IPT is to clarify the nature of the dispute and the divergent expectations of each person, to identify any problems of communication, understanding or unreasonable expectations in the relationship, and then to help the client learn the necessary tools to better manage and resolve these disputes.

    Role Transitions: These are changes that a person will experience in their life circumstances, be it moving to a new home, changing jobs, graduating from school, the end of a relationship, getting married, or any other numerous examples, big or small, of life changes. These life transitions, even when they seem positive, can lead to Depression or other mental health difficulties when they are experienced as a significant loss of a part of one's life that one is giving up or leaving behind. In these cases, the goal of IPT is to help the client to reappraise the old and new roles, to identify sources of difficulty in the new role and come up with solutions for these.

    Grief: In IPT, this refers solely to a loss of a loved one through death (other forms of loss are included in the category of Role Transitions). The role of the IPT therapist in these cases will be to help the client gain a clear and meaningful picture of their relationship with the one they lost, which includes both the positive and negative aspects of this relationship, and where the client is encouraged to let themselves experience the various emotions related to this loss. The goal is also to help the client become ready to be open to new relationships.

    Interpersonal Deficits: These are cases where a client has few close interpersonal relationships. The aim of IPT here will be to identify some of the reasons why the client seems to have difficulty finding or maintaining close relationships, in part by using the therapeutic relationship between the client and therapist as a way for understanding the client's way of being with other people. The therapist will then help the client to develop certain skills that could improve their chances of having healthy and satisfying relationships.

Applications of Interpersonal Psychotherapy

IPT is considered a first-line therapy for Major Depression based on the numerous studies that have shown it to be effective for this purpose [ref]. It can also be used for treating Dysthymia [ref], and an offshoot of IPT, called Interpersonal and Social Rhythm Therapy (IPSRT) has shown promise in the treatment of Bipolar Disorder [ref, ref, ref]. A small but growing body of research indicates that IPT may have a role to play in the treatment of Eating Disorders [ref, ref] and Panic Disorder [ref].