Interpersonal Psychotherapy in Practice

Interpersonal psychotherapy is a focused, empirically grounded approach to treatment for clients with depression and other mental health issues.

Developed by Gerald L. Klerman and Myrna M. Weissman, interpersonal psychotherapy is a psychodynamic-based approach that uses a medical model to conceptualize presenting problems and then uses present-focused, active, and supportive techniques that help clients with their life issues.

The theoretical framework of this approach is that mental health disorders generally occur in an interpersonal context. Therapy therefore focuses on finding the connection between the client’s presenting issues and the client’s social circumstances, and then helping the client learn ways to resolve and anticipate interpersonal challenges, taking care to reiterate throughout therapy how doing so can help reduce troublesome mental health symptoms.

In this video, Dr. Ellen Frank introduces this approach, demonstrates it with a client, and then discusses key moments from the demonstration with a panel of mental health practitioners and students.

Deceptively simple, interpersonal psychotherapy (often referred to as IPT) takes the position that depression and other mental disorders arise in an interpersonal context in which interpersonal difficulties may either lead to the disorder or be caused by the presence of the disorder, but that regardless of the direction of causality, resolving the interpersonal problem most closely linked to the onset of the disorder, will lead to a resolution of symptoms.

The treatment begins by giving the often-confusing array of symptoms a name, in this case, “depression,” and by reassuring the patient that this condition is well known to mental health professionals and generally has an excellent prognosis. The therapist then takes a history of the illness and conducts what is called the “interpersonal inventory,” an attempt to understand who the important people in the patient’s life are currently, who has been important in the patient’s past life and what the nature of each of those relationships has been.

The goal of the interpersonal inventory is to move toward an interpersonal problem area to focus on during the treatment, something that is negotiated with the patient.

The classic IPT problem areas are:

• unresolved grief
• transition to a new life role
• role disputes with an important person in the patient’s life (usually a parent, significant other or child)
• more pervasive problems in multiple interpersonal relationships or the lack of close relationships

IPT defines specific strategies and tactics for each of these interpersonal problem areas and these form the bulk of the IPT work which is very much present-focused and practical. The therapist’s stance is active and supportive throughout.

The work typically concludes with a two-session review of the patient’s accomplishments and discussion of what might represent early warning signs of an impending relapse.

A short-term approach, IPT is usually offered as a 12 to 16-week treatment contract, with the therapist frequently marking how many sessions have occurred and how many remain so that the patient can be prepared for termination.

Ellen Frank is Distinguished Professor Emeritus of Psychiatry at the University of Pittsburgh School of Medicine.

Dr. Frank received her initial training in interpersonal psychotherapy (IPT) from Drs. Klerman and Weissman and her supervision from Dr. Bruce Rounsaville, one of their original collaborators in the development of IPT. Since then, she has trained hundreds of individuals in the IPT model and has been responsible for a series of adaptations of IPT to various disorders and treatment settings.

For more than 35 years, Dr. Frank’s work focused on a better understanding of mood disorders and their treatment, primarily through the vehicle of randomized controlled trials. Her 1990 study of maintenance therapies in recurrent unipolar depression, in which she demonstrated the preventive efficacy of maintenance interpersonal psychotherapy, is now considered a classic in the field.

She and her colleagues subsequently demonstrated the preventive efficacy of interpersonal and social rhythm therapy (IPSRT), a psychosocial intervention that seeks to stabilize circadian function in patients with bipolar disorder by increasing the regularity of their daily routines.

Much more information about IPT and its adaptations and a good reading list are available on the International Society of Interpersonal Psychotherapyopens in new window website.

APA Videos

• Brief Dynamic Therapy Over Time
  Hanna Levenson
• Interpersonal Psychotherapy for Older Adults With Depression
  Gregory A. Hinrichsen
• Interpersonal Reconstructive Therapy
  Lorna Smith Benjamin
• Interpersonal Reconstructive Therapy for Passive–Aggressive Personality Disorder
  Lorna Smith Benjamin
• Mentalization-Based Therapy
  Norka T. Malberg
• Personality-Guided Therapy Over Time
  Jeffery J. Magnavita
• Time-Limited Dynamic Psychotherapy
  Hanna Levenson

APA Books

• Interpersonal Psychotherapy
  Ellen Frank and Jessica C. Levenson
• Interpersonal Psychotherapy for Depressed Older Adults
  Gregory A. Hinrichsen and Kathleen F. Clougherty
• Interpersonal Reconstructive Therapy for Anger, Anxiety, and Depression: It’s About Broken Hearts, Not Broken Brains
  Lorna Smith Benjamin