Interpersonal Psychotherapy

Assessment Phase

In the assessment phase, the therapist conducts a thorough diagnostic interview, identifies the patient's current interpersonal relationships, and [Page 901]explores the degree to which the patient perceives a connection between his or her interpersonal functioning and psychological problems. The assessment phase concludes when the therapist and patient agree to proceed with a specified course of IPT.

Initial Phase

The initial phase of IPT usually occurs during the first three sessions. In this phase, the therapist gathers specific information about the patient's interpersonal landscape by conducting an Interpersonal Inventory. The Interpersonal Inventory includes a detailed review of the patient's key relationships and the strengths and shortcomings of those relationships from the patient's perspective. Using this information, the patient and therapist determine which of the patient's current interpersonal problems appear to be most relevant to the patient's current psychological problems.

The Four IPT Problem Areas

IPT encourages the selection of one treatment target from among four interpersonal problem areas: role transition, interpersonal conflict, loss/grief, and interpersonal sensitivity. When role transition is selected, the therapist helps the patient to identify the changing social role, such as parenthood or retirement; acknowledges the distress that can accompany the transition, and problem solves strategies to increase the patient's likelihood of success in adopting the new role. When the therapeutic focus is on interpersonal conflicts, the therapist uses IPT techniques, such as role-play and communication analysis, to facilitate the patient's understanding of how his or her communication patterns may contribute to his or her relationship difficulties. Once maladaptive patterns have been identified, the therapist helps the patient to resolve his or her interpersonal disputes by clearly expressing his or her interpersonal needs to others and responding productively to significant others' unmet needs in return. Loss and grief are also salient problem areas. Identifying and addressing losses in treatment reduce the likelihood that they will serve as triggers for a psychiatric relapse. Finally, some patients suffer from interpersonal sensitivity, or chronic problems relating to others, that can hinder their interpersonal functioning and lay the foundation for pervasive relationship difficulties. When interpersonal sensitivity is selected, the therapist's main objectives are to modify the patient's dysfunctional expectations about relationships, establish and maintain close relationships with others, and develop a network of support that can adequately address the patient's interpersonal needs.

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