Interpersonal Therapy – How It Works, Structure, Techniques and More

It is a brief attachment-focused psychotherapy, which deals with interpersonal problem solving and symptomatic recovery, is an empirically supported treatment that follows a highly structured and time-limited approach and is scheduled to be completed within 12 hours. -16 weeks. It is based on the principle that relationships and life events affect mood and that the reverse is also true.

It was developed by Gerald Klerman and Myrna Weissman for major depression in the 1970s and has since been adapted for other mental disorders. It is an empirically validated intervention for depressive disorders, and it is most effective when used in combination with psychiatric medications, along with cognitive behavioral therapy, it is recommended in treatment guidelines as a psychosocial treatment of choice, both are the only psychosocial interventions in which psychiatric residents in the United States must receive training for professional practice.

Depression is not always caused by an event or a relationship, but it affects relationships and can create problems with interpersonal connections. The goals of this type of therapy are to help you communicate better with others and address the issues that contribute to your depression.

Main characteristics of interpersonal therapy

Key features of interpersonal therapy include:

• It is a short-term treatment approach,
• It is of limited duration rather than open.
• It is very focused on specific problems identified in the initial sessions.
• The focus is on interpersonal problems rather than intrapsychic problems (conflicts within the person rather than others). Unconscious underlying problems are not explored.
• Current interpersonal issues and relationships are emphasized rather than past relationships (some therapies place a strong emphasis on childhood events). Issues are acknowledged and can be briefly discussed if relevant but
• are not the focus.
• The main focus is on interpersonal patterns that contribute to mood symptoms, not cognitive distortions and beliefs (which is the focus of cognitive therapies, such as cognitive behavioral therapy).

How does interpersonal therapy work?

Treatment usually begins when your therapist conducts an interview, based on the problems you describe, they can identify goals and create a treatment scheme, you and your therapist will focus on the key problems you want to solve. A typical program involves up to 20 hour-long sessions per week.

Interpersonal therapy is not about finding an unconscious source for your current feelings and behavior. In this way, it is different from other forms of psychotherapy, it focuses on the current reality of their depression, analyzes how the more immediate difficulties contribute to the symptoms which can complicate personal relationships, and this often causes people with depression to become want to isolate everything and everyone.

Feelings of depression follow a major change in your life, these changes fall into one of four categories:

• Complicated grief: The death of a loved one or an unresolved grief.
• Role transition: The beginning or end of a relationship or marriage or the diagnosis of a disease.
• Role dispute: A struggle in a relationship.
• Interpersonal deficit: The absence of a major life event.

Your therapist will try to identify the events in your life that lead to your depression, they will try to equip you with the skills you need to address difficult emotions in a positive way. You may be encouraged to participate in social activities that have been stressful or painful in the past, this may be a way to practice new coping techniques.

Structure of interpersonal therapy

The opening sessions (1-3). They focus on gathering information and making decisions about the approach to therapy, which helps the patient to create a list of all the key relationships in the patient’s life (interpersonal inventory), these relationships are grouped according to the four main problem areas.

The middle sessions (4 – 14). The patient concentrates on trying to improve the chosen problem area or areas with the support of the therapist. The patient and therapist work to develop solutions to problems, and the patient tries to implement the solutions between sessions.

The final sessions (15 to 16). They focus on dealing with any sense of loss associated with the end of therapy, as well as reviewing the problems that were identified in the interpersonal inventory and the progress in treating them.

Interpersonal therapy techniques

All therapy sessions will be different based on individual circumstances, however there are certain techniques that can be especially helpful with interpersonal therapy . These include:

Identifying your emotions

For some of us, accurately identifying the emotion we are feeling can be difficult, an interpersonal therapist will seek to help you identify the emotions from an unbiased perspective.

For example, sadness can be misinterpreted as anger, and vice versa. Learning to identify your emotions objectively, that is, without prejudice, judgment or moralizing (that is, labeling them as “good” or “bad”) is a valuable skill, when you judge yourself harshly for feeling a certain way, it reinforces the depression.

Express emotions

Most people experience painful and / or intense emotions from time to time, especially during difficult interactions with others, if they are expressed in an unhealthy way, it usually makes the conflict much worse. During therapy, you can experience uncomfortable emotions in a safe environment, learn to accept them, and learn to express them in a healthy and appropriate way.

Address past issues.

Although it is not a central theme of therapy, there may be times when discussing past relationships that are affecting your current interactions is essential to moving forward, this can also help to identify problematic patterns that arise from those past problems.

Supportive listening

As the name implies, the therapist listens carefully to your problems, experience and concern, in a matter that is supportive rather than critical or critical, this helps establish a good relationship, creates a safe therapeutic atmosphere and helps you feel more comfortable opening up to therapy.

Clarification

Your therapist will use clarification to help you identify and understand how your own personal biases and perceptions play a role in your interpersonal problems. Clarification also helps identify patterns in how you feel and think when interacting with others.

