Docstoc

Interpersonal Psychotherapy

Document Sample
Interpersonal Psychotherapy Powered By Docstoc
					    Interpersonal Psychotherapy
Original Position

“Our original intent was not to develop a new psychotherapy,
but to describe what we believed was reasonable and current
practice with depressed patients who might be considered for
inclusion under the rubric of short term supportive
psychotherapy.”

                     Weissman & Klerman, (1993)
 Interpersonal Psychotherapy
IPT focuses on the relationship between mood and interpersonal
events.

Disturbing events and psychosocial stress may precipitate
depression,whereas having confidants and other intimate relationships
may protect against depression.


Once depressed the person experiences impaired interpersonal
functioning. Depressed patients tend to withdraw socially. As
depression compromises their mood, energy, enjoyment, cognitive
functioning and expectations of each encounter they have with others,
the patient functions less competently at work and in relationships.
  Interpersonal Psychotherapy
IPT avoids etiological statements about whether untoward
psychosocial events cause depression or vice versa;
clinically it may not matter.

The salient points are that patients learn to link mood with
interpersonal contacts, and to recognise that by
appropriately addressing interpersonal situations they may
simultaneously improve both their relationships and
depressive state.
                    Klerman & Weissman, 1993
  Interpersonal Psychotherapy
Goals of IPT


Reduce symptoms of depression


Improve the quality of the patient’s social and
interpersonal functioning
     Interpersonal Psychotherapy
Characteristics of IPT

Time limited not long term

Focused not open ended

Current not past interpersonal relationships

Interpersonal not intrapsychic

Interpersonal not cognitive behavioural

Personality recognised but not the focus
    Interpersonal Psychotherapy
Intervention Level

Symptom Function



Social and Interpersonal Relations



Personality and Character Problems
    Interpersonal Psychotherapy
Symptom Function

The development of depressive affect and the negative signs

and symptoms, which may derive from psychobiological

and/or psychodynamic mechanisms
     Interpersonal Psychotherapy
Social and Interpersonal Relations

Interactions in social roles with other people derived from

learning based on childhood experiences, concurrent social

reinforcement, and/or personal mastery and competence.
     Interpersonal Psychotherapy
Personality and Character Problems

Enduring traits, such as inhibited expression of anger or guilt,

poor psychological communication with significant others,

and/or difficulty with self-esteem. Personality patterns form

part of the person’s predisposition to depressive symptom

episodes.
    Interpersonal Psychotherapy
Intervention Level

Symptom Function



Social and Interpersonal Relations
     Interpersonal Psychotherapy
Role of the Therapist

Advocate

Active

Transference is not interpreted

Attend to therapeutic relationship
    Interpersonal Psychotherapy
Overview of IPT Sessions

Initial Sessions

Dealing with the depression

Relate depression to interpersonal context

Identify major problem area

Explain IPT concepts and contract
    Interpersonal Psychotherapy
Middle Sessions



Strategies and Goals
    Interpersonal Psychotherapy
Final Sessions



Termination Issues
     Interpersonal Psychotherapy
IPT Focus Areas

Interpersonal Role Transition


Grief


Interpersonal Role Disputes


Interpersonal Deficits
     Interpersonal Psychotherapy
Interpersonal Role Transition

Depression associated with role transition occurs when a

person has difficulty with life changes. In these cases the

transition is more likely to be experienced as a loss by the

person.
     Interpersonal Psychotherapy
Grief

IPT deals with depression associated with abnormal grief

reactions which result from failure to go through the various

phases of the normal mourning process
     Interpersonal Psychotherapy
Interpersonal Role Disputes

An interpersonal role dispute occurs when the patient and at

least one other significant person in their life have non-

reciprocal role expectations about their relationship. In these

cases the dispute is usually stalled or repetitious in character,

with little immediate hope for improvement.
     Interpersonal Psychotherapy
Interpersonal Deficits

Interpersonal deficits are chosen as the focus when a patient

presents with a history of social impoverishment, which

involves inadequate or unsatisfying interpersonal

relationships.
    Interpersonal Psychotherapy
Levels of Intervention

• Combating demoralisation/depressive symptoms

• Increasing acceptance of self/others

• Teaching interpersonal coping strategies/accessing existing
  strategies
    Interpersonal Psychotherapy
Techniques
• Topical Focus
• Exploratory Techniques
• Management/encouragement of affect
• Clarification
• Communication Analysis
• Use of the therapeutic relationship
• Behaviour change techniques
• Directive techniques
• Decision Analysis
• Role Play

				
DOCUMENT INFO