What is Interpersonal Therapy?
Interpersonal psychotherapy, or IPT, is a form of psychodynamic therapy that is often used to treat depressive disorders. It is also used to treat substance abuse and eating disorders. This type of therapy primarily focuses on the connection between current symptoms and interpersonal (relationship) problems. For example, IPT hypothesizes that an eating disorder is maintained by interpersonal problems. Thus, the treatment focuses on identifying and modifying those problems rather than on the symptoms themselves.
There are generally three phases of treatment in IPT. The first phase is very similar to the beginning of most other types of therapy, as it includes gathering a history of the symptoms and building a relationship between the therapist and client. The therapist will also determine a diagnosis during this time and provide education about the diagnosis and what to expect during treatment and recovery. During the second phase, the therapist and client explore the nature of the current problem, problematic relationships and strategies of change. The third phase is primarily a review of the work done and a reinforcement of changes made.
There are four primary types of interpersonal problems that IPT focuses on:
- Complicated bereavement can occur when someone important dies in the client’s life.
- Role disputes occur when the client is struggling with a significant other.
- Role transitions or life changes can also be a cause of stress for a person.
- Interpersonal deficits is a term used to describe a variety of relational challenges, including social isolation and trouble with social skills.
IPT was originally developed as a short-term treatment, as it is designed to occur over 12-16 sessions. However, there is also a maintenance option that can occur for several years as a way to prevent relapse and continue working on the current issues.
Does Interpersonal Therapy Work?
Current research shows that interpersonal psychotherapy is effective for the treatment of eating disorders, including bulimia nervosa, anorexia nervosa, and binge eating disorder. It has been compared to cognitive-behavioral therapy in randomized, controlled trials and has been found to be as successful as CBT.
It is also recognized by the 2004 NICE (National Institute of Clinical Excellence) Guidelines as a treatment of choice for eating disorders in the United Kingdom as well. This means that it is a documented treatment option.
Who Makes a Good Candidate for Interpersonal Therapy?
Because IPT has been shown to be successful in treating the three primary eating disorder diagnoses in adults, it could be a potential treatment option for the majority of sufferers. It may also be an option for sufferers who have not found other types of therapy to be effective. Interpersonal therapy is also considered quite flexible as it has been adapted for use in group therapy settings and can be used at both the outpatient and inpatient levels of care.
Who is Not a Good Candidate for Interpersonal Therapy?
Because IPT requires a significant commitment on the part of the client, it may not be a good fit for clients who are not engaged in the therapy process. It would also be difficult to use IPT with clients who are currently misusing drugs or in a psychotic state.
Interpersonal therapy may be used with both adults and adolescents. However, it is important to note that the majority of research regarding IPT has been done with adult clients. Adolescent clients may also need a different or adapted type of therapy to accommodate their developmental stage so that it can include their families in treatment. Currently, family-based treatment is the most well-researched option for adolescents struggling with anorexia nervosa.
Carter, F.A., Jordan, J., McIntosh, V.W., Luty, S.E., Framptom, C., Bulik, C.M., & Joyce, P.R. (2011). The long-term efficacy of three psychotherapies for anorexia nervosa: A randomized, controlled trial. International Journal of Eating Disorders, 44. 647-654.
Markowitz, J.C. & Weissman, M.M. (2004). Interpersonal psychotherapy: Principles and applications. World Psychiatry, 3(3). 136-139.
McIntosh, V.V., Bulik, C.M., McKenzie, J.M., Luty, S.E., & Jordan, J. (2000). Interpersonal psychotherapy for anorexia nervosa. International Journal of Eating Disorders, 27(2). 125-139.
National Institute for Clinical Excellence (2004). Eating disorders: Core intereventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders (Clinical Guideline No.9). London: Author. (Available at www.nice.org.uk/guidance/CG9).
Trull, T.J. & Phares, E.J. (2001). Clinical Psychology, 6th ed. Belmont, CA: Wadsworth.
Wilfley, D.E., Agras, W.S., Telch, C.F., Schneider, J.A., Cole, A.G., Sifford, L., & Raeburn, S.D. (1993). Group cognitive-behavioral therapy and group interpersonal psychotherapy for the nonpurging bulimic individual: A controlled comparison. Journal of Consulting and Clinical Psychology, 61(2). 296-305.
Wilson, G.T., Grilo, C.M. & Vitousek, K.M. (2007). Psychological treatment of eating disorders. American Psychologist, 62(3). 199-216.