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Interpersonal Psychotherapy (IPT)

Scientific Rating:
1
Well-Supported by Research Evidence
See scale of 1-5
Child Welfare Relevance Level:
Medium

See descriptions of 3 levels

Brief Description

The information in this program outline is provided by the program representative and edited by the CEBC staff. The Interpersonal Psychotherapy (IPT) program has been rated by the CEBC in the area of: Depression Treatment (Adult).

  • Types of Maltreatment: Does not target any specific kind of maltreatment
  • Target Population: Adults with depression. The program is also designed to treat the children of a depressed parent.

IPT is a time-limited and manual-specified psychotherapy developed initially for patients with major depressive disorder, but later adapted for other disorders and tested in numerous clinical trials. Designed for administration by trained mental health professionals, it can also be taught, with adaptations, to less trained health workers. IPT has been used with and without medication. IPT is based on the idea that the symptoms of depression have multiple causes. The onset of depressive symptoms is usually associated with a trigger in the patient’s current personal life. IPT helps the patient to identify and learn how to deal with those personal problems and to understand their relationship to the onset of symptoms. There are three phases:

  1. The diagnostic and problem identification phase where a formulation and treatment contract are made;
  2. Identification of the problem area(s): grief, disputes, transition, or deficits, which is the focus of the middle phase;
  3. Termination.

Essential Components

  • IPT is time-limited, manualized, and diagnostic-based (usually depression).
  • It uses the relationship between symptom onset and the development of problem areas, grief, disputes, transitions, role deficits, and helps the patient develop skills for coping with and relieving depression.
  • IPT has been adapted for depressed adolescents, geriatric patients, pregnant, and postpartum depressed woman.
  • A diagnostic evaluation is made initially.
  • It relates the onset of symptoms to a problem area defined above.
  • The therapist conducts an interpersonal inventory to determine important people both supportive and not in the patient's life.
  • It is a medical model.
  • Standard techniques are used (e.g., clarification, role play, decision analysis), but focus is on the here and now problems in relationship to the onset of symptoms.

Child Component

Interpersonal Psychotherapy (IPT) was designed with a child component that addresses the following presenting problems and symptoms:

  • Child of a depressed parent.

Age range: 6 – 17

Developmental Delays:

This program was not developed for children with developmental delays, and has not been tested for children with developmental delays.

Parent / Caregiver Component

Interpersonal Psychotherapy (IPT) was designed with a parent/caregiver component that addresses the following presenting problems and symptoms:

  • Depression.

Group Format

Interpersonal Psychotherapy (IPT) was designed to be conducted in a group setting, and has been tested for use in a group setting.

Recommended group size:

12 -15 individuals.

Testing References:

Bolton, P., Bass, J., Neugebauer, R., Verdeli, H., Clougherty, K. F., Wickramaratne, P., Weissman, M. (2003). Group interpersonal psychotherapy for depression in rural Uganda. Journal of the American Medical Association, 289(23), 3117-3124.

Miller, L., Gur, M., Shanok, A., & Weissman, M. M. (2008). Interpersonal psychotherapy with pregnant adolescents: two pilot studies. The Journal of Child Psychology and Psychiatry, 49(7), 733-742.

Verdeli, H., Clougherty, K., Onyango, G., Lewandowski, E., Speelman, L., Betancourt, T. S., Bolton, P. (2008). Group Interpersonal Psychotherapy for depressed youth in IDP camps in Northern Uganda: Adaptation and training. Child and Adolescent Psychiatric Clinics of North America, 17(3), 605-624.

Delivery Settings

This program is typically conducted in a(n):

  • Hospital
  • Outpatient Clinic
  • School

Homework

This program does not include a homework component.

Languages

Interpersonal Psychotherapy (IPT) has materials available in languages other than English:

Danish, French, German, Italian, Japanese, Portuguese

For information on which materials are available in these languages, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

Therapeutic skills and a knowledge of the treatment.

Minimum Provider Qualifications

Supervisors must be field experienced clinicians, psychologists, social workers, etc. (MD, PhD, MSW). Nurses and healthcare professionals not in the mental health field can be trained as well.

Education and Training Resources

There is a manual that describes how to implement this program, and there is training available for this program.

Training is obtained:

This is tailored to the organization being trained. Contact the International Society for Interpersonal Psychotherapy (ISIPT) for training programs or email Myrna M. Weissman.

Number of days/hours:

This is tailored to the organization being trained.

Implementation Information

Since Interpersonal Psychotherapy (IPT) is highly rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

Show implementation information...

Pre-Implementation Assessments

There are no pre-implementation assessments to measure organizational or individual provider readiness.

