Hey, because May is Mental Health Month, this is another one of my Dirty Dozen lectures. It’s on Interpersonal Psychotherapy.
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Dirty Dozen on Interpersonal Psychotherapy by Jim Amos, MD
Definition of IPT
–Time-limited, dynamically informed therapy.
–Goals are to relieve symptoms and improve interpersonal functioning and social support.
–Focuses specifically on interpersonal relationships to bring about change.
Applications for IPT
–Major Depression
–Postpartum and peripartum Depression
–Dysthymia
Essential Characteristics of IPT
–Focuses specifically on interpersonal relationships as a point of intervention.
–Time-limited when used as an acute treatment (12-16 sessions).
–Interventions used do not directly address the transference relationship.
Premises of IPT
–Interpersonal distress closely associated with psychological symptoms.
–Helping people improve communications in relationships or change their expectations about those relationships relieves symptoms.
–Helping people build or improve social support network improves ability to cope with crises that precipitated distress.
IPT Contrasted with CBT & Psychoanalytic Approaches
–CBT focus is on cognitions.
–Psychoanalytic focus is on understanding contributions of early life experiences.
–IPT focus is on improving interpersonal communications in the present.
Theoretical Framework of IPT
–Attachment Theory
–People are driven instinctively to form attachments to get and give care.
–Hallmark of good mental health is ability to form flexible attachments.
Theoretical Framework of IPT cont.
–Communication Theory
–Securely attached persons able to communicate needs effectively.
–Insecurely attached persons communicate in an indirect, ambivalent way that may elicit neutrality or hostility.
Problem Areas of Focus for IPT; Conducting IPT
–Grief
–Interpersonal Disputes
–Role Transitions
–More important than technique is the focus on extratherapeutic interpersonal relationships and fostering of productive therapeutic alliance.
Conducting IPT
–Opening Phase: diagnose, frame the treatment, relieve symptoms.
–Middle Phase: develop strategies for problem areas: identify situations which elicit feelings, validate feelings, explore and role play options, summarize sessions.
–Conclusion and Maintenance Phases: reinforce independence.
Conducting IPT cont.
–Communication Analysis and Interpersonal Incidents (accurately describe in detail).
–Use of both content and process affect (what happened outside and inside).
–Observe transference but don’t comment on or interpret it.
IPT References and Links
–Core Competencies in Psychotherapy. The Art and Science of Brief Psychotherapies: A Practitioner’s Guide, eds. Dewan, Steenberg, Greenberg. APPI 2004
–Stuart, S. (2012). “Interpersonal psychotherapy for postpartum depression.” Clin Psychol Psychother 19(2): 134-140.
–Interpersonal Psychotherapy Institute
In observance of May being Mental Health Month, this is one of my Dirty Dozen lectures. It’s on the elements that are shared among some of the important psychotherapy methods.
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Dirty Dozen on Common Elements of Psychotherapy by Jim Amos, MD
What is Psychotherapy?
-Change facilitation
-Self awareness development
-Doesn’t necessarily have to occur in formal therapy encounters
-Can happen between patients and a wide range of professionals
Patient Variables and Relationship Factors
-Ability to relate, psychological mindedness
-Therapeutic alliance
-Readiness to change
-Respect, listening for understanding
Placebo, Hope, and Expectancy Effects
-Power of providing a “treatment experience”
-An emotionally charged relationship in which therapy instills hope for change
-A particular set of procedures that enhance belief in the therapist’s competency
-A therapeutic explanation of the problems that fits the patient’s belief system
Motivational Interviewing
-Intended to raise patient’s awareness of ambivalence between opposing thoughts and behaviors
-Accepts the “yes, but” responses without confrontation
-Emphasizes validation, reflection, reframing
-Source: Miller, W. R. and S. Rollnick (1991). Motivational interviewing : preparing people to change addictive behavior. New York, Guilford Press.
Motivational Interviewing cont. Stages of Readiness to Change
-Precontemplation
-Contemplation
-Preparation
-Action
-Maintenance
-Termination
Cognitive Behavioral Therapy (CBT)
-Foci of treatment are internally based cognitions and challenging, unhelpful or harmful thoughts and behaviors.
-Time limited
Interpersonal Therapy (IPT)
-Focus on interpersonal communications with others
-Focus on helping improve communication and social support in the present
-Time limited
Psychodynamic Psychotherapy
-Focus of treatment is on understanding contributions of early life experiences to psychological functioning and unhelpful or harmful behaviors
-Can be lengthy or open-ended
Essential Operations of Psychodynamic Psychotherapy
-Accepting: Therapist affirms the patient’s past and present subjective experience
-Understanding: Therapist appreciates both the conscious and unconscious contributions to the patient’s emotional problems
-Explaining: Therapist expresses, through interpretations, his or her understanding to the patient
Integrating Therapies
-Skillfully staged combinations of approaches may be more successful than one used alone
-Cognitive behavioral or interpersonal approaches first for more immediate symptom relief
-Psychodynamic approaches first for increasing self-awareness and exploring the need for change
References
-Dewan, M. J., MD,, B. N. Steenbarger, PhD,, et al., Eds. (2004). The Art and Science of Brief Psychotherapies: A Practitioner’s Guide. Core Competencies in Psychotherapy. Washington, DC, American Psychiatric Publishing, Inc.
-Miller, W. R. and S. Rollnick (1991). Motivational interviewing : preparing people to change addictive behavior. New York, Guilford Press.
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