Interpersonal Psychotherapy for Depressed Adolescents (IPT-A)

About This Program

Target Population: Adolescents ages 12-18 years old suffering from nonpsychotic depression who can be treated on a once-a-week outpatient basis

For children/adolescents ages: 12 – 18

Program Overview

Interpersonal Psychotherapy (IPT) is a time-limited, manualized psychosocial treatment for depression in adolescents and adults. IPT for adults has been rated by the CEBC in the area of Depression Treatment (Adult). IPT identifies how interpersonal issues are related to the onset or maintenance of depressive symptoms while recognizing the contributions of genetic, biological, and personality factors to vulnerability for depression. Patients work to understand the effects of interpersonal events on their mood and to improve their communication and problem-solving skills in order to increase their effectiveness and satisfaction in current relationships.

Interpersonal Psychotherapy for Depressed Adolescents (IPT-A) is defined in a treatment manual that was adapted to address the developmental needs of adolescents and their families. IPT-A is an outpatient treatment designed for adolescents with mild to moderate depression severity. It is not indicated for adolescents who are acutely suicidal or homicidal, psychotic, bipolar, or mentally retarded, or for adolescents who are actively abusing substances.

Program Goals

The goal of Interpersonal Psychotherapy for Depressed Adolescents (IPT-A) are:

  • Improve relationships by:
    • Improving communication skills
    • Improving problem solving skills

Logic Model

The program representative did not provide information about a Logic Model for Interpersonal Psychotherapy for Depressed Adolescents (IPT-A).

Essential Components

The essential components of Interpersonal Psychotherapy for Depressed Adolescents (IPT-A) include:

  • Initial Phase:
    • Psychoeducation about depression
    • Assignment of the limited sick role
    • Creation of the closeness circle
    • Conduct an interpersonal inventory
    • Problem Area Formulation - 1 of 4 areas: grief, role transitions, role disputes, interpersonal deficits
  • Middle Phase - Work on Interpersonal Problem Area:
    • Clarification and expression of emotions
    • Communication analysis
    • Decision analysis for problem-solving
    • Teach communication skills
    • Role playing
    • Assign interpersonal experiments to do in between sessions
  • Termination:
    • Review of warning symptoms of depression
    • Review of interpersonal strategies
    • Generalization of strategies to future situations
    • Discuss feelings about ending treatment
    • Assess need for further treatment

Program Delivery

Child/Adolescent Services

Interpersonal Psychotherapy for Depressed Adolescents (IPT-A) directly provides services to children/adolescents and addresses the following:

  • Interpersonal problems and depression symptoms.
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: There is recommended parental involvement to address psychoeducation about depression, interpersonal and communication skills, problem-solving and to practice these skills with their children.

Recommended Intensity:

Once a week with each session lasting approximately 45-50 minutes. During this time, the clinician may also conduct 1-3 additional parent sessions as needed.

Recommended Duration:

12-16 weeks.

Delivery Settings

This program is typically conducted in a(n):

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

Homework

Interpersonal Psychotherapy for Depressed Adolescents (IPT-A) includes a homework component:

There is no prescribed homework, but during treatment teens are asked to practice different interpersonal skills and interactions.

Resources Needed to Run Program

The typical resources for implementing the program are:

Therapy offices and clinicians.

Manuals and Training

Prerequisite/Minimum Provider Qualifications

Master's or doctoral degree in clinical 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:
Training Type/Location:

Upon request, experts willing to provide informal consultation and supervision, but trainings are not set up as a regular offering.

Number of days/hours:

Varies.

Implementation Information

Pre-Implementation Materials

There are no pre-implementation materials to measure organizational or provider readiness for Interpersonal Psychotherapy for Depressed Adolescents (IPT-A).

Formal Support for Implementation

There is no formal support available for implementation of Interpersonal Psychotherapy for Depressed Adolescents (IPT-A).

Fidelity Measures

There are fidelity measures for Interpersonal Psychotherapy for Depressed Adolescents (IPT-A) as listed below:

The fidelity measures are checklists of the main tasks for the sessions that a supervisor can check off if they are done based on supervision and/or review of audiotapes.

Implementation Guides or Manuals

There are no implementation guides or manuals for Interpersonal Psychotherapy for Depressed Adolescents (IPT-A).

Research on How to Implement the Program

Research has not been conducted on how to implement Interpersonal Psychotherapy for Depressed Adolescents (IPT-A).

Relevant Published, Peer-Reviewed Research

Child Welfare Outcome: Child/Family Well-Being

Mufson, L., Weissman, M., Moreau, D., & Garfinkel, R. (1999). Efficacy of Interpersonal Psychotherapy for Depressed Adolescents. Archives of General Psychiatry, 56(6), 573–579. https://doi.org/10.1001/archpsyc.56.6.573

Type of Study: Randomized controlled trial
Number of Participants: 48

Population:

  • Age — 12-18 years
  • Race/Ethnicity — IPT-A Group: 79% Hispanic; Clinical Monitoring Group: 63% Hispanic
  • Gender — IPT-A Group: 75% Female and 25% Male; Clinical Monitoring Group: 71% Female and 29% Male
  • Status — Participants were clinic-referred adolescents who met the criteria for Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) major depressive disorder.

Location/Institution: New York

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate Interpersonal Psychotherapy for Depressed Adolescents (IPT-A). Participants were randomly assigned to either weekly IPT-A or clinical monitoring. Measures utilized include the Diagnostic Interview Schedule for Children Version 2.3 (DISC 2.3), the Schedule for Affective Disorders and Schizophrenia for School-Aged Children (K-SADS-E), the Hamilton Rating Scale for Depression (HRSD), the Beck Depression Inventory (BDI), and the Children’s Global Assessment Scale (C-GAS). Results indicate that patients who received IPT-A reported a notably greater decrease in depressive symptoms and greater improvement in overall social functioning, functioning with friends, and specific problem-solving skills. Limitations include small sample size, predominantly Latino and low socioeconomic status sample, and the lack of follow-up data.

Length of controlled postintervention follow-up: None.

Rossello, J., & Bernal, G. (1999). The efficacy of cognitive-behavioral and interpersonal treatments for depression in Puerto Rican adolescents. Journal of Consulting & Clinical Psychology, 67(5), 734-744. https://doi.org/10.1037/0022-006X.67.5.734

Type of Study: Randomized controlled trial
Number of Participants: 71

Population:

  • Age — 13-17 years
  • Race/Ethnicity — Not specified
  • Gender — 54% Female and 46% Male
  • Status — Participants were adolescents who had a diagnosis for major depressive disorder, dysthymia, or both, based on the Diagnostic and Statistical Manual of Mental Disorders (3rd ed.).

Location/Institution: Centro Universitario de Servicios y Estudios Psicologicos (University Center for Psychological Services and Research) at University of Puerto Rico.

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the efficacy of cognitive behavioral therapy (CBT) and Interpersonal Psychotherapy (IPT) [now called Interpersonal Therapy for Depressed Adolescents (IPT-A)], with depressed adolescents. Participants were randomly assigned to 1 of 3 conditions: CBT, IPT or waitlist (WL). Measures utilized include the Children’s Depression Inventory (CDI), the Piers-Harris Children’s Self-Concept Scale (PHCSCS), the Social Adjustment Scale for Children and Adolescents (SASCA), the Family Emotional Involvement and Criticism Scale (FEICS), and the Child Behavior Checklist (CBCL). Results indicate that both IPT and CBT significantly reduced depressive symptoms and increased self-esteem when compared with the WL condition. At posttreatment, it was found that 82% of those in IPT and 59% of those in CBT showed a clinically significant change. Limitations include the small sample size and the primary use of self-report measures.

Length of controlled postintervention follow-up: 3 months.

Mufson, L., Dorta K. P., Wickramaratne, P., Nomura, Y., Olfson, M., & Weissman, M. M. (2004). A randomized effectiveness trial of Interpersonal Psychotherapy for Depressed Adolescents. Archives of General Psychiatry, 61(6), 577-584. https://doi.org/10.1001/archpsyc.61.6.577

Type of Study: Randomized controlled trial
Number of Participants: 63

Population:

  • Age — 12-18 years
  • Race/Ethnicity — 71% Hispanic
  • Gender — 84% Female and 16% Male
  • Status — Participants were referred to mental health clinicians in 1 of 5 school-based health clinics.

Location/Institution: Mental health clinics in New York City

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to assess the effectiveness of Interpersonal Psychotherapy for Depressed Adolescents (IPT-A) compared with treatment as usual (TAU) in school-based mental health clinics. Participants were randomly assigned to receive IPT-A or TAU. Measures utilized include the Hamilton Depression Rating Scale (HAMD), the Beck Depression Inventory (BDI), the Children’s Global Assessment Scale (C-GAS), the Clinical Global Impressions (CGI) Scale, and the Social Adjustment Scale – Self-Report (SAS-SR). Results indicate that adolescents treated with IPT-A compared with TAU showed greater symptom reduction and improvement in overall functioning. Compared with the TAU group, the IPT-A group showed significantly fewer clinician-reported depression symptoms on the HAMD and BDI, significantly better functioning on the C-GAS, significantly better overall social functioning on the SAS-SR, and significantly greater clinical improvement and significantly greater decrease in clinical severity on the CGI scale. Limitations include the small sample size and questionable generalizability of the predominantly female and Hispanic sample.

Length of controlled postintervention follow-up: 1 month or less.

Gunlicks-Stoessel, M., Mufson, L., Jekal, A., & Turner, J. (2010). The impact of perceived interpersonal functioning on treatment for adolescent depression: IPT-A versus treatment as usual in school-based health clinics. Journal of Consulting & Clinical Psychology, 78(2), 260-667. https://doi.org/10.1037/a0018935

Type of Study: Randomized controlled trial
Number of Participants: 63

Population:

  • Age — 12-18 years
  • Race/Ethnicity — 75% Latino, 14% African American, 10% Other, and 2% Asian American
  • Gender — 84% Female and 16% Male
  • Status — Participants were referred for mental health treatment in five school-based health clinics in New York City, and each had a diagnosis of major depression, dysthymia, depressive disorder not otherwise specified, or adjustment disorder with depressed mood.

Location/Institution: Columbia University College of Physicians and Surgeons; New York State Psychiatric Institute

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine aspects of depressed adolescents’ perceived interpersonal functioning as moderators of response to treatment among adolescents treated with Interpersonal Psychotherapy for Depressed Adolescents (IPT-A). Participants were randomly assigned to receive IPT-A or treatment as usual (TAU) delivered by school-based mental health clinicians. Measures utilized include the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS), the Hamilton Rating Scale for Depression (HRSD), the Conflict Behavior Questionnaire (CBQ-20), and the Social Adjustment Scale – Self-Report (SAS-SR). Results indicate that adolescents treated with IPT-A showed greater and more rapid reductions in depression symptoms, as compared with participants treated with TAU. Results showed that the benefits of IPT-A over TAU were particularly strong for the adolescents who reported high baseline levels of conflict with their mothers and social dysfunction with friends. Limitations include the small sample size and questionable generalizability of a sample primarily consisting of low-income Hispanic females, as well as the lack of follow-up data.

Length of controlled postintervention follow-up: None.

Gunlicks-Stoessel, M., & Mufson, L. (2011). Early patterns of symptom change signal remission with interpersonal psychotherapy for depressed adolescents. Depression and Anxiety, 28(7), 525–531. https://doi.org/10.1002/da.20849

Type of Study: Randomized controlled trial
Number of Participants: 63

Population:

  • Age — 12-18 years
  • Race/Ethnicity — 75% Hispanic, 14% African American, 10% Other, and 1% Asian
  • Gender — 84% Female and 16% Male
  • Status — Participants were referred to mental health clinicians in 1 of 5 school-based health clinics (3 middle schools and 2 high schools) within schools located in urban, impoverished areas of New York City.

Location/Institution: New York

Summary: (To include basic study design, measures, results, and notable limitations)
This study used the sample from Mufson et al. (2004). The purpose of the study was to examine whether reductions in depression symptoms at different time points over the course of therapy predict remission for depressed adolescents treated with Interpersonal Psychotherapy for Depressed Adolescents (IPT-A) or treatment as usual (TAU) delivered in school-based health clinics. Measures utilized include the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SAD) and the Hamilton Rating Scale for Depression (HRSD). Results indicate that a 16.2% reduction in HRSD from baseline represented the best combined sensitivity and specificity in predicting week 16 remission status for adolescents treated with IPT-A. A 24.4% reduction in depressive symptoms represented the best combined sensitivity and specificity in predicting remission status for TAU. Limitations include the small sample size, generalizability to adolescents receiving other kinds of treatments for depression, and unknown if results are generalizable to other populations of depressed adolescents.

Length of controlled postintervention follow-up: None.

O’Shea, G., Spence, S. H., & Donovan, C. L. (2015). Group versus individual Interpersonal Psychotherapy for Depressed Adolescents. Behavioural and Cognitive Psychotherapy, 43(1), 1-19. https://doi.org/10.1017/S1352465814000216 

Type of Study: Randomized controlled trial
Number of Participants: 39

Population:

  • Age — 13-19 years
  • Race/Ethnicity — 38 Caucasian and 1 Aboriginal
  • Gender — 33 Female and 6 Male
  • Status — Participants were adolescents diagnosed with Major Depressive Disorder.

Location/Institution: Brisbane, Australia

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the long-term efficacy of group versus individual delivery of Interpersonal Psychotherapy for Depressed Adolescents (IPT-A). Participants were randomly assigned to either group or individual IPT-A. Measures utilized include the Schedule for Affective Disorders and Schizophrenia for School Aged Children – Epidemiological version, 5th edition (K-SADS-E), the Beck Depression Inventory – II (BDI-II), the Children’s Global Assessment Scale (CGAS), the Youth Self-Report-Revised (YSR), Child Behavior Check List (CBCL), and the Spence Children’s Anxiety Scale (SCAS-C). Results indicate that there was significant improvement in depression, anxiety, youth-reported internalizing problems and global functioning from pretest to posttest treatment for those receiving IPT-A, with no significant differences in outcome between group and individual formats of delivery. Improvements were maintained at 12 month follow-up. Individual IPT-A showed significantly greater improvement than group IPT-A in parent-reporting internalizing problems for the completer but not the intent-to-treat analyses. Limitations include small sample size, lack of wait list control group, and lack of comparison of dosages across experimental conditions.

Length of controlled postintervention follow-up: 12 months.

Toth, S. L., Handley, E. D., Manly, J. T., Sturm, R., Adams, T. R., Demeusy, E. M., & Cicchetti, D. (2020). The moderating role of child maltreatment in treatment efficacy for adolescent depression. Journal of Abnormal Child Psychology, 48(10), 1351–1365. https://doi.org/10.1007/s10802-020-00682-z

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

Population:

  • Age — IPT-A: Mean=13.97 years; ECS: Mean=13.94 years
  • Race/Ethnicity — IPT-A: 59% Black, 25% White, 21% Latinx, and 16% Other; ECS: 73% Black, 15% White, 12% Other, and 6% Latinx
  • Gender — IPT-A: 100% Female; ECS: 100% Female
  • Status — Participants were low-income adolescent girls with and without histories of child maltreatment. 

Location/Institution: Not specified

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the efficacy of Interpersonal Psychotherapy for Depressed Adolescents (IPT-A). Participants were randomly assigned to either IPT-A or Enhanced Community Standard (ECS) treatment. Measures utilized include the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children—Present and Lifetime (K-SADS-PL), the Beck Depression Inventory for Youth (BDI-Y), the UCLA-PTSD Reaction Index, the Beck Depression Inventory, second edition (BDI-II), and the Childhood Trauma Questionnaire (CTQ). Results indicate that among adolescent girls who had experienced two or more subtypes of maltreatment, IPT-A was found to be more efficacious than ECS treatment. Among girls with a history of sexual abuse, preliminary evidence found that IPT-A was significantly more effective than ECS in reducing depressive symptoms, and the effect size was large. Limitations include rates of compliance with treatment were not as high as they might have been in a more controlled setting, small sample size, and lack of follow up.

Length of controlled postintervention follow-up: None.

Additional References

Brunstein-Klomek, A., & Mufson, L. (2006). Interpersonal Psychotherapy for Depressed Adolescents. Child and Adolescent Psychiatric Clinics of North America, 15(4), 959-975. https://doi.org/10.1016/j.chc.2006.05.005

Mufson, L. (2010). Interpersonal Psychotherapy for Depressed Adolescents (IPT-A): Extending the reach from academic to community settings. Child & Adolescent Mental Health, 15(2), 66–72. https://doi.org/10.1111/j.1475-3588.2009.00556.x

Mufson, L., Pollack Dorta, K., Moreau, D., & Weissman, M. M. (2004). Interpersonal Psychotherapy for Depressed Adolescents (2nd ed.). Guilford Publications, Inc.

Contact Information

Laura Mufson, PhD
Agency/Affiliation: Columbia University College of Physicians and Surgeons
Email:
Phone: (646) 774-5791
Fax: (212) 543-6660

Date Research Evidence Last Reviewed by CEBC: April 2021

Date Program Content Last Reviewed by Program Staff: April 2016

Date Program Originally Loaded onto CEBC: August 2010