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Interpersonal Therapy

by Lynn Mollick

You hear about Interpersonal Therapy all the time. It's the treatment that stacked up just as well as CBT in the recent NIMH study of the treatment of depression. But if you've been wondering what Interpersonal Therapy actually is, you should have attended ACT's September 26 meeting when Kathleen Clougherty let psychotherapy's best-kept secret out of the bag.

Designed for use in research, Interpersonal Therapy is Gerald Klerman's attempt to operationalize what good therapists do. It is an active therapy that focuses on four general areas: grief, role disputes, role transitions, and interpersonal deficits. It is present-oriented and emphasizes patients' exploring options and increasing their activities and social life.

Although IPT is a programmed treatment, it is flexible enough to address patients' individual problems and situations. Treatment begins by taking a history of the problem. The therapist then suggests which of the four problem areas is most relevant and then asks the patient what he or she wishes to accomplish. Since IPT is time-limited (usually only 16 session long), Ms. Clougherty emphasized working on no more than two problems.

The IPT therapist begins each session by asking, "how have you been since our last visit?" Patients usually answer by describing recent dysphoric moods or recent upsetting events. The therapist attempts to link moods to recent events in the problem area.

One very interesting point about IPT is that this model works from the assumption that patients suffer from chronic (mental) illness. At the beginning of treatment, the therapist may tell a patient he or she is too "sick" to accomplish certain tasks, although later the therapist will strongly encourage the patient to take on the same or other tasks.

Working from this "medical" model, the therapist tells the patient that since he or she has already been depressed, he or she will probably be depressed again. Although Ms. Clougherty didn't say so, this assumption seems to encourage the use of medication, even though patients are told to continue to address their problem areas after termination. Of course, since IPT is limited to 16 visits and one or two problems, how could a reasonable observer expect permanent remission of symptoms?

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