Chapter 10: Interpersonal Therapy
CHAPTER 10
Interpersonal Therapy
LEARNING OBJECTIVES
A昀琀er studying this chapter, students should be able to:
1 List the four key interpersonal problem areas that have been de昀椀ned as
depressogenic triggers in interpersonal psychotherapy.
2 Iden琀椀fy similari琀椀es and di昀昀erences between interpersonal
psychotherapy and Beck’s cogni琀椀ve therapy.
3 Describe the history of interpersonal psychotherapy and iden琀椀fy the
most important historical 昀椀gures in its development.
4 Brie昀氀y describe the di昀昀erences between interpersonal counseling (IPC)
and interpersonal psychotherapy (IPT).
5 Iden琀椀fy the typical course of treatment and the stages of treatment
associated with interpersonal psychotherapy.
6 List four speci昀椀c mechanisms that have been shown to produce
change in interpersonal psychotherapy.
7 Give examples of 昀椀ve di昀昀erent techniques that are used in
interpersonal psychotherapy.
8 Describe the di昀昀erence between e昀케ciency tes琀椀ng and e昀昀ec琀椀veness
studies.
CHAPTER OUTLINE
Overview
Basic Concepts
Other Systems
History
Precursors
Interperonal Context of Depression
Beginnings
Current Status
Personality
Theory of Personality
Variety of Concepts
Psychotherapy
Theory of Psychotherapy
Process of Psychotherapy
Middle Phase
Termina琀椀on Phase (Last Two Sessions)
Copyright © 2018 Cengage Learning. All rights reserved.
,Chapter 10: Interpersonal Therapy
Mechanisms of Psychotherapy
Applica琀椀ons
Who Can We Help?
Treatment
Evidence
Psychotherapy in a Mul琀椀cultural World
Case Example
Summary
CHAPTER SUMMARY
Interpersonal psychotherapy (IPT) is a 琀椀me-limited, symptom-focused therapy that was originally
developed by Gerald Klerman and Myrna Weissman in the 1970s to treat unipolar, nonpsycho琀椀c
depression in adults (Klerman, Weissman, Rounsaville, & Chevron, 1984; Weissman, Markowitz, &
Klerman, 2017). The fundamental principle of IPT is that depression occurs in an interpersonal context.
Regardless of the causes of depression, the triggers of depressive episodes involve disrup琀椀ons of
signi昀椀cant a琀琀achments and social roles. Four interpersonal problem areas have been de昀椀ned as
depressogenic triggers and become the focus of IPT: grief, interpersonal disputes, role transi琀椀ons, and
interpersonal de昀椀cits. While recognizing the gene琀椀c, personality, and early childhood factors that
contribute to depression, the IPT therapist focuses on the recovery from the current depressive episode
by (1) clarifying the rela琀椀onship between the onset of pa琀椀ent’s current depressive symptoms and
interpersonal problems and (2) building interpersonal skills to resolve or manage more e昀昀ec琀椀vely these
interpersonal problems.
SUGGESTIONS FOR ACTIVITIES
1. Although most pa琀椀ents might appreciate the focus of interpersonal psychotherapy (IPT) on
interpersonal issues, IPT strongly asserts that depression is a biological illness that can be
triggered by stress—most notably interpersonal stressors. Describing the biological and
interpersonal factors related to depression might seem complicated or contradictory to a
pa琀椀ent. Ask students to role-play how they would explain the theory behind IPT and the
ra琀椀onale for the treatment approach to a pa琀椀ent.
2. Have students brainstorm a list of presen琀椀ng problems. Then ask them to sort that list into
the categories of depressogenic triggers (grief, interpersonal disputes, role transi琀椀ons,
interpersonal de昀椀cits). Prompt a discussion of the u琀椀lity of these categories, and whether
they adequately capture the breadth of presen琀椀ng problems considered.
3. Have students locate videos on YouTube of Ainsworth’s strange situa琀椀on experiment and
the four a琀琀achment styles. Ask them to re昀氀ect on their observa琀椀ons of the styles and the
relevance of the styles to ITP.
DISCUSSION QUESTIONS
Copyright © 2018 Cengage Learning. All rights reserved.
,Chapter 10: Interpersonal Therapy
1. Using Table 10.1 in the Applica琀椀ons sec琀椀on of the text, lead a discussion on the goals and
strategies used in the middle phase of ITP treatment.
2. Interpersonal therapy for depressed adolescents (IPT-A) di昀昀ers from the model used for
adults. Have the students discuss how the use of 12 sessions, integra琀椀on of telephone
contacts, and engagement in a collabora琀椀ve rela琀椀onship with the parents and school might
enhance the model with adolescents. Ask the students to consider any nega琀椀ve consequences
to these altera琀椀ons to the model.
