In Interpersonal Psychotherapy for Older Adults With Depression, Gregory A. Hinrichsen demonstrates his approach to working with older clients suffering with this common disorder. Interpersonal psychotherapy (IPT) is a time-limited therapy that has been found to be effective in the treatment of depression in different age groups, including older adults. IPT focuses on one or two interpersonally relevant problems including interpersonal role disputes, role transitions, grief, and interpersonal deficits.
In this session, Dr. Hinrichsen works with a 77-year-old woman who recently lost her husband following a long period of caregiving during which one of her sons died. Despite the presence of many depressive symptoms, the client is unaware that she has a major depression. Dr. Hinrichsen demonstrates effectively the process of interpersonal psychotherapy as he helps the client to understand depression, its precipitants, and the path to improvement.
Interpersonal Psychotherapy (IPT) is a time-limited psychotherapy that has been found to be effective in the treatment of depression. IPT is based on theory and research that have demonstrated that interpersonally relevant issues often precede the onset of depression and that depression itself may seed interpersonal difficulties.
IPT is divided into three phases. During the initial sessions a diagnosis of depression is made, an inventory of social relationships is gathered, recent interpersonal problems are identified, and goals of treatment are set. In the intermediate sessions, the therapist works with the client to address one or at most two interpersonal problems: role transitions (major life change), interpersonal role dispute (conflict with a significant other), grief (complicated bereavement), or interpersonal deficits (individuals who have problems in initiating and/or sustaining relationships). The final phase of treatment is termination during which the course of treatment is reviewed and feelings associated with end of treatment are discussed.
The therapeutic ethos of IPT is one of collaborative empowerment. The psychoeducational components of IPT bring the client into a conversation about depression and its treatment. While establishing an emphatic understanding of how depression impairs the individual's ability to function, the therapist also quickly moves the client into an exploration of options to deal with challenging interpersonal issues. The therapeutic mantra of IPT is "What are your options?"
A typical IPT client is a depressed woman in her seventies who is providing care to a husband with dementia or physical health problems.
IPT would not be recommended for older adults who are not depressed or who do not have an interpersonally relevant issue.
Gregory A. Hinrichsen, PhD, is the director of psychology training at The Zucker Hillside Hospital, North Shore–Long Island Jewish Health System, and is associate professor of psychiatry at the Albert Einstein College of Medicine. During 30 years in the field of aging, he has provided clinical services, conducted research, directed psychology internship and fellowship programs, and had leadership roles in state and professional organizations.
He is past president of the American Psychological Association's (APA's) Division 12, Section II (Clinical Geropsychology) and past chair of APA's Committee on Aging. He is also a fellow of the APA and the Gerontological Society of America.
His research work has addressed family issues in late-life depression, dementia, and first-episode schizophrenia; adaptation to medical problems; and geropsychological education. Clinical interest in the application of Interpersonal Psychotherapy (IPT) to older adults developed from findings from his research that underscored the importance of interpersonal issues in late-life depression.
In the last years, Dr. Hinrichsen has conducted IPT with depressed older clients and directs an IPT training program for psychology trainees working with older adults. He and IPT collaborator, Kathleen Clougherty, are authors of Interpersonal Psychotherapy for Depressed Older Adults (APA, 2006). Dr. Hinrichsen lives in New York City.
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