Klerman’s Interpersonal Therapy For Depression

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

Interpersonal psychiatry is based on the work of Adolf Meyer and Harry Stack Sullivan. It incorporates some ideas from social psychiatry and takes up the concepts of social roles of the Chicago school. However, it is not an application of the general principles of interpersonal psychiatry to depressive disorders. This intervention was built based on several pieces of evidence from five fields of research. 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 uses some of the concepts of these currents. In doing so, it contributes to increasing the patient’s interpersonal skills and his control over his psychosocial context.

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

Interpersonal therapy for depression examines the patient’s current personal relationships and intervenes in symptom formation. It also intervenes in social dysfunction associated with the current depressive or another episode.

Interpersonal therapy for depression is not a form of cognitive-behavioral therapy. Its goal is not to address negative thought patterns, cognitive distortions, or false attributions.

Emphasis on the psychosocial

In interpersonal therapy for depression, psychosocial refers primarily to the different roles played by a patient and his or her environmental interactions. The role is understood as the meeting place between the individual way of being and what is presented to others.

Different roles and relationships can be altered by emotional or work overload, conflicts, and losses. The alteration due to overload tends to weaken the strength. Conflicts tend to produce anxiety and losses, depression.

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

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 patient’s social and interpersonal relationships.
  • Explicit conflicts.

Interpersonal therapy for depression does not consider personality traits or existential and anthropological factors as 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 patient’s present. The past matters, but only to better understand each patient’s interactive style. The therapeutic space given to the past does not exceed the space given 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-records to be completed at home. Some behavioral techniques such as systematic desensitization, exposure therapy, or analysis of cognitive distortions may be considered, but are not included as a general rule.

Interpersonal therapy for depression is based on the medical model

Interpersonal therapy for depression is based on 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 form of brief psychotherapy. One session is held per week throughout 3 to 6 months. Each session lasts between 40 and 50 minutes.

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

  • Initial or diagnostic phase: goes from the first to the third session.
  • Intermediate or focused phase: from the fourth to the tenth session.
  • Final phase or concluding 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 the patient’s preferences. To educate the patient, he or she informs him or her about the diagnosis and treatment.

In this therapeutic framework, the important thing is the strategies and objectives, and not so much the techniques. This differentiates it from other therapies for treating depression.

Interpersonal therapy for depression enjoys great prestige and acceptance in the complex field of treatment of depressive disorders. Studies show that it is a valid alternative or complement for the acute, continuation, or maintenance treatment of major depression.

2024-08-16