3. World Vision sponsored the Uganda project using the World Health Organiza琀椀on’s task
shi昀琀ing model (i.e., the delega琀椀on of tasks to less specialized local health workers). Ask the
students to discuss the pros and cons of the task shi昀琀ing model.
CASE STUDIES IN PSYCHOTHERAPY
“A Case Study for the New IPT Therapist” was specifically selected by Myrna Weissman and Lena
Verdeli to illustrate the principles of interpersonal psychotherapy (IPT) they describe in their chapter in
Current Psychotherapies. Although this approach is used in the treatment of a wide variety of disorders, it
was initially developed as a treatment for depression, and most of the research done with IPT has looked at
the therapy as an intervention with depressed clients. This case illustrates the use of IPT to treat a
depressed woman who is romantically involved with a married man.
The patient is a part of a randomized clinical trial, and treatment is specific, detailed, and manualized. The
treatment focuses on interpersonal disputes, and the therapist (a) seeks information; (b) explores parallels
in various relationships; (c) explores relationship patterns; and (d) explores the client’s communication
patterns. In addition, the therapist signals what is likely to be significant; provides supports; explores
affect; explores options; helps with problem solving; draws analogies; and challenges the client when
necessary. The therapist also attempts to identify, describe, and classify the most salient themes that
emerge during the course of therapy.
Ask your students if they find comfort in an approach to therapy that is detailed, exacting, and specific—
or are they more likely to want an approach in which the therapist has wider latitude in determining “what
to do next?” Some experts believe manualized treatments are best for inexperienced therapists. Do your
students agree? How much latitude can therapists take with a manualized approach while still maintaining
fidelity to the basic principles detailed in the treatment manual? Is it fair to trivialize manualized
approaches as simply “cookie cutter therapies?”
KEY CONCEPTS AND TERMS
Depressogenic Triggers: Social or interpersonal situa琀椀ons that trigger a depressive episode.
E昀昀ect Modi昀椀ers: A third variable that changes the magnitude of the rela琀椀onship between two other
variables.
E昀케cacy Tes琀椀ng: Tes琀椀ng the performance of an interven琀椀on under ideal condi琀椀ons (e.g., within a
homogenous group of pa琀椀ents and delivered by highly trained professionals using a treatment
manual).
Interpersonal Counseling: A brief psychosocial interven琀椀on derived from IPT intended to train
professionals with no mental-health background for the treatment of primary care pa琀椀ents with
depression.
Rela琀椀ve Risk: The ra琀椀o of the disease rate among those exposed to a puta琀椀ve causal factor versus the
Copyright © 2018 Cengage Learning. All rights reserved.
, Chapter 10: Interpersonal Therapy
disease rate among people not exposed.
Sick Role: A temporary role assigned to the pa琀椀ent by the therapist in the ini琀椀al phase of the therapy
to explain that the pa琀椀ent may not be able to func琀椀on at an op琀椀mal level un琀椀l he or she gets out of
the current episode.
LO/STANDARDS CORRELATION CHART
A-Head LO Standard 1— Standard 2—EPAS Standard 3—
CACREP CSHSE
Overview 1 List the four key 3a. Theories of 7b. Apply 2a. Theories of
interpersonal individual and knowledge of human
problem areas family human behavior development
that have been development and the social
de昀椀ned as across the environment,
depressogenic lifespan person-in-
triggers in environment, and
interpersonal other
psychotherapy. mul琀椀disciplinary
theore琀椀cal
frameworks in the
analysis of
assessment data
from clients and
cons琀椀tuencies.
Other Systems 2 Iden琀椀fy 3a. Theories of 7b. Apply 2a. Theories of
similari琀椀es and individual and knowledge of human
di昀昀erences family human behavior development
between development and the social
interpersonal across the environment,
psychotherapy lifespan person-in-
and Beck’s environment, and
cogni琀椀ve therapy. other
mul琀椀disciplinary
theore琀椀cal
frameworks in the
analysis of
assessment data
from clients and
cons琀椀tuencies.
History 3 Describe the 1a. History and 7b. Apply 2a. Theories of
history of philosophy of the knowledge of human
interpersonal counseling human behavior development
psychotherapy profession and its and the social
and iden琀椀fy the specialty areas environment,
most important person-in-
historical 昀椀gures environment, and
in its other
development. mul琀椀disciplinary
Copyright © 2018 Cengage Learning. All rights reserved.
