Interpersonal+Therapy


 * What is it? **

Interpersonal therapy is a relatively new form of psychotherapy descended from Freud’s Psychodynamic theory. Like other therapies stemming from the psychodynamic paradigm, interpersonal therapy works by helping the client (typically those suffering from depression) to gain insight about how they experience the world (Herkov). With this framework, the client’s suffering is seen as the result of dysfunctional and unsatisfactory relationships with others (Herkov). Insight gained through therapy is thus directed at understanding one’s interactions with others and why those interactions are leading to the client’s depression. According to Michael Herkov’s article ‘About Interpersonal Therapy,’ the three main techniques employed in interpersonal therapy are Emotion Identification, Emotional Expression, and Dealing with Emotional Baggage.

‘About Interpersonal Therapy’ (Herkov) explains that Emotion Identification refers to helping the client to better understand their emotions. This includes being able to connect the physical sensations (eg. upset stomach) they experience with its emotional salience (eg. anxiety). This also means learning to accurately identify and name the emotion one might be feeling, for example learning that what may have manifested as shouting was not anger but hurt. Once identification has been mastered, Emotional Expression becomes the focus. Emotional Expression refers to helping the client to learn effective and healthy ways to express their emotional experience. Specifically, this could mean learning to speak using ‘I’ statements when confronting a spouse about something upsetting to prevent yelling and name calling. Finally, Dealing with Emotional Baggage is fairly self explanatory.

According to Herkov, the term baggage refers to the feelings and experiences we tend to bring with us from past relationships into current relationships. Dealing with that baggage refers to the clinician helping the client to understand where those displaced feelings come from and how to prevent them from infecting other relationships. For example, as a boy, James may have felt abandoned by his busy mother. Now, in his relationship with his wife, he may act jealous or hostile when his wife becomes busy with activities that do not include him. Through interpersonal therapy, James will hopefully come to understand that those feelings of jealousy and hostility that are negatively impacting his marriage are actually residual feelings from his relationship with his mother. Gaining this insight may provide James with the perspective he needs to spur behaviour change.

In a preliminary examination of the effectiveness of Interpersonal Therapy to alleviate depression, the answer appears to be a tentative yes. In a fascinating study by Peeters et al. (2013) Interpersonal Therapy was employed in two of their four treatment modality groups. In this study, clients suffering from Major Depressive Disorder as defined by the Beck Depression Inventory received one of four treatment options in a true clinical setting. The first group received only Interpersonal therapy for fifteen to twenty weeks and received a follow up at week twenty-six. The second group using the same timeline experienced both Interpersonal Therapy and an SSRI treatment (to be discussed in a later section). The third and fourth groups followed the same pattern and consisted of Cognitive Behavioural Therapy both alone and with an SSRI drug treatment.
 * Does it work? **

Peeters et al. (2013) found that overall all four groups saw a statistically significant remission rate by week twenty-six. On average across all four treatment groups 35% of participants met the criteria for remission by the follow-up date. They also found that the Cognitive Behavioural group without SSRIs experienced remission at a slightly faster rate.

What does this mean for Interpersonal Therapy? Essentially, Peeters et al. (2013) found that this form of therapy was just as effective for relief from depressive symptoms as its more popular cousin Cognitive Behavioural Therapy. Moreover, both psychotherapy groups were equally preferred over those groups that also included SSRI treatments. Indeed, client preference may have been one of the major factors in the findings of this study. In contrast to some previous studies that conclude the use of SSRIs are more effective than psychotherapy (Cuijpers et al. 2009), this study found no such trend. Perhaps the greatest effectiveness is derived from the client’s choice, which may reflect their belief about whether a certain treatment will work for them. Indeed, there was a slight age disparity in clients who chose CBT and IPT, with older participants opting for IPT.