Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST)

About This Program

Target Population: Adolescents, 12-16 years old, with elevated depression symptoms

For children/adolescents ages: 12 – 16

For parents/caregivers of children ages: 12 – 16

Program Overview

IPT-AST is a group-indicated prevention program that is based on Interpersonal Psychotherapy for Depressed Adolescents (IPT-A) and its group adaptation. The intervention involves two initial individual sessions and eight weekly 90-minute group sessions. The group focuses on psychoeducation and general skill-building that can be applied to different relationships within the framework of three interpersonal problem areas: interpersonal role disputes, role transitions, and interpersonal deficits. The psychoeducation component includes defining prevention, educating members about depression, and discussing the relationship between feelings and interpersonal interactions. The interpersonal skill-building component consists of two stages. First, communication and interpersonal strategies are taught through didactics, activities, and role-plays. Once group members understand the skills, they are asked to apply them to different people in their lives, practicing first in group and then at home.

Program Goals

The overall goals of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) are:

  • Improved interpersonal functioning
  • Improved depressive symptoms
  • Prevention of depression

Logic Model

The program representative did not provide information about a Logic Model for Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST).

Essential Components

The essential components of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) include:

  • Recommended group size of 4 to 7 adolescents
  • Completion of the interpersonal inventory
  • Education about depression
  • Discussion of the link between depressed mood and interpersonal events
  • Communication analysis
  • Instruction on interpersonal techniques and communication strategies aimed at improving one's relationships
  • Role playing
  • Completion of assigned interpersonal work at home
  • Review of depression warning symptoms

Program Delivery

Child/Adolescent Services

Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) directly provides services to children/adolescents and addresses the following:

  • Elevated depression symptoms

Parent/Caregiver Services

Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) directly provides services to parents/caregivers and addresses the following:

  • Caregiver for adolescent with depressive symptoms

Recommended Intensity:

Weekly contact recommended; first, 45-minute individual pregroup sessions then 90-minute group sessions

Recommended Duration:

10 weeks - 2 weeks of individual sessions then 8 weeks of group sessions

Delivery Setting

This program is typically conducted in a(n):

  • School Setting (Including: Day Care, Day Treatment Programs, etc.)

Homework

Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) includes a homework component:

Homework is an outgrowth of work conducted in the group. Adolescents are asked to utilize the interpersonal techniques in their relationships and to report back to the group on the outcome of these interactions.

Resources Needed to Run Program

The typical resources for implementing the program are:

  • A room to run the group
  • 1-2 group leaders
  • Binders for group members

Manuals and Training

Prerequisite/Minimum Provider Qualifications

Master's or doctoral degree in clinical, school, or counseling psychology, or Master's in social work

Manual Information

There is a manual that describes how to deliver this program.

Training Information

There is training available for this program.

Training Contact:
  • Jami Young, PhD
    Children's Hospital of Philadelphia; University of Pennsylvania Perelman School of Medicine
Training Type/Location:

Training arranged on an as needed basis

Number of days/hours:

Typically 1-2 days of didactics followed by consultation on preliminary groups

Implementation Information

Pre-Implementation Materials

There are no pre-implementation materials to measure organizational or provider readiness for Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST).

Formal Support for Implementation

There is no formal support available for implementation of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST).

Fidelity Measures

There are fidelity measures for Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) as listed below:

There are fidelity measures that outline the techniques and strategies for each session/phase of the intervention. To date, an external rater has listened to the sessions to rate adherence to the manual and competency of the delivery using these fidelity measures. They could also be completed by the person delivering the intervention.

Implementation Guides or Manuals

There are no implementation guides or manuals for Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST).

Research on How to Implement the Program

Research has not been conducted on how to implement Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST).

Relevant Published, Peer-Reviewed Research

Child Welfare Outcome: Child/Family Well-Being

Young, J. F., Mufson, L., & Davies, M. (2006). Efficacy of Interpersonal Psychotherapy-Adolescent Skills Training: An indicated preventive intervention for depression. Journal of Child Psychology and Psychiatry, 47(12), 1254-1262. https://doi.org/10.1111/j.1469-7610.2006.01667.x

Type of Study: Randomized controlled trial
Number of Participants: 41

Population:

  • Age — 11-16 years
  • Race/Ethnicity — 93% Hispanic
  • Gender — 85% Female and 15% Male
  • Status — Participants were youth in predominately single-parent low-income households with undiagnosed subthreshold depression symptoms.

Location/Institution: Three Catholic schools in New York City, NY

Summary: (To include basic study design, measures, results, and notable limitations)
The current study examined the efficacy of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) for adolescents with depression in comparison to group programs that are typically delivered in school settings. Participants were randomized to receive either IPT-AST or school counseling (SC). Measures utilized include the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL), the Children's Global Assessment Scale (CGAS), and Center for Epidemiologic Studies Depression Scale (CES-D). Results indicate that adolescents who received IPT-AST had significantly fewer depression symptoms and better overall functioning postintervention on the CES-D at 3 months and at 6 months. The IPT-AST group reported significantly better functioning on the CGAS at 3 months and 6 months posttreatment. Adolescents in IPT-AST also reported fewer depression diagnoses than adolescents in SC. Limitations include small sample size, less than half of the eligible adolescents agreed to participate in the eligibility evaluation, the unbalanced randomization resulted in a small number of adolescents in the SC group, and the majority of the sample was Hispanic and female.

Length of controlled postintervention follow-up: 6 months.

Young, J. F., Gallop, R., & Mufson, L. (2009). Mother-child conflict and its moderating effects on depression outcomes in a preventive intervention for adolescent depression. Journal of Clinical Child and Adolescent Psychology, 38(5), 696–704. https://doi.org/10.1080/15374410903103577

Type of Study: Randomized controlled trial
Number of Participants: 41

Population:

  • Age — 11-16 years (Mean=13.37 years)
  • Race/Ethnicity — 93% Hispanic
  • Gender — 85% Female and 15% Male
  • Status — Participants were youth from single-parent household with undiagnosed subthreshold depression symptoms.

Location/Institution: Three Catholic schools in New York City, NY

Summary: (To include basic study design, measures, results, and notable limitations)
This study used the same sample as Young et al. (2006). The purpose of the study was to examine the efficacy of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) for adolescents with depression in comparison to group programs that are typically delivered in school settings. Participants were randomly assigned to receive IPT-AST or school counseling (SC). Measures utilized include the Center for Epidemiologic Studies Depression Scale (CES-D), the Conflict Behavior Questionnaire (CBQ), the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL), and the Children's Global Assessment Scale (CGAS). Results indicate that adolescents in IPT–AST showed significantly greater reductions in mother–child conflict. Baseline mother–child conflict moderated the programs’ effects on depression symptoms. Adolescents in IPT–AST who had high baseline conflict showed significantly greater decreases in depression symptoms than adolescents in SC who had high conflict. Among those adolescents with low baseline conflict, the difference between the two interventions was not significant. Limitations include small sample size, unbalanced randomization that resulted in less students in the SC group, using only adolescent reports of mother-child conflict, and the majority of the sample was Hispanic and female.

Length of controlled postintervention follow-up: 3, 6, and 12 months.

Young, J. F., Mufson, L., & Gallop, R. (2010). Preventing depression: A randomized trial of Interpersonal Psychotherapy-Adolescent Skills Training. Depression and Anxiety, 27(5), 426-433. https://doi.org/10.1002/da.20664

Type of Study: Randomized controlled trial
Number of Participants: 57

Population:

  • Age — 13-17 years
  • Race/Ethnicity — 74% Hispanic and 26% African American
  • Gender — 60% Female and 40% Male
  • Status — Participants were youth from inner city, minority, single-parent homes, subthreshold depression symptoms without diagnosis.

Location/Institution: Three Catholic high schools in New York City, NY

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the efficacy of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) for adolescents with depression in comparison to group programs that are typically delivered in school settings. Participants were randomly assigned to receive IPT-AST or school counseling (SC). Measures utilized include the Center for Epidemiologic Studies Depression Scale (CES-D), the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL), the Children's Global Assessment Scale (CGAS), and the Children's Depression Rating Scale, Revised (CDRS-R). Results indicate that adolescents in IPT-AST reported significantly greater rates of change in depression symptoms and overall functioning than SC adolescents from baseline to post-intervention. At post-intervention, IPT-AST adolescents reported significantly fewer depression symptoms and better overall functioning. During the follow-up phase, rates of change slowed for the IPT-AST adolescents, whereas the SC adolescents continued to show improvements. By 12-month follow-up, there were no significant mean differences in depression symptoms or overall functioning between the two groups. IPT-AST adolescents reported significantly fewer depression diagnoses in the first 6 months following the intervention but by 12-month follow-up the difference in rates of diagnoses was no longer significant. Limitations include that only a third of adolescents with elevated symptoms agreed to participate in the eligibility evaluation, small sample size, SC involved individual counseling which may question the effectiveness of specific IPT-AST techniques over general group processes, many did not complete follow-up assessments, and minority youth were overrepresented which may affect generalizability.

Length of controlled postintervention follow-up: 6, 12, and 18 months.

Young, J. F., Benas, J. S., Schueler, C. M., Gallop, R., Gillham, J. E., & Mufson, L. (2016). A randomized depression prevention trial comparing Interpersonal Psychotherapy-Adolescent Skills Training to group counseling in schools. Prevention Science, 17(3), 314-324. https://doi.org/10.1007/s11121-015-0620-5

Type of Study: Randomized controlled trial
Number of Participants: 186

Population:

  • Age — Mean=14.01 years
  • Race/Ethnicity — 38% White/Non-Hispanic, 38% Hispanic, 20% African-American, 8% Other, and 4% Asian
  • Gender — 67% Female
  • Status — Participants were adolescents in 7th to 10th grade at participating middle schools diagnosed with depression.

Location/Institution: New Jersey

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the efficacy of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) for adolescents with depression in comparison to group programs that are typically delivered in school settings. Participants were randomly assigned to receive IPT-AST or group counseling (GC) delivered by school counselors. Measures utilized include the Center for Epidemiologic Studies-Depression Scale (CES-D), the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-PL), the Therapy Procedures Checklist (TPC), and the Children’s Global Assessment Scale (CGAS). Results indicate that adolescents in IPT-AST showed significantly greater improvements in self-reported depressive symptoms and evaluator-rated overall functioning than GC adolescents from baseline to the 6-month follow-up. However, there were no significant differences between the two conditions in onset of depression diagnoses. Although both intervention conditions demonstrated significant improvements in depressive symptoms and overall functioning, results indicate that IPT-AST has modest benefits over groups run by school counselors which were matched on frequency and duration of sessions. In particular, IPT-AST outperformed GC in reduction of depressive symptoms and improvements in overall functioning. Limitations include only a third of adolescents with elevated symptoms agreed to participate in the eligibility evaluation; despite significant efforts to make GC an equivalent control group, there were differential rates of attendance for IPT-AST and GC; and length of follow-up.

Length of controlled postintervention follow-up: 6 months.

Young, J. F., Jones, J. D., Sbrilli, M. D., Benas, J. S., Spiro, C. N., Haimm, C. A., Gallop, R., Mufson, L., & Gillham, J. E. (2019). Long-term effects from a school-based trial comparing Interpersonal Psychotherapy-Adolescent Skills Training to group counseling. Journal of Clinical Child & Adolescent Psychology, 48(sup1), S362-S370. https://doi.org/10.1080/15374416.2018.1479965

Type of Study: Randomized controlled trial
Number of Participants: 186

Population:

  • Age — IPT-AST: Mean=13.56 years; GC: Mean=13.42 years
  • Race/Ethnicity — IPT-AST: 37% Hispanic, 37% White/ Nonminority/Non-Hispanic, 22% African American, 7% More Than One Race, and 3% Asian; GC: 40% Hispanic, 40% White/Nonminority/Non-Hispanic, 18% African American, 8% More Than One Race, 6% Asian, and 1% American Indian
  • Gender — IPT-AST: 67% Female; GC: 66% Female
  • Status — Participants were adolescents with elevated depressive symptoms. 

Location/Institution: Participating middle and high schools

Summary: (To include basic study design, measures, results, and notable limitations)
This study used the sample from Young et al. (2016). The purpose of the study was to examine differences in rates of change in depressive symptoms and overall functioning and differences in rates of depression diagnoses. Participants were randomly assigned to either Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST) delivered by research clinicians or group counseling (GC) delivered by school counselors. Measures utilized include the Center for Epidemiologic Studies–Depression Scale (CES-D), the Schedule for Affective Disorders and Schizophrenia for School-Age Children–Present and Lifetime version (KSADS-PL), and the Children’s Global Assessment Scale (CGAS). Results indicate that youth in both conditions showed significant improvements in depressive symptoms and overall functioning from baseline to 24-month follow-up, demonstrating the efficacy of school-based depression prevention programs. However, the two groups did not differ in overall rates of change or in rates of depression diagnoses from baseline to 24-month follow-up. Although IPT-AST demonstrated advantages over GC in the short term, these effects dissipated over long-term follow-up. Specifically, from 6- to 24- month follow-up, GC youth showed continued decreases in depressive symptoms, whereas IPT-AST youth showed a nonsignificant increase in symptoms. GC youth remained relatively stable in overall functioning, whereas IPT-AST youth experienced a small but statistically significant worsening in functioning. Limitations include testing for common mediators across the whole group, which may obscure intervention effects and reliance on self-report measures.

Length of controlled postintervention follow-up: 6, 12, 18, and 24 months.

Spiro-Levitt, C., Gallop, R., & Young, J. F. (2019). Trajectories of change in maternal and adolescent depressive symptoms in the depression prevention initiative. Journal of Affective Disorders, 253, 176–183. https://doi.org/10.1016/j.jad.2019.04.089

Type of Study: Randomized controlled trial
Number of Participants: 167 mother-adolescent dyads

Population:

  • Age — Adolescents: Mean=13.49 years; Mothers: Not specified
  • Race/Ethnicity — Adolescents: 38% Hispanic, 22% African-American, 7% Other or Mixed Race, 5% Asian-American, and 0.6% American Indian; Mothers: 38% Hispanic, 20% African-American, 5% Asian-American, and 2% Other or Mixed Race
  • Gender — Adolescents: 68% Female; Mothers: 100% Female
  • Status — Participants were adolescents with elevated symptoms of depression.

Location/Institution: Not specified

Summary: (To include basic study design, measures, results, and notable limitations)
This study used a subsample from Young et al. (2016). The purpose of the study was to investigate the relationship between maternal and adolescent depressive symptoms. Participants were randomly assigned to Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST) or enhanced group counseling (GC). Measures utilized include the Center for Epidemiologic Studies-Depression Scale (CES-D), and the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-PL). Results indicate that initial levels of maternal and adolescent symptoms were positively associated. Additionally, maternal symptoms improved across the two-year period. Maternal and adolescent outcomes were related across time: as adolescents improved in our study, their mothers also improved. Limitations include the study utilized self-report data only and did not allow for the testing of causality in the relationship between mother-youth depression.

Length of controlled postintervention follow-up: 6, 12, 18, and 24 months.

The following studies were not included in rating IPT-AST on the Scientific Rating Scale...

Horowitz, J. L., Garber, J., Ciesla, J. A., Young, J. F., & Mufson, L. (2007). Prevention of depressive symptoms in adolescents: A randomized trial of cognitive-behavioral and interpersonal prevention programs. Journal of Consulting and Clinical Psychology, 75(5), 693-706. https://doi.org/10.1037/0022-006X.75.5.693

The purpose of the study was to examine the efficacy of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) for adolescents. Participants were randomly assigned to a cognitive-behavioral program (CB), IPT-AST, or a no-intervention control. Measures utilized include the Children’s Depression Inventory (CDI), Center for Epidemiologic Studies Depression Scale (CES-D), Sociotropy-Achievement Scale for Children (SASC), Children's Attributional Style Questionnaire-Revised (CASQ-R), Coping with Stress Course (COPE), and the Conflict Behavior Questionnaire (CBQ). Results indicate that at postintervention, the CB and IPT-AST groups showed significantly lower levels of depressive symptoms than in the no-intervention group, controlling for baseline depression scores. Differences between control and intervention groups were largest for adolescents with high levels of depressive symptoms at baseline. No significant effects for gender, but results indicate that higher levels of sociotropy were related to lower levels of depression in the IPT-AST group and control group, but not the CB group. Intervention effects were short-term and were not maintained at 6-month follow-up. Limitations include low rates of follow-up data for students in the control group with elevated symptoms, not obtaining information regarding treatment between assessments, not conducting diagnostic interviews or individual pregroup sessions in the IPT-AST condition, questionable generalization due to the 63% participation rate, and absolute therapist fidelity to treatment protocol was not monitored. Note: Since this study did not include a broader target population than specified in the Depression Treatment (Child & Adolescent) topic area definition and focused on prevention, this study was not used in the rating/review process .

