Systems of Psychotherapy: A Transtheoretical Analysis Chapter 7. Interpersonal Therapies Chapter 7 Copyright © 2014 Cengage Learning, Inc.

A Sketch of Interpersonal Psychotherapy (IPT) Developed in early 1970s by Gerald Klerman and colleagues. Originally intended as treatment for depression. Established in the research heritage. Myrna Weisssman and John Markowitz updated treatment manual after Klerman’s death. Chapter 7 Copyright © 2014 Cengage Learning, Inc.

Theory of Psychopathology Relationships affect mood, and mood affects relationships. Interpersonal disruption causes and results from depression. Disorders surface when situational stressors expose inability to cope. Chapter 7 Copyright © 2014 Cengage Learning, Inc.

4 Major Interpersonal Problems Interpersonal losses (e.g., loss of a loved one) Disputes (incompatible expectations of a relationship) Transitions (e.g., loss of job) Deficits (trouble forming and maintaining relationships) Chapter 7 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. IPT is Time-limited Focused About current relationships Interpersonal Improving relationships Identifying assets Learning how to cope IPT is not Long-term Open-ended About past relationships Intrapsychic Cognitive/behavioral Achieving insight Identifying defenses Curing the problem Chapter 7 Copyright © 2014 Cengage Learning, Inc.

Therapeutic Processes Short-term, present-oriented therapy. Therapist should not address additional problems, but remain focused on primary problem. No ideological hesitation to use medication. Chapter 7 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. Therapeutic Content Intrapersonal Conflicts Anxieties and defenses Self-esteem Responsibility Interpersonal Conflicts Intimacy and sexuality Communication Hostility Control Chapter 7 Copyright © 2014 Cengage Learning, Inc.

Therapeutic Content (cont.) Indivduo-Social Conflicts Adjustment versus transcendence Impulse control Beyond Conflict to Fulfillment Meaning Chapter 7 Copyright © 2014 Cengage Learning, Inc.

Therapeutic Relationship Patient advocate, not neutral commentator. Not a manifestation of transference. IPT rarely analyzes the interpersonal relationship in psychotherapy. Therapist expresses empathy and warmth but not unconditional acceptance. Chapter 7 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. Practicalities of IPT Best conducted by those with favorable attitude toward short-term treatment and no attachment to theoretical system. IPT typically 12-16 weeks in duration. Therapist adheres to treatment manual. Disposed toward cost-efficient formats and combining therapy with medication. Chapter 7 Copyright © 2014 Cengage Learning, Inc.

A Major Alterative: Transactional Analysis (TA) Personality is structured into 3 ego states: Parent: Both nurturing and controlling; copied from parents in childhood. Child: Impulsive and stimulus-bound state; present since childhood. Adult: Information gathering, data processing, and decision making. Chapter 7 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. Games Have overt social meanings and covert psychological meanings. Complex series of ulterior transactions progress to a psychological payoff. Psychological payoff are feelings such as guilt, depression, or anger. Examples: Kiss off, Kick me. Chapter 7 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. Therapeutic Process TA helps clients achieve increased consciousness. Increased consciousness allows clients to choose ego state and life position. Frequently combined with systems theory in couple/family treatment. Combined with Gestalt to form redecision therapy. Chapter 7 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. Brief IPT 12- to 16-week duration Weekly face-to-face Present-oriented Focus on recovery (not character change) Provides protection against reemergence of symptoms. Chapter 7 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. Effectiveness of IPT IPT is more effective than no treatment and placebo. Effective for treatment of mood and eating disorders. Tends to be most effective in combination with medication. Combination treatment has lower relapse likelihood. Chapter 7 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. Criticisms of IPT From a cognitive-behavioral perspective From a psychoanalytic perspective From a humanistic perspective From a cultural perspective From an integrative perspective Chapter 7 Copyright © 2014 Cengage Learning, Inc.

Future Directions of IPT Increasingly popular orientation. Broadened to other disorders beyond depression. Compatible and concurrent with pharmacotherapy. Briefer IPT rendered by nurse practitioners. Chapter 7 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. Key Terms attachment styles bibliotherapy combined treatment dissolution ego state expressed emotion (EE) games (people play) impasse interpersonal psychotherapy (IPT) interpersonal school of psychoanalysis life positions NIMH Collaborative Treatment Study Parent-Adult-Child (PAC) participant-observer payoff primary problem area Chapter 7 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. Key Terms (Cont.) randomized clinical trials (RCTs) redecision therapy renegotiation ritual role disputes role transitions stroking structural analysis switch transactional analysis (TA) transactions Chapter 7 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. Recommended Websites International Society for Interpersonal Psychotherapy: www.interpersonalpsychotherapy.org/index International Transactional Analysis Association: www.itaa-net.org/ Society for Interpersonal Theory and Research (SITAR): www.sitarsociety.org/ United States of America Transactional Analysis Association: www.usataa.org/ Chapter 7 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. Chapter 7 Copyright © 2014 Cengage Learning, Inc.