Implementation Tools — for the program (e.g., implementation guides or manuals)

There are a number of guides for IPT. Here are the two primary ones:

  • Weissman, M. M., Markowitz, J. C., Klerman, G. L. (2007) A clinician's quick guide to Interpersonal Psychotherapy. New York: Oxford University Press.
  • Weissman, M. M., Markowitz, J. C., Klerman, G. L. (2000). Comprehensive guide to Interpersonal Psychotherapy. New York: Basic Books.

Fidelity Measures

There are no fidelity measures available for this program.

Relevant Published, Peer-Reviewed Research

This program is rated a "1 - Well-Supported by Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least two rigorous randomized controlled trials with one showing a sustained effect of at least 1 year. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being

Show relevant research...

Numerous studies have been conducted of IPT. The seven studies described below are a selection of those most relevant to the topic area. For a complete listing of studies, please refer to:

  • Weissman, M. M., Markowitz, J. C., & Klerman, G. L. (2000). Comprehensive guide to Interpersonal Psychotherapy. Basic Books, New York, NY.
  • Weissman, M. M., Markowitz, J. C., & Klerman, G. L. (2007). A clinician’s quick guide to Interpersonal Psychotherapy. Oxford University Press, New York, NY.

In addition, a systematic review of IPT showed that IPT was superior to a placebo, similar to medication, and, overall, was more efficacious than Cognitive Behavioral Therapy (CBT):

  • de Mello, M. F., de Jesus, M. J., Bacaltchuk, J., Verdeli, H., Neugebauer, R. (2005). A systematic review of research findings on the efficacy of interpersonal therapy for depressive disorders. European archives of psychiatry and clinical neuroscience, 255, 75-82.

Weissman, M. M., Klerman,G. L., Prusoff, B. A., Sholomskas, D., & Padian, N. (1981). Depressed outpatients: Results one year after treatment with drugs and/or Interpersonal Psychotherapy. Archives of General Psychiatry, 38,:51-55.

Type of Study: Randomized controlled trial
Number of Participants: 81

Population:

  • Age range — 18-65 years old
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Acutely depressed ambulatory patients with a diagnosis of nonbipolar, nonpsychotic acute primary major depression.

Location / Institution: The Connecticut Mental Health Center (Yale University), New Haven, CT, and Boston (MA) State Hospital (Tufts University).

Summary: (To include comparison groups, outcomes, measures, notable limitations)
A one-year follow-up was conducted on patients who received amitriptyline hydrochloride and/or interpersonal psychotherapy (IPT), each alone and in combination, as part of a four-month clinical trial. There were no differential long-term effects of the initially randomized treatment on clinical symptoms one year later, since most of the patients were asymptomatic. While most patients were functioning reasonably well, there were some main effects of IPT on social functioning at the one-year follow-up. Patients who received IPT with or without pharmacotherapy were doing significantly better on some measures of social functioning. Study measures included the Raskin Depression Scale, the Hamilton Depression rating Scale, the Symptom Checklist, and the Social Adjustment Scale. Limitations include the naturalistic nature of the follow-up study, in which some patients received treatment during the follow-up year that was not related to the study.

Length of post-intervention follow-up: 1 year.

Blatt, S. J., Zuroff, D. C., Bondi, C. M., Sanislow III, C. A. (2000). Short- and long-term effects of medication and psychotherapy in the brief treatment of depression: Further analyses of data from the NIMH TDCRP.Psychotherapy Research, 10(2), 215-234.

Type of Study: Randomized controlled trial
Number of Participants: 162

Population:

  • Age range — Mean age 35 yrs
  • Race/Ethnicity — 89% White
  • Gender — Not Specified
  • Status — Participants were referred from psychiatric outpatient services at the research sites, as well as self-referral and referral from other mental health facilities.

Location / Institution: University of Pittsburgh, George Washington University, University of Oklahoma.

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Analyses of previously unanalyzed data from the NIMH-sponsored Treatment for Depression Collaborative Research Program (TDCRP) from ratings by therapists, clinical evaluators, and patients at termination and at 18-month follow-up indicated no significant differences among these treatments in symptom reduction or ratings of current clinical condition. However, significant treatment differences emerged at the 18-month follow-up in patients' ratings of the effects of treatment on their life adjustment. Patients in IPT reported greater satisfaction with treatment, and patients in both IPT and CBT reported significantly greater effects of treatment on their capacity to establish and maintain interpersonal relationships and to recognize and understand sources of their depression than did patients in the imipramine plus clinical management (IMI-CM) or placebo groups. Measures included the Hamilton Rating Scale for Depression, Global Adjustment Scale, Hopkins Symptom Checklist, Beck Depression Inventory, and Social Adjustment Scale.

Length of post-intervention follow-up: 18 months.

O'Hara, M. W., Stuart, S., Gorman, L. L., & Wenzel, A. (2000). Efficacy of Interpersonal Psychotherapy for Postpartum Depression, Archives of General Psychiatry, 57,, 1039-1045.

Type of Study: Randomized controlled trial
Number of Participants: 120

Population:

  • Age range — Mean age: Intervention: 29.4 years. Control: 29.7 years
  • Race/Ethnicity — Not listed, article states that almost all were White.
  • Gender — Not Specified
  • Status — Women giving birth in 4 Iowa counties between October 1994 and July 1997 were sent letters inviting them to participate.

Location / Institution: Four counties in Iowa

Summary: (To include comparison groups, outcomes, measures, notable limitations)
120 postpartum women meeting Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for major depression were recruited from the community and randomly assigned to 12 weeks of interpersonal psychotherapy (IPT) or to a waiting list condition (WLC) control group. Subjects completed interview and self-report assessments of depressive symptoms and social adjustment every 4 weeks. Ninety-nine patients completed the protocol. Hamilton Rating Scale for Depression (HRSD) scores of women receiving IPT declined from 19.4 to 8.3, a significantly greater decrease than occurred in the WLC group (19.8 to 16.8). The Beck Depression Inventory (BDI) scores of women who received IPT declined from 23.6 to 10.6 over 12 weeks, a significantly greater decrease than occurred in the WLC group (23.0 to 19.2). A significantly greater proportion of women who received IPT recovered from their depressive episode based on HRSD scores of 6 or lower (37.5%) and BDI scores of 9 or lower (43.8%) compared with women in the WLC group (13.7% and 13.7%, respectively). Women receiving IPT also had significant improvement on the Postpartum Adjustment Questionnaire and the Social Adjustment Scale–Self-Report relative to women in the WLC group.

Length of post-intervention follow-up: None.

Browne, G., Steinera, M., Robertsa, J., Gafnia, A., Byrnea, C., Dunnf, E., & Kraemera, J. (2002). Sertraline and/or interpersonal psychotherapy for patients with dysthymic disorder in primary care: 6-month comparison with longitudinal 2-year follow-up of effectiveness and costs. Journal of Affective Disorders, 68(2), 317-330.

Type of Study: Randomized controlled trial
Number of Participants: 707

Population:

  • Age range — Mean age 42.1 years (range 18–74 years of age)
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Adults were recruited from the patient roster of the Health Services organization, as well as self-referral from the general community based on advertisements.

Location / Institution: Primary care university-affiliated Health Services organization (HSO) located in a Southern Ontario, Canada community.

Summary: (To include comparison groups, outcomes, measures, notable limitations)
In a single-blind, randomized clinical trial, 707 adults with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) dysthymic disorder were randomized to treatment with either Sertraline alone, IPT alone (10 sessions), or Sertraline plus IPT combined. In the acute treatment phase (first 6 months), all groups received full active treatment. This was followed by an additional 18-month naturalistic follow-up phase. Subjects were assessed for effectiveness of treatment in reducing depressive symptoms using the Montgomery Asberg Depression Rating Scale (MADRS) by blind independent observers. At 2 years, 525 subjects were retained for follow-up. There was no statistically significant difference between Sertraline alone and Sertraline plus IPT in symptom reduction. However, both were more effective than IPT alone in reducing depressive symptoms (P=0.03). There was a statistically significant difference between groups in costs for use of health and social services. The IPT treatment groups had the lower costs for use of health and social services. Over the long term (2 years), all three treatments provide reasonably effective treatment for reducing symptoms of dysthymia, but Sertraline or combining Sertraline with IPT is more effective than IPT alone. Of these two more effective treatments, subjects in the Sertraline plus IPT group had less health and social service costs by $480 per person over 2 years. These findings underscore the effects of combining pharmacotherapy and psychotherapy and the economic value of this more comprehensive treatment of dysthymia in primary care.

Length of post-intervention follow-up: 2 years.

Spinelli, M. G., & Endicott, J. (2003). Controlled clinical trial of Interpersonal Psychotherapy versus parenting education program for depressed pregnant women. American Journal of Psychiatry,160(3), 555-562.

Type of Study: Randomized controlled trial
Number of Participants: 38 women

Population:

  • Age range — Intervention: 28.3 years, Control: 29.3
  • Race/Ethnicity — Intervention: 61.9% Latina, 28.6% Caucasian, 9.5% African American. Control: 70.6% Latina, 29.4% Caucasian, 0.0% African American.
  • Gender — Not Specified
  • Status — Participants were recruited from the outpatient clinics at the NY State Psychiatric Institute of Columbia University and other institutions in the NY metropolitan area. Some clients self-referred based on advertisements.

Location / Institution: New York, NY

Summary: (To include comparison groups, outcomes, measures, notable limitations)
A 16-week randomized clinical trial compared a group receiving IPT for antepartum depression to a parenting education control program. Depressed mood was measured with the Edinburgh Postnatal Depression Scale, the Beck Depression Inventory, and the Hamilton Depression Rating Scale. The Clinical Global Impression (CGI) and the Hamilton Rating Scales for Depression measured recovery. The IPT group showed significant improvement compared to the parenting education control program on all three measures of mood at termination. Recovery criteria were met in 60% of the women treated with IPT.

Length of post-intervention follow-up: None.

Bass, J., Neugebauer, R., Clougherty, K. F., Verdeli, H., Wickramaratne, P., Ndogoni, L., Bolton, P. (2006). Group interpersonal psychotherapy for depression in rural Uganda: 6-month outcomes. British Journal of Psychiatry, 188, 567-573.

Type of Study: Randomized controlled trial
Number of Participants: 216

Population:

  • Age range — Intervention: 47.6 on average; Control: 45.3 on average.
  • Race/Ethnicity — African
  • Gender — Not Specified
  • Status — Participants were identified by both local key informants and themselves as suffering from a depression-like syndrome.

Location / Institution: Rural Uganda

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Participants were located through identification by local leaders and healers and by self-identification as suffering from depression-like symptoms. Diagnosis was confirmed through interviews using Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. The six-month follow-up used the Hopkins Symptom Checklist (HSCL) and a gender-specific questionnaire assessing functional impairment on important activities. Those in the IPT group showed significantly lower HSCL scores and functional impairment scores. Improvements in depression symptoms were maintained between 2 weeks and 6 months after the intervention.

Length of post-intervention follow-up: 6 months.

Swartz, H. A., Frank, E., Zuckoff, A., Cyranowski, J. M., Houck, P. R., Cheng, Y., Shear, M. K. (2008). Brief interpersonal psychotherapy for depressed mothers whose children are receiving psychiatric treatment. American Journal of Psychiatry, 165(9), 1155-1162.

Type of Study: Randomized controlled trial
Number of Participants: 47 mother-child pairs

Population:

  • Age range — Mothers - mean age: intervention-41.6 control-44.2 years. Child – mean age: intervention-13.7 control-13.9
  • Race/Ethnicity — 73-86% Caucasian
  • Gender — Not Specified
  • Status — Participants were recruited from general pediatric mental health clinic or from a clinic that specializes in the treatment of suicidal adolescents.

Location / Institution: Pittsburgh, PA

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This randomized, controlled trial compared the Interpersonal Psychotherapy for Depressed Mothers (IPT-MOMS), a nine-session intervention based on standard interpersonal psychotherapy, to treatment as usual for depressed mothers with psychiatrically ill offspring. Mother-child pairs were assessed at three time points: baseline, 3-month follow-up, and 9-month follow-up. Compared to subjects assigned to treatment as usual, subjects assigned to IPT-MOMS showed significantly lower levels of depression symptoms, as measured by the Hamilton Depression Rating Scale, and higher levels of functioning, as measured by the Global Assessment of Functioning, at 3-month and 9-month follow-ups. Assignment to IPT-MOMS was associated with reduced levels of maternal symptoms and improved functioning at the 3- and 9-month follow-ups compared to treatment as usual. Then study is limited by its small sample size and 19% dropout rate at the 9 month follow-up.

Length of post-intervention follow-up: 9 months.

References

Weissman, M. M., Markowitz, J. C., & Klerman, G. L. (2000). Comprehensive guide to Interpersonal Psychotherapy. Basic Books, New York, NY.

Weissman, M. M., Markowitz, J. C., & Klerman, G. L. (2007). A clinician’s quick guide to Interpersonal Psychotherapy. Oxford University Press, New York, NY.

Wilfley, D. E., Mackenzie, K. R., Welch, R., Ayres, V., & Weissman, M. M. (Eds.). (2000). Interpersonal Psychotherapy for group. Basic Books, New York, NY.

Contact Information

Name: Myrna M. Weissman, PhD
Agency/Affiliation: Columbia University College of Physicians & Surgeons
Email:
Phone: (212) 543-5880
Fax: (212) 568-3534

Date Reviewed: March 2010