Klerman’s Interpersonal Therapy For Depression

Interpersonal therapy for depression is a procedure specifically designed to intervene in depressive disorders. It is based on an antecedent to the mindset of psychiatry that became known in the United States as interpersonal psychiatry.

Interpersonal psychiatry starts from the work of Adolf Meyer and Harry Stack Sullivan. It incorporates some ideas from social psychiatry and takes up the conceptions of social roles from the Chicago school. However, this is not an application to depressive disorders of the general principles of interpersonal psychiatry. This intervention was built on the basis of a number of evidences from five research fields. These fields highlight the importance of interpersonal events in depressive disorders.

What is interpersonal therapy for depression?

Interpersonal therapy for depression is a psychotherapy focused on the psychosocial and interpersonal problems of the person seeking treatment. This therapy is not derived directly from psychoanalysis, behaviorism, or cognitive therapy. However, it does use some of the concepts of these streams. With this, it contributes to increasing the interpersonal skills of the patient and their mastery over their own psychosocial context.

We can affirm that interpersonal therapy for depression is an essentially eclectic therapeutic tool. Interpersonal therapy for depression focuses on the connections between pathology and the psychosocial context. Give more importance to the present than to the past.

Interpersonal therapy for depression examines the current personal relationships of the patient and intervenes in the formation of symptoms. It also intervenes in the social dysfunction associated with the present depressive or other episode.

Interpersonal therapy for depression is not a form of cognitive behavioral therapy. Your goal is not to tackle negative thinking patterns, cognitive distortions, or false attributions.

Emphasis on the psychosocial

In interpersonal therapy for depression, the psychosocial mainly refers to the different roles played by a patient and their environmental interactions. Role is understood as the meeting place between the individual way of being and what is presented to others.

The different roles and relationships can be altered by emotional or work overloads, conflicts and losses. Disturbance due to overload tends to lessen forces. Conflicts tend to produce anguish and losses depression.

Typically, the losses to be treated in interpersonal psychotherapy are grief, divorce, or unemployment. In the interpersonal therapy of depression it is assumed that the appearance of the disorder already modifies the psychosocial and interpersonal context of the patient.

The practice of interpersonal therapy for depression

For interpersonal therapy,  depression shows three levels of approach. These three levels would be the following:

• The symptoms.
• The social and interpersonal relationships of the patient.
• Explicit conflicts.

Interpersonal therapy for depression does not consider personality traits or existential and anthropological factors important. Its fundamental mission is to alleviate the patient’s symptoms and help him develop strategies to cope with his social and interpersonal difficulties.

Interpersonal therapy for depression emphasizes the actuality of the patient. The past matters, but only to better understand each patient’s interactive style. The therapeutic space granted to the past does not exceed the space granted to the present.

This therapy works with the patient’s cognitions, but not in a structured way. It does not use detailed protocols or homework and self-registration. Some behavioral techniques such as systematic desensitization, exposure therapy, or analysis of cognitive distortions can be considered, but are not included as a general rule.

Interpersonal therapy for depression is based on the medical model

Interpersonal therapy for depression has its foundations in the medical model. It may or may not be accompanied by antidepressant medication and other psychotropic drugs. This type of therapy, in its original form, is a short form of psychotherapy. One session per week is held for 3 to 6 months. Each session lasts between 40 and 50 minutes.

The new applications of interpersonal therapy for depression have led to changes in both content and duration, which tends to be prolonged. Therefore, its duration can be longer than 6 months. Interpersonal therapy for depression is developed in three phases :

• Initial or diagnostic phase: it goes from the first to the third session.
• Intermediate or focused phase : from the fourth to the tenth session.

• Last phase or conclusive phase : from the eleventh to the twelfth session.

The number of sessions per phase is approximate. Interpersonal therapy for depression advocates flexibility as a general rule to be followed by the psychologist. The therapist assesses the need for medication based on the severity of symptoms, medical history, response to treatment, and patient preferences. To educate the patient, it informs them about diagnosis and treatment.

In this therapeutic framework, the important thing is the strategies and the objectives, and not so much the techniques. This sets it apart from other therapies to treat depression.

Interpersonal therapy for depression is highly regarded and accepted in the complex field of treating depressive disorders. Studies show that it  is a valid alternative or complement for the acute, continuation or maintenance treatment of major depression.