CHAPTER 10
Interpersonal Therapy
LEARNING OBJECTIVES
A昀琀er studying this chapter, students should be able to:
1 List the four key interpersonal problem areas that have been de昀椀ned as
depressogenic triggers in interpersonal psychotherapy.
2 Iden琀椀fy similari琀椀es and di昀昀erences between interpersonal
psychotherapy and Beck’s cogni琀椀ve therapy.
3 Describe the history of interpersonal psychotherapy and iden琀椀fy the
most important historical 昀椀gures in its development.
4 Brie昀氀y describe the di昀昀erences between interpersonal counseling (IPC)
and interpersonal psychotherapy (IPT).
5 Iden琀椀fy the typical course of treatment and the stages of treatment
associated with interpersonal psychotherapy.
6 List four speci昀椀c mechanisms that have been shown to produce
change in interpersonal psychotherapy.
7 Give examples of 昀椀ve di昀昀erent techniques that are used in
interpersonal psychotherapy.
8 Describe the di昀昀erence between e昀케ciency tes琀椀ng and e昀昀ec琀椀veness
studies.
CHAPTER OUTLINE
Overview
Basic Concepts
Other Systems
History
Precursors
Interperonal Context of Depression
Beginnings
Current Status
Personality
Theory of Personality
Variety of Concepts
Psychotherapy
Theory of Psychotherapy
Process of Psychotherapy
Middle Phase
Termina琀椀on Phase (Last Two Sessions)
Copyright © 2018 Cengage Learning. All rights reserved.
,Chapter 10: Interpersonal Therapy
Mechanisms of Psychotherapy
Applica琀椀ons
Who Can We Help?
Treatment
Evidence
Psychotherapy in a Mul琀椀cultural World
Case Example
Summary
CHAPTER SUMMARY
Interpersonal psychotherapy (IPT) is a 琀椀me-limited, symptom-focused therapy that was originally
developed by Gerald Klerman and Myrna Weissman in the 1970s to treat unipolar, nonpsycho琀椀c
depression in adults (Klerman, Weissman, Rounsaville, & Chevron, 1984; Weissman, Markowitz, &
Klerman, 2017). The fundamental principle of IPT is that depression occurs in an interpersonal context.
Regardless of the causes of depression, the triggers of depressive episodes involve disrup琀椀ons of
signi昀椀cant a琀琀achments and social roles. Four interpersonal problem areas have been de昀椀ned as
depressogenic triggers and become the focus of IPT: grief, interpersonal disputes, role transi琀椀ons, and
interpersonal de昀椀cits. While recognizing the gene琀椀c, personality, and early childhood factors that
contribute to depression, the IPT therapist focuses on the recovery from the current depressive episode
by (1) clarifying the rela琀椀onship between the onset of pa琀椀ent’s current depressive symptoms and
interpersonal problems and (2) building interpersonal skills to resolve or manage more e昀昀ec琀椀vely these
interpersonal problems.
SUGGESTIONS FOR ACTIVITIES
1. Although most pa琀椀ents might appreciate the focus of interpersonal psychotherapy (IPT) on
interpersonal issues, IPT strongly asserts that depression is a biological illness that can be
triggered by stress—most notably interpersonal stressors. Describing the biological and
interpersonal factors related to depression might seem complicated or contradictory to a
pa琀椀ent. Ask students to role-play how they would explain the theory behind IPT and the
ra琀椀onale for the treatment approach to a pa琀椀ent.
2. Have students brainstorm a list of presen琀椀ng problems. Then ask them to sort that list into
the categories of depressogenic triggers (grief, interpersonal disputes, role transi琀椀ons,
interpersonal de昀椀cits). Prompt a discussion of the u琀椀lity of these categories, and whether
they adequately capture the breadth of presen琀椀ng problems considered.
3. Have students locate videos on YouTube of Ainsworth’s strange situa琀椀on experiment and
the four a琀琀achment styles. Ask them to re昀氀ect on their observa琀椀ons of the styles and the
relevance of the styles to ITP.
DISCUSSION QUESTIONS
Copyright © 2018 Cengage Learning. All rights reserved.
,Chapter 10: Interpersonal Therapy
1. Using Table 10.1 in the Applica琀椀ons sec琀椀on of the text, lead a discussion on the goals and
strategies used in the middle phase of ITP treatment.
2. Interpersonal therapy for depressed adolescents (IPT-A) di昀昀ers from the model used for
adults. Have the students discuss how the use of 12 sessions, integra琀椀on of telephone
contacts, and engagement in a collabora琀椀ve rela琀椀onship with the parents and school might
enhance the model with adolescents. Ask the students to consider any nega琀椀ve consequences
to these altera琀椀ons to the model.