Jones, J. D., Gallop, R., Gillham, J. E., Mufson, L., Farley, A. M., Kanine, R., & Young, J. F. (2021). The depression prevention initiative: Mediators of Interpersonal Psychotherapy–Adolescent Skills Training. Journal of Clinical Child & Adolescent Psychology, 50(2), 202–214. https://doi.org/10.1080/15374416.2019.1644648

This study used the sample from Young et al. (2016). The purpose of the study was to examine interpersonal mediators of Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST). Participants were randomly assigned to receive either IPT-AST or group counseling (GC). Measures utilized include the Network of Relationships Inventory–Short Form, the Conflict Behavior Questionnaire, the Social Adjustment Scale–Self-Report (SAS-SR), the Center for Epidemiologic Studies–Depression Scale (CES-D), and the Children’s Global Assessment Scale. Results indicate that at postintervention, youth in IPT-AST had lower depressive symptoms and higher overall functioning scores than youth in GC. Improvements in adolescent romantic functioning, reductions in peer conflict, and improvements in a factor score reflecting mother–adolescent conflict and difficulties in family functioning emerged as significant mediators. However, the effects of the intervention on change in the mediators were not statistically significant. Limitations include reliance on self-report measures, internal consistency of the SAS-SR subscales was low, and lack of follow-up. Note: Since this study did not include a broader target population than specified in the Depression Treatment (Child & Adolescent) topic area definition and focused on prevention, this study was not used in the rating/review process.

Young, J. F., Jones, J. D., Gallop, R., Benas, J. S., Schueler, C. M., Garber, J., & Hankin, B. L. (2021). Personalized depression prevention: A randomized controlled trial to optimize effects through risk-informed personalization. Journal of the American Academy of Child & Adolescent Psychiatry, 60(9), 1116–1126. https://doi.org/10.1016/j.jaac.2020.11.004

The purpose of the study was to evaluate whether evidence-based depression prevention programs; Coping With Stress (CWS) or Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST) can be optimized by matching youths to interventions that address their psychosocial vulnerabilities. Participants were randomly assigned to CWS or IPT-AST. Some participants received a match between risk and prevention (e.g., high cognitive–low interpersonal risk teen in CWS, low cognitive–high interpersonal risk teen in IPT-AST), others received a mismatch (e.g., low cognitive-high interpersonal risk teen in CWS). Measures utilized include the Schedule for Affective Disorders and Schizophrenia for School-Age Children–Present and Lifetime version (KSADS-PL), the Children’s Depression Inventory (CDI), the Adolescent Cognitive Style Questionnaire (ACSQ), the Children’s Dysfunctional Attitudes Scale (CDAS), the Children’s Response Styles Questionnaire (CRSQ), the Network of Relationships Inventory (NRI), and the IPT-AST supervision checklist. Results indicate that matched adolescents showed significantly greater decreases in depressive symptoms than mismatched adolescents from postintervention through 18-month follow-up and across the entire 21-month study period. There was no significant difference in rates of depressive disorders among matched adolescents compared with mismatched adolescents. Limitations include study adolescents were recruited from the general community, which resulted in a sample with relatively low baseline levels of depressive symptoms; more than a third of the sample had experienced a prior depressive episode using a broad definition (MDD-definite, MDD-probable, or minor depression); and modest power to detect effects on diagnoses and symptoms. Note: Since this study did not include the target population specified in the Depression Treatment (Child & Adolescent) topic area definition, this study was not used in the rating/review process.

Additional References

Young, J. F., & Mufson, L. (2008). Interpersonal psychotherapy and prevention. In J. R. Z. Abela & B. L. Hankin (Eds.), Depression in children and adolescents: Cause, treatment, and prevention (pp. 288-308). Guilford.

Young, J. F., Mufson, L., & Schueler, C. M. (2016). Preventing adolescent depression: Interpersonal Psychotherapy-Adolescent Skills Training. https://global.oup.com/academic/product/preventing-adolescent-depression-9780190243180?cc=us&lang=en&

Contact Information

Jami Young, PhD
Agency/Affiliation: Children's Hospital of Philadelphia; University of Pennsylvania Perelman School of Medicine
Website: global.oup.com/academic/product/preventing-adolescent-depression-9780190243180?cc=us&lang=en&
Email:
Phone: (267) 425-1328

Date Research Evidence Last Reviewed by CEBC: April 2021

Date Program Content Last Reviewed by Program Staff: January 2023

Date Program Originally Loaded onto CEBC: December 2010