Roleplay

It involves acting out potential scenarios that will allow you to see things from a different perspective, as well as practicing new behaviors during therapy sessions. For example, the therapist may take on the role of a close friend or family member with whom there are frequent conflicts, while you try different ways of interacting. Role play also allows you to explore and discuss the emotions you experience, what you learn can be applied in real life situations outside of therapy.

Communication analysis

It is probably one of the most important techniques used, since this implies that the therapist reminds you, in detail, of a problematic interaction that you had with someone in your life, which includes the tone of voice, the gestures with the hands, the Body language and the specific statements that you and the other person made, this allows the therapist to identify problematic communication patterns that are common in depressed people, such as passive behavior that leads to resentment or feelings of use by others. Furthermore, these unhealthy patterns serve to reinforce depression.

For example, if you feel worthless or disrespectful when others take advantage of you, one of the goals of therapy may be to learn to stand up for yourself and express your feelings in a calm and appropriate way.

Decision analysis

This technique involves exploring and learning new ways to resolve conflicts and other problems that occur in your relationships with others, when analyzing alternative options, you will also consider the possible results of their use, allow you to choose the courses of action that are most likely to yield the results. desired results.

Interpersonal therapy intervention areas

In the depression model, four areas are generally addressed during treatment: interpersonal conflict, role transitions, grief, and interpersonal deficits. Below are the key aspects of each area.

Interpersonal conflicts

Conflicts with other people are a normal part of life, they inevitably occur from time to time when two or more people interact frequently. Disputes take place between family members, partners, friends and acquaintances, schoolmates, and coworkers. The underlying problem of any conflict is a difference in expectations. These conflicts are discussed in therapy when they are a major cause of distress for the client.

Role transitions

Life is full of transitions, sometimes a transition or change in one’s role, for example, going from being single to being in a romantic relationship, is something positive and happy but sometimes role transitions, for example, a breakup or divorce, are undesirable and cause emotional pain. These transitions can trigger or worsen depression because they are experienced as a painful loss in the person’s life, if the person cannot adjust to their new role, then discussing it in interpersonal therapy can be helpful.

Grief and pain

Grief occurs when a loved one dies (or has to be gone for a long time), although grieving a loss is a normal and healthy process, some people, particularly those who are vulnerable to depression, get caught up in it. process. Depression tends to increase a person’s sensitivity to loss, so the death of someone important can be especially difficult to handle and should be discussed within this therapy.

Interpersonal deficits

Interpersonal deficits refer to any lack in the quality or quantity of relationships that a person has. For some people, the problem here might be having too few close or supportive friendships and for others, it would mostly correspond to the quality of their relationships (for example, toxic or one-sided relationships). In interpersonal therapy, it is important to identify relationship deficits and discuss the best way to remedy them.

By addressing these four areas, you help therapy clients make a connection between their symptoms and their interpersonal struggles, problems can be with anyone in your life, such as family members, a loved one, or friends.

Efficacy of interpersonal therapy

It is recognized as an effective mode of treatment for mental health problems by professional entities such as the American Psychological Association and the National Institutes of Health. Since its development in the 1970s, many studies have determined that it is both versatile and effective, although it is not effective for every population, it has been shown to provide relief from some depressive symptoms equal to those found in drug regimens. antidepressant medications.

It can be administered as a single form of therapy or together with medications, the decision to receive this type of therapy, medication or a combination of both is up to the therapist and the person, however, most studies seem to indicate that the combination of Medication and interpersonal therapy may be more beneficial than on its own.

Conditions treated by interpersonal therapy.

Interpersonal therapists provide non-judgmental and active treatment to help people in therapy successfully manage challenges and improve mental health. Things that could be addressed during the course of treatment may include role disputes, interpersonal deficiencies, life stage transitions, relational conflicts, grief, and other attachment problems. It is well researched as an effective treatment for depression and has been modified to treat several other mental health problems. These include:

• Bipolar disorder.
• Borderline personality disorder.
• Depression as a result of an illness, such as HIV.
• dysthymia.
• Eating disorders.
• Marriage disputes.
• Panic disorder
• Prolonged grief.
• Substance abuse.
• Anxiety.
• Bulimia nervosa
• Chronic fatigue
• Postpartum depression.
• Social phobia.
• Post traumatic stress.

This therapy has been adapted to treat patients from adolescence to old age, it is effective as a standalone treatment and in combination with medications.

Limitations of interpersonal therapy

Most research includes very few limitations, however there are a few things to keep in mind if you are trying to find a therapist who offers this type of therapy. First, the therapeutic process is based on the assumption that the person is motivated to change and for this to be effective, the person in therapy must be willing to examine their own role in the problem. In addition, they must have a level of awareness and understanding of interpersonal relationships to be able to work on them, this is not always possible in some populations or for some people with certain mental health conditions.

Interpersonal therapy may be an attractive therapy option for some because it is a short-term model of therapy. For therapists, this means that there is less chance that people in therapy will drop out of treatment. Overall, it is a reputable treatment option for many mental health problems and populations.