3. World Vision sponsored the Uganda project using the World Health Organiza琀椀on’s task
shi昀琀ing model (i.e., the delega琀椀on of tasks to less specialized local health workers). Ask the
students to discuss the pros and cons of the task shi昀琀ing model.
CASE STUDIES IN PSYCHOTHERAPY
“A Case Study for the New IPT Therapist” was specifically selected by Myrna Weissman and Lena
Verdeli to illustrate the principles of interpersonal psychotherapy (IPT) they describe in their chapter in
Current Psychotherapies. Although this approach is used in the treatment of a wide variety of disorders, it
was initially developed as a treatment for depression, and most of the research done with IPT has looked at
the therapy as an intervention with depressed clients. This case illustrates the use of IPT to treat a
depressed woman who is romantically involved with a married man.
The patient is a part of a randomized clinical trial, and treatment is specific, detailed, and manualized. The
treatment focuses on interpersonal disputes, and the therapist (a) seeks information; (b) explores parallels
in various relationships; (c) explores relationship patterns; and (d) explores the client’s communication
patterns. In addition, the therapist signals what is likely to be significant; provides supports; explores
affect; explores options; helps with problem solving; draws analogies; and challenges the client when
necessary. The therapist also attempts to identify, describe, and classify the most salient themes that
emerge during the course of therapy.
Ask your students if they find comfort in an approach to therapy that is detailed, exacting, and specific—
or are they more likely to want an approach in which the therapist has wider latitude in determining “what
to do next?” Some experts believe manualized treatments are best for inexperienced therapists. Do your
students agree? How much latitude can therapists take with a manualized approach while still maintaining
fidelity to the basic principles detailed in the treatment manual? Is it fair to trivialize manualized
approaches as simply “cookie cutter therapies?”
KEY CONCEPTS AND TERMS
Depressogenic Triggers: Social or interpersonal situa琀椀ons that trigger a depressive episode.
E昀昀ect Modi昀椀ers: A third variable that changes the magnitude of the rela琀椀onship between two other
variables.
E昀케cacy Tes琀椀ng: Tes琀椀ng the performance of an interven琀椀on under ideal condi琀椀ons (e.g., within a
homogenous group of pa琀椀ents and delivered by highly trained professionals using a treatment
manual).
Interpersonal Counseling: A brief psychosocial interven琀椀on derived from IPT intended to train
professionals with no mental-health background for the treatment of primary care pa琀椀ents with
depression.
Rela琀椀ve Risk: The ra琀椀o of the disease rate among those exposed to a puta琀椀ve causal factor versus the
Copyright © 2018 Cengage Learning. All rights reserved.
, Chapter 10: Interpersonal Therapy
disease rate among people not exposed.
Sick Role: A temporary role assigned to the pa琀椀ent by the therapist in the ini琀椀al phase of the therapy
to explain that the pa琀椀ent may not be able to func琀椀on at an op琀椀mal level un琀椀l he or she gets out of
the current episode.
LO/STANDARDS CORRELATION CHART
A-Head LO Standard 1— Standard 2—EPAS Standard 3—
CACREP CSHSE
Overview 1 List the four key 3a. Theories of 7b. Apply 2a. Theories of
interpersonal individual and knowledge of human
problem areas family human behavior development
that have been development and the social
de昀椀ned as across the environment,
depressogenic lifespan person-in-
triggers in environment, and
interpersonal other
psychotherapy. mul琀椀disciplinary
theore琀椀cal
frameworks in the
analysis of
assessment data
from clients and
cons琀椀tuencies.
Other Systems 2 Iden琀椀fy 3a. Theories of 7b. Apply 2a. Theories of
similari琀椀es and individual and knowledge of human
di昀昀erences family human behavior development
between development and the social
interpersonal across the environment,
psychotherapy lifespan person-in-
and Beck’s environment, and
cogni琀椀ve therapy. other
mul琀椀disciplinary
theore琀椀cal
frameworks in the
analysis of
assessment data
from clients and
cons琀椀tuencies.
History 3 Describe the 1a. History and 7b. Apply 2a. Theories of
history of philosophy of the knowledge of human
interpersonal counseling human behavior development
psychotherapy profession and its and the social
and iden琀椀fy the specialty areas environment,
most important person-in-
historical 昀椀gures environment, and
in its other
development. mul琀椀disciplinary
Copyright © 2018 Cengage Learning. All rights reserved.
