Blog
The Psychotherapy Practice Research Network (PPRNet) blog began in 2013 in response to psychotherapy clinicians, researchers, and educators who expressed interest in receiving regular information about current practice-oriented psychotherapy research. It offers a monthly summary of two or three published psychotherapy research articles. Each summary is authored by Dr. Tasca and highlights practice implications of selected articles. Past blogs are available in the archives. This content is only available in English.
This month...
…I blog about therapist empathy, psychotherapeutic treatment for borderline personality disorder, and research on psychological treatment of depression.
Type of Research
Topics
- ALL Topics (clear)
- Adherance
- Alliance and Therapeutic Relationship
- Anxiety Disorders
- Attachment
- Attendance, Attrition, and Drop-Out
- Client Factors
- Client Preferences
- Cognitive Therapy (CT) and Cognitive-Behavioