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Interpersonal Psychotherapy for Depression

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1 Interpersonal Psychotherapy for Depression
Bob Hill, Ph.D. Appalachian State University Boone, NC 28608 Title page for IPT Depression Presentation Bob Hill, Ph.D., Psychology, Appalachain State University

2 Interpersonal Psychotherapy for Depression
Overview Depression Theoretical Sources for IPT Prominent Features of IPT Outline of IPT Phases of IPT Treatment Clinical Examples Empirical Support Bob Hill, Ph.D., Psychology, Appalachain State University

3 Interpersonal Psychotherapy for Depression
IPT clearly effective for treating Depression Diagnostic Criteria for Depression: A.Five (or more) of the following symptoms have been present during the same 2-week period; at least one of the symptoms is either 1.depressed mood most of the day, nearly every day, as indicated by either subjective report or observation made by others. Note in children, can be irritable mood. 2. anhedonia: markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day Bob Hill, Ph.D., Psychology, Appalachain State University

4 Depression Criteria continued (2+ needed):
Interpersonal Psychotherapy for Depression Depression Criteria continued (2+ needed): 3.significant weight loss when not dieting or weight gain or decrease or increase in appetite.. 4.insomnia or hypersomnia nearly every day 5.psychomotor agitation or retardation observable by others 6.fatigue or loss of energy nearly every day 7.feelings of worthlessness or excessive or inappropriate guilt 8.diminished ability to think or concentrate, or indecisiveness 9.recurrent thoughts of death, recurrent suicidal ideation with or without a specific plan, or suicidal intent. Bob Hill, Ph.D., Psychology, Appalachain State University

5 Reasons to consider Medication
Interpersonal Psychotherapy for Depression Reasons to consider Medication Client too depressed to participate in treatment Client not psychological, resistant to talking tx Client who is at risk for suicide Client with recurrent Depressive episodes, with symptoms of Melancholic Features May respond more quickly with medication and IPT combined Bob Hill, Ph.D., Psychology, Appalachain State University

6 Depression with Melancholic Features
Interpersonal Psychotherapy for Depression Depression with Melancholic Features 1) anhedonia 2) lack of reactivity to usually pleasant stimuli 3) Three or more of: Distinct quality of depressed mood Depression is worse in a.m. Early morning awakening (at least 2 hrs) Marked psychomotor agitation or retardation Significant anorexia or weight loss Excessive or inappropriate guilt Psychotic symptoms Suicide risk Bob Hill, Ph.D., Psychology, Appalachain State University

7 Prevalence of Depression
Interpersonal Psychotherapy for Depression Prevalence of Depression Dysthymia Depression Disorder Total Males Females 6.4 % 4.8 % 8.0 % 17.1 % 12.7 % 21.3 % National Comorbidity Survey (1994) Bob Hill, Ph.D., Psychology, Appalachain State University

8 Historical Influences of IPT
Interpersonal Psychotherapy for Depression Historical Influences of IPT Psychoanalysis Harry Stack Sullivan Object Relations Therapy Interpersonal Theory (Leary, Kiesler) Bob Hill, Ph.D., Psychology, Appalachain State University

9 IPT: Roots in Psychodynamic Theory
Interpersonal Psychotherapy for Depression IPT: Roots in Psychodynamic Theory Primary instincts of sex and aggression involve relating to others Relationships with others contribute to personality development Psychological Problems due to deficits in early relations Transference and counter-transference are interpersonal Bob Hill, Ph.D., Psychology, Appalachain State University

10 Object Relations Influence
Interpersonal Psychotherapy for Depression Object Relations Influence “Object” is human being “Relations” are internal, external, fantasied or real interactions with others Early parent-child relations are internalized as expectations for future relationships Identity/personality derived from pattern of early relationship experiences Expectations of others impacts quality of current interpersonal relationships and mood Bob Hill, Ph.D., Psychology, Appalachain State University

11 Manualized Interpersonal Therapy
Interpersonal Psychotherapy for Depression Manualized Interpersonal Therapy Klerman, G. (1984). Interpersonal Psychotherapy for Depression. Weissman, M. (2002). Comprehensive Guide to Interpersonal Psychotherapy. Bob Hill, Ph.D., Psychology, Appalachain State University

12 Prominent Features of IPT
Interpersonal Psychotherapy for Depression Prominent Features of IPT IPT designed for symptom reduction and improved interpersonal relationships Focus on current disputes, frustrations, anxieties in the interpersonal context which impact mood and self esteem Bob Hill, Ph.D., Psychology, Appalachain State University

13 IPT Compared to Other Therapies
Interpersonal Psychotherapy for Depression IPT Compared to Other Therapies Time-limited- outcome studies document efficacy of short-term (12-16 weeks) tx Not designed for personality change Focused on current interpersonal disputes, anxieties, frustrations Addresses 1-2 problem areas in interpersonal functioning Bob Hill, Ph.D., Psychology, Appalachain State University

14 IPT Compared to Other Therapies
Interpersonal Psychotherapy for Depression IPT Compared to Other Therapies Interpersonal, not intrapsychic Interpersonal, not Cognitive Behavioral Goal is to change feelings, thoughts, actions in problematic relationships Negative/irrational cognitions are addressed only in interpersonal function IPT attends to distorted thinking in relation to significant others Goal is to change relationship pattern rather than depressive cognitions Bob Hill, Ph.D., Psychology, Appalachain State University

15 Interpersonal Psychotherapy for Depression
IPT Compared to CBT Focus on affect and expression of emotions Explores avoidance and resistance behavior Identification of patterns in client’s behavior, thinking, feeling and relationships Attention to past experiences Focus on interpersonal experience Emphasis on the therapeutic relationship Exploration of client’s wishes, dreams, fantasies Blagys & Hilsenroth, 2000 Bob Hill, Ph.D., Psychology, Appalachain State University

16 IPT and Personality Change
Interpersonal Psychotherapy for Depression IPT and Personality Change IPT does not target alteration of personality Personality pathology may limit IPT outcome IPT may help patient recognize maladaptive personality features IPT may improve social skills and thus ameliorate maladaptive personality traits Bob Hill, Ph.D., Psychology, Appalachain State University

17 Interpersonal Psychotherapy for Depression
Role of IPT Therapist Therapist is patient advocate, not neutral Expresses unconditional positive regard Intentionally cultivates positive expectations of treatment Optimistic, positive, reassuring Therapist is active in keeping interpersonal problem areas to focus Bob Hill, Ph.D., Psychology, Appalachain State University

18 Outline of IPT Intervention
Interpersonal Psychotherapy for Depression Outline of IPT Intervention Initial Sessions (Overview) Assess Depressive symptoms Complete Interpersonal Assessment Identify Major Interpersonal Problem Area Explain IPT and make treatment contract Bob Hill, Ph.D., Psychology, Appalachain State University

19 Initial Sessions (“Sick Role”)
Interpersonal Psychotherapy for Depression Initial Sessions (“Sick Role”) Review Sxs, Dx of depression to communicate “sick role” Functions of “Sick Role” Sick person exempt from responsibilities Sick person in need of help Sick is undesirable and needs to be improved Sick person obliged to cooperate with Tx Sick role shifts blame from client to illness Mitigates self blame Bob Hill, Ph.D., Psychology, Appalachain State University

20 Relate Depression to Interpersonal Context
Interpersonal Psychotherapy for Depression Relate Depression to Interpersonal Context What interpersonal events related to depression? Review current & past interpersonal relationships Who does client interact with? Frequency of contact, activities shared? Assess quality and themes of relationships Assess expectations of client (and other) in relationships Assess satisfying and unsatisfying aspects of relationships Discuss changes client wants in relationships Bob Hill, Ph.D., Psychology, Appalachain State University

21 Inventory of Interpersonal Problems
Interpersonal Psychotherapy for Depression Inventory of Interpersonal Problems 64 items assess diverse interpersonal problems: • Being too controlling or manipulative • Being self-centered and resentful • Having minimal feelings of affection for, and little connection with, other people • Being socially avoidant • Being nonassertive • Being gullible and easily taken advantage of • Being excessively selfless, generous, trusting, • Being too intrusive Available from Psychological Corporation Bob Hill, Ph.D., Psychology, Appalachain State University

22 Interpersonal Problems Circumplex
Interpersonal Psychotherapy for Depression Interpersonal Problems Circumplex Bob Hill, Ph.D., Psychology, Appalachain State University

23 Interpersonal Psychotherapy for Depression
IIP Circumplex Evan Bob Hill, Ph.D., Psychology, Appalachain State University

24 Interpersonal Psychotherapy for Depression
IIP Scale Profile Bob Hill, Ph.D., Psychology, Appalachain State University

25 Identification of Major Problem Area
Interpersonal Psychotherapy for Depression Identification of Major Problem Area Assess interpersonal experience and depression to identify of one of Four Problem Areas: Interpersonal Role Dispute: with spouse, lover, family member, friends, co-worker Role Transition: e.g. new job, relocation, divorce Interpersonal Deficits: evidenced by social impoverishment, loneliness, isolation Grief: following death if abnormally severe, protracted or impairing Bob Hill, Ph.D., Psychology, Appalachain State University

26 Interpersonal Psychotherapy for Depression
Problem Area Focus Four problems areas are: Not exhaustive, nor mutually exclusive Not “deep” conceptual theory Communicate to client Problem area focus Problem area ensures focus on recognized problem rather than personal weakness E.g. ‘try to discover what you want and need from others and help you learn how to get it’ Bob Hill, Ph.D., Psychology, Appalachain State University

27 Explain Interpersonal Focus
Interpersonal Psychotherapy for Depression Explain Interpersonal Focus Tx focus will be interpersonal satisfaction, not intrapsychic exploration Educate about link between depressed mood and difficulty getting what we want/need from others Therapist describes nature of clients interpersonal difficulty Agree on goal of improved interpersonal relations Set expectation: make changes btwn sessions Bob Hill, Ph.D., Psychology, Appalachain State University

28 Setting Treatment Contract
Interpersonal Psychotherapy for Depression Setting Treatment Contract Set 2 –3 treatment goals with client related to problem area focus Ask client what would be the: Best possible outcome Most expectable outcome Worst possible outcome Describe expected Duration and Frequency of treatment (12-16 weeks) Bob Hill, Ph.D., Psychology, Appalachain State University

29 Teaching Client Their Role in IPT
Interpersonal Psychotherapy for Depression Teaching Client Their Role in IPT “Talk about things that affect you emotionally “Your responsibility to select topics that are most important to you” “No right or wrong thing to talk about” “When important feelings emerge, raise them” “including feeling about me or the therapy” Bob Hill, Ph.D., Psychology, Appalachain State University

30 Starting Intermediate Sessions
Interpersonal Psychotherapy for Depression Starting Intermediate Sessions Initial Assessment and Development of Treatment Contract Typically 2-3 Sessions Important tasks of Intermediate Sessions: Help client discuss topics pertinent to problem area Attend to clients affective state Assist client in discussing therapeutic relationship Prevent client from sabotaging treatment Bob Hill, Ph.D., Psychology, Appalachain State University

31 Interpersonal Disputes: Diagnosis
Interpersonal Psychotherapy for Depression Interpersonal Disputes: Diagnosis Current Overt or Covert disputes with a significant other Client and other have non-reciprocal expectations Dispute related to onset or perpetuation of depression Client demoralized about relationship Poor patterns of communication or irreconcilable differences Bob Hill, Ph.D., Psychology, Appalachain State University

32 Interpersonal Disputes: Goals
Interpersonal Psychotherapy for Depression Interpersonal Disputes: Goals Identify the dispute Make choices about a plan of action Modify communication patterns or Reassess Expectations Consider satisfying needs outside relationship Bob Hill, Ph.D., Psychology, Appalachain State University

33 Interpersonal Disputes: Strategies
Interpersonal Psychotherapy for Depression Interpersonal Disputes: Strategies Assess stage of Role Dispute: Impasse- discussion stopped, low-level resentment exists Tx may initially increase disharmony Renegotiation- aware of differences, actively trying to change Tx may require calming parties to facilitate resolution Dissolution- implies the relationship is irretrievably disrupted Treatment may resemble grief therapy Bob Hill, Ph.D., Psychology, Appalachain State University

34 Interpersonal Disputes: Issues
Interpersonal Psychotherapy for Depression Interpersonal Disputes: Issues Differences in expectations/values between client and other? Clients wishes in relationship? Other wishes? What are the client’s options? How have they resolved disagreements in past? Strengths and weaknesses in relationship? What changes are realistically possible? Bob Hill, Ph.D., Psychology, Appalachain State University

35 Interpersonal Disputes: Strategies
Interpersonal Psychotherapy for Depression Interpersonal Disputes: Strategies Find Parallels in previous relationships What does client gain by the behavior? What are unspoken assumptions that lie behind behavior? Optimistic tone: “lets figure out what went wrong here so we can decide how to help you make it better” Often communication problems are revealed- Tx involves improving skills Bob Hill, Ph.D., Psychology, Appalachain State University

36 Interpersonal Disputes: Strategies
Interpersonal Psychotherapy for Depression Interpersonal Disputes: Strategies Help identify “mixed feelings” e.g. anger, fear, sadness Devise strategies for managing feelings e.g. direct communications, reducing irrational suspicions Role Play Rehearse expressing feelings and wishes Anticipate communication problems Consider Conjoint sessions with significant other Bob Hill, Ph.D., Psychology, Appalachain State University

37 Problem Area: Role Transitions
Interpersonal Psychotherapy for Depression Problem Area: Role Transitions Diagnosis: Depression and interpersonal problems related to role changes e. g. separation/divorce, children left home, start/end job or school, retired, promoted, financial or health problems Assess: How did life change? What people in you life changed or left? Bob Hill, Ph.D., Psychology, Appalachain State University

38 Role Transition: Tx Strategies
Interpersonal Psychotherapy for Depression Role Transition: Tx Strategies Facilitate evaluation of lost role “Tell me about the old ___. What were the good, and bad, things? What has changed? Encourage expression of affect How did it feel to give up ___? Identify positive aspects of new role Are there potential benefits? Bob Hill, Ph.D., Psychology, Appalachain State University

39 Role Transition: Tx Strategies
Interpersonal Psychotherapy for Depression Role Transition: Tx Strategies Develop Social Skills needed for new role What is required in new role? Are assumptions of role demands accurate? Role play or rehearse difficult situations Assist with managing performance anxiety Establish new relationships and social support Facilitate discovery of new opportunities for social support Bob Hill, Ph.D., Psychology, Appalachain State University

40 Interpersonal Deficits: Diagnosis
Interpersonal Psychotherapy for Depression Interpersonal Deficits: Diagnosis History of social impoverishment, chronic inadequate or unsustained relationships Consider Dysthymia (or Double Depression) IPT adaptation for dysthymia Long standing or temporary deficits in social skills yields low self-esteem, withdrawal Bob Hill, Ph.D., Psychology, Appalachain State University

41 Interpersonal Deficits: Goals
Interpersonal Psychotherapy for Depression Interpersonal Deficits: Goals Reduce Client’s social isolation Enable: close relationships with intimates or family members satisfying relationships with friends adequate relationships in work role Bob Hill, Ph.D., Psychology, Appalachain State University

42 Interpersonal Deficits: Strategies
Interpersonal Psychotherapy for Depression Interpersonal Deficits: Strategies Review past significant relationships including childhood relationships with family members depressed patients minimize or forget positive experiences explore repetitive or parallel problems in past relationships define interpersonal situations that lead to difficulties Bob Hill, Ph.D., Psychology, Appalachain State University

43 Interpersonal Deficits: Strategies
Interpersonal Psychotherapy for Depression Interpersonal Deficits: Strategies Use therapist-client relationship explore client’s positive and negative feelings toward therapist discuss distorted or unrealistic thoughts or feelings toward therapist model resolution of relationship tension by open and genuine communication Bob Hill, Ph.D., Psychology, Appalachain State University

44 Interpersonal Deficits: Strategies
Interpersonal Psychotherapy for Depression Interpersonal Deficits: Strategies Encourage patient to increase social interactions review attempts in treatment to identify deficits identify deficits in communication skills look for assumptions client makes about others thoughts and feelings Bob Hill, Ph.D., Psychology, Appalachain State University

45 Use Communication Analysis
Interpersonal Psychotherapy for Depression Use Communication Analysis Get detailed account of conversation or argument identify communication difficulties ambiguous, indirect, & non-verbal as substitute for open confrontation incorrect assumptions re communication assuming that others know their feelings accompanied by anger, frustration, silence failing to make sure they are heard, understood Bob Hill, Ph.D., Psychology, Appalachain State University

46 Use Communication Analysis
Interpersonal Psychotherapy for Depression Use Communication Analysis Incorrect interpretation of others statements perceive criticism where none intended indirect verbal communication inhibited directly expressing expectations or criticism instead use hints and ambiguous messages prone to build resentments toward others who are unaware of offense silence - unaware of destructive impact Bob Hill, Ph.D., Psychology, Appalachain State University

47 Use Communication Analysis
Interpersonal Psychotherapy for Depression Use Communication Analysis Use role playing rehearse difficult interactions with client explore style of communicating with others practice new skills e.g. expressing anger or being assertive rehearsal with therapist increases client’s interpersonal confidence Bob Hill, Ph.D., Psychology, Appalachain State University

48 Interpersonal Deficits: Prognosis
Interpersonal Psychotherapy for Depression Interpersonal Deficits: Prognosis Treatment of interpersonal deficits difficult client often lacks relationships to practice and develop skills treatment goals limited to making early gains interpersonally, not resolving interpersonal deficits Bob Hill, Ph.D., Psychology, Appalachain State University

49 Grief Problem Area Focus
Interpersonal Psychotherapy for Depression Grief Problem Area Focus Normal Grief involves: Symptoms including sadness, disturbed sleep, agitation, impairment, etc. Symptoms usually resolve in 2 –4 weeks without treatment Bob Hill, Ph.D., Psychology, Appalachain State University

50 Abnormal Grief Evidence
Interpersonal Psychotherapy for Depression Abnormal Grief Evidence Inadequate grief in bereavement period Multiple losses Avoidance behavior (re funeral, grave, talk) Symptoms around significant anniversary Preserving environment of deceased Fear of illness that caused death Absence of social support during bereavement Bob Hill, Ph.D., Psychology, Appalachain State University

51 Abnormal Grief Treatment Goals
Interpersonal Psychotherapy for Depression Abnormal Grief Treatment Goals Facilitate the mourning process Help client reestablish interests and relationships to substitute for what has been lost Bob Hill, Ph.D., Psychology, Appalachain State University

52 Grief Treatment Strategies
Interpersonal Psychotherapy for Depression Grief Treatment Strategies Explore Events and Elicitation of Feelings Discuss events prior to, during and after the death Reconstruction of Relationship Use photos and stories to discuss relationship Use belongings and memories to evoke painful feelings client has avoided What were the ups and downs in relationship? (normalize negative features) Facilitate Expression of Affect Bob Hill, Ph.D., Psychology, Appalachain State University

53 Grief Treatment Strategies (cont.)
Interpersonal Psychotherapy for Depression Grief Treatment Strategies (cont.) Behavior change: Plan and discuss development of new social relationships (e.g. organizations, church, work, dating) Support client as they learn to fill “empty space” Bob Hill, Ph.D., Psychology, Appalachain State University

54 Termination of Treatment
Interpersonal Psychotherapy for Depression Termination of Treatment For time-limited treatment, important to keep initial contract for weeks Termination Treatment issues explicit discussion of termination during last 3-4 sessions acknowledge ending may involve loss and grief normalize fear, anger, sadness may need to distinguish sadness from depression Bob Hill, Ph.D., Psychology, Appalachain State University

55 Interpersonal Psychotherapy for Depression
Termination Issues Foster client’s self-confidence in coping independently deflect client’s attribution of success to therapist call attention to client’s accomplishments anticipate future difficulties with client help plan for future problems rehearse explicit scenarios if helpful discuss possibility of relapse of depression Bob Hill, Ph.D., Psychology, Appalachain State University

56 Termination Difficulties
Interpersonal Psychotherapy for Depression Termination Difficulties Failure depression to resolve refer for other treatment, encourage hope client wants to continue schedule 8 week waiting period impart to client self-confidence in ability to cope maintenance IPT may be appropriate for: chronic or recurring depression clients with personality problems or interpersonal deficits Bob Hill, Ph.D., Psychology, Appalachain State University

57 Specific IPT Techniques
Interpersonal Psychotherapy for Depression Specific IPT Techniques Essential IPT techniques include: discuss feelings (both positive & negative) about interpersonal experience take action to change interpersonal experience Other IPT techniques common to other psychotherapies Bob Hill, Ph.D., Psychology, Appalachain State University

58 Exploratory Techniques
Interpersonal Psychotherapy for Depression Exploratory Techniques Non-directive exploration Begin sessions with: “How have things been since we last met?” use open-ended questions encourage clients sense of responsibility Direct questioning necessary to review depressive symptoms necessary to review interpersonal relationships Bob Hill, Ph.D., Psychology, Appalachain State University

59 Interpersonal Psychotherapy for Depression
Encourage Affect Learning in psychotherapy is emotional learning eliciting affect informs client re meaningful goals facilitate acceptance of painful affect encourage clear expression of painful, suppressed or unacknowledged feelings inquire into sensitive areas Bob Hill, Ph.D., Psychology, Appalachain State University

60 Use emotions in relationships
Interpersonal Psychotherapy for Depression Use emotions in relationships Assist client to negotiate painful affect in significant relationships client may change relationship behavior (self or other) to eliminate painful affect client may learn new ways to cope with anger or anxiety client may eliminate irrational thinking and emotional sequelae Bob Hill, Ph.D., Psychology, Appalachain State University

61 Help Client with suppressed emotions
Interpersonal Psychotherapy for Depression Help Client with suppressed emotions For Clients who may be emotionally constricted or unassertive client may lack awareness or confidence to express some clients distressed by strong emotions (e.g. trauma history) may need help suppressing overwhelming emotions may be counter-productive to encourage emotional display Bob Hill, Ph.D., Psychology, Appalachain State University

62 Interpersonal Psychotherapy for Depression
Clarification Communication techniques to review content, clarify feelings, promote awareness repeating, rephrasing statements calling attention to logical implications of statements raising contradictions or contrasts Alert client to false, irrational or pervasive beliefs regarding interpersonal relationships Bob Hill, Ph.D., Psychology, Appalachain State University

63 Communication Analysis
Interpersonal Psychotherapy for Depression Communication Analysis Identify communication failures to improve relationship satisfaction Frequently review important conversations or arguments Illuminate common communication difficulties Bob Hill, Ph.D., Psychology, Appalachain State University

64 Use of Therapeutic Relationship
Interpersonal Psychotherapy for Depression Use of Therapeutic Relationship Client’s feelings toward therapist and therapy are helpful focus may reflect characteristic ways of feeling and behaving in other relationships Therapist instructs client to express complaints, fears, that arise about therapist model genuine negotiation with such feeling therapist can correct distortions and acknowledge genuine deficiencies Bob Hill, Ph.D., Psychology, Appalachain State University

65 Interpersonal Psychotherapy for Depression
Directive Techniques Include educating, advising, modeling initially open to practical help: depressed clients may need “case management” provide suggestions if client unable to make successful decisions independently modeling may involve informing client how therapist might handle similar situation use directive techniques sparingly use early, w/o undermining clients autonomy Bob Hill, Ph.D., Psychology, Appalachain State University

66 Interpersonal Psychotherapy for Depression
Decision Analysis Depressed clients often have history of self-defeating decisions because they fail to consider consequences and fail to see alternatives Therapist helps with decision analysis to help client recognize range of options insist on delaying action until each option is explored for interpersonal situations Bob Hill, Ph.D., Psychology, Appalachain State University

67 Decision Analysis Involves
Interpersonal Psychotherapy for Depression Decision Analysis Involves Set goal for interpersonal situation: “What do you want to happen?” Consider all useful alternatives observe alternatives that client omits direct client to explore probable consequences of each line of behavior clients often restrict range of alternatives or unrealistically assess consequences beware of premature decision analysis Bob Hill, Ph.D., Psychology, Appalachain State University

68 Interpersonal Psychotherapy for Depression
Role Playing Useful to explore client’s feelings and style of communicating with others Rehearse new ways for client to communicate in safe setting e.g. practice more assertiveness or expressing affection Bolsters client’s self-confidence in communicating genuinely Bob Hill, Ph.D., Psychology, Appalachain State University

69 Evidence for IPT Efficacy
Interpersonal Psychotherapy for Depression Evidence for IPT Efficacy Boston-New Haven Study (1979) 4 Tx Groups (16 wks & 1yr follow-up): IPT, amitriptyline, both combined, control IPT and amitriptyline equally effective Combination IPT & amitrip. most effective IPT grp. Sustained improved psychosocial functioning 1 yr later (not amitrip. Grp) Bob Hill, Ph.D., Psychology, Appalachain State University

70 NIMH Tx Depression Research (1989)
Interpersonal Psychotherapy for Depression NIMH Tx Depression Research (1989) 4 Tx grps (16 wks, multi-site, N=250) IPT, CBT, Imipramine & clinical management (CM), placebo & CM IPT comparable to Imipramine & CM CBT showed somewhat less improvement IPT grp. had lowest attrition rate Results for mod.-severe depression Bob Hill, Ph.D., Psychology, Appalachain State University

71 Brain Activity Changes with either IPT or Antidepressant Tx
Interpersonal Psychotherapy for Depression Brain Activity Changes with either IPT or Antidepressant Tx Pet scans showed higher prefrontal and less temporal activity in depressed vs controls Both IPT and Paxil resulted in normalized Pet scan activity and improved Dep. Sxs Brody (2001); Martin (2001) Bob Hill, Ph.D., Psychology, Appalachain State University

72 IPT Also Useful for Treating:
Interpersonal Psychotherapy for Depression IPT Also Useful for Treating: Dysthymia (see chapter in Weissman (2000) Comprehensive Guide to IPT) Social Phobia (Lipsitz et al., 1999) Adolescent Depression (Muffson et al., 1999) Postpartum Depression (O’Hara et al., 2000) Bulimia (Wilson et al., 2002) Late-Life Depression (Miller et al., 2001) Many of adaptations of the IPT intervention for disorders are described in the Weisman book. See also the references provided with handout. Bob Hill, Ph.D., Psychology, Appalachain State University

73 Bob Hill’s IPT Website:
Interpersonal Psychotherapy for Depression Bob Hill’s IPT Website: Click on link at: Bob Hill, Ph.D., Psychology, Appalachain State University


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