What is Interpersonal Therapy, What Does It Do?

Interpersonal therapy (IPT) is a type of psychotherapy aimed at developing strong bonds. Research suggests that it can help improve symptoms of various mental health conditions. IPT is a type of psychotherapy that can treat depression and some other mental health problems. In the 1970s, two psychotherapists developed IPT to help with depression, and clinicians have used it to treat various mental health problems since then.

What is Interpersonal Therapy?

IPT is a short-term form of treatment that usually takes less than 12-16 weeks. It focuses on improving communication and interpersonal effectiveness skills; Practitioners believe that many mental health problems are caused by relational deficiencies or role conflicts. IPT practitioners consider depression and other mental health conditions as real diseases that require treatment. It focuses on this in therapy to prevent clients from blaming themselves for their difficulties. These therapy advocates also argue that mood and life situations, especially relationships, are closely related. Improving relationships can improve a person’s mental health. In IPT interviews, the person learns and applies skills that can help improve relationships and prevent the development of additional relationship problems.

What Does It Do?

IPT is a structured type of therapy, meaning that treatment progresses in three different stages. During the first one to three sessions, the therapist diagnoses the problem and helps the therapy recipient identify interpersonal problems that precede or sustain psychological distress. For example, a person experiencing a breakup realizes that their depression develops after the breakup. The therapist also develops an interpersonal inventory that reviews the client’s behavioral pattern in relationships and the assessment of existing relationships. IPT therapists believe that four conflict areas typically trigger relationship and mental health issues. These are as follows:

• Relationship conflicts that cause stress
• Life changes that alter the person’s role or relationships
• Difficulty starting or maintaining relationships
• Grief or loss

After the therapist and client identify the area of ​​conflict that causes the latter’s distress, the therapy focuses on managing that conflict. In the middle part of treatment, the therapist develops targeted relationship strategies to support interpersonal functionality. For example, it helps a person through a separation mourn the relationship and the role it represents, then helps them develop new skills and ways of relating to others. In the last weeks of treatment, the therapist helps the patient to apply their new skills by reminding the treatment that the treatment will end soon.

Some therapists use a combination of IPT and other therapies. When this is the case, it takes longer or becomes less formulaic. As with all types of therapy, the therapist encourages the client to talk about their feelings, identify patterns in their behavior, and be open about treatment goals. However, the therapist should keep the patient’s information confidential. Research has consistently shown that IPT works well for depression, especially depression related to relationship problems. More recent research has begun testing IPT for other psychological problems. For example, a 2020 study of family caregivers of patients with schizophrenia found that IPT combined with psychoeducation can help increase self-efficacy and reduce family care burden.

Origins

In the 1970s, psychotherapists Myrna Weissman and Gerald Klerman developed IPT to treat mood disorders such as depression. They especially benefited from the researches of John Bowlby and Mary Ainsworth, who examined the role of attachment at an early age in relationships. IPT practitioners highlighted research showing that social factors such as the loss of a relationship are often the main factors in the onset and maintenance of depression. Based on these data, Weissman and Klerman used IPT to treat depression and other mood problems. Since then, researchers have shown that IPT can also treat social phobia, anxiety disorders, post-traumatic stress disorder, and eating disorders.

IPT and Other Types of Treatment

Most studies show that IPT works just as well as other types of therapy, and in some cases even seem to give better results. A 2005 meta-analysis of IPT for depression treatment looked at studies comparing IPT with cognitive behavioral therapy (CBT) versus placebo. IPT was more effective than CBT and placebo and produced similar results to the drug. A much broader 2016 meta-analysis evaluated the effectiveness of IPT for various mental health problems. Based on data from 90 studies, researchers could not find a significant difference between IPT and other clinically evaluated studies. Although the study suggests that CBT is probably more effective in the early stages of eating disorder treatment, IPT has been effective in treating depression, eating disorders and similar problems. It is built on many theories including attachment theory and therefore, its methods are similar to some other approaches. Emotionally focused therapy, for example, also prioritizes attachments and human relationships.

Strengths and Weaknesses

IPT has some strengths and these are as follows:

• Focusing on relationships, communication skills and living conditions rather than seeing mental health problems as things that happen in a vacuum

• A structured, formulaic approach that makes it easy to monitor progress

• Ability to establish a strong relationship with the therapist, which can enable the client to test new skills

Studies have consistently shown that IPT works well for depression, relationship transitions, and conflict. While many studies have shown it to work well for some other problems, the evidence is less consistent and some other treatments may work better. One potential weakness of IPT is the shorter timetable, which may not provide adequate support for people with chronic or recurrent mental health problems. However, IPT practitioners acknowledge that maintenance sessions may be necessary for recurrent symptoms. Also, its formulaic approach may mean that therapy does not provide relief if a person is released early or cannot return for ongoing treatment.

Can IPT Work in Group Environment?

There are many advantages of interpersonal therapy applied to group therapy. First, group members have the opportunity to learn by observing what other members of the group have learned. In addition, learning takes place through the process of modeling the adjustments and behaviors of others in the group. Also, there are more opportunities to see various types of interpersonal interactions and associations. These help the individual better understand the various approaches to making interpersonal adjustments.

Before joining a group, there are one or two individual sessions to learn about the group process. These sessions are also used to identify one or two interpersonal issues to focus on during therapy.

Initially, the group goes through a participation process. This includes defining the group’s common goals and common focus. The therapist then facilitates the group to form a collaborative approach. This is followed by group members who differentiate themselves and find how to work on their individual problems. In this second stage, conflicts are likely to arise and partnerships or alliances to be built.

As the sessions progress, the focus of each individual will be addressed, and both the therapist and other group members help this person learn how to adjust their approach to matters. Role play or brainstorming is recommended to help the therapist find the right intervention. Or, the therapist can suggest communication training between group members. When conflict arises between group members, the therapist usually serves as a mediator to help avoid excessive negativity or criticism, while allowing group members to resolve the problem on their own.

What Happens After Interpersonal Therapy Is Over?

Because depression is sometimes recurrent and some people may experience multiple relapses, patients are encouraged to support IPT with ongoing care. Care takes the form of monthly sessions in which adjustments made during short-term IPT are reinforced. The goal is to prevent the stress of increased social interaction from triggering new episodes of depression and to help the individual continue to function at least at the same level as normal sessions are over.

Like all forms of psychotherapy, IPT empowers a person to change the way they think and interact with others. Focusing on relationships is especially helpful for people who mourn lost relationships or struggle to keep their relationship going. It is a highly effective treatment option for people with depression that can be an alternative to medication. Whatever treatment the person chooses, it is important to work with a licensed mental health counselor who is experienced in treating the particular issue the person wishes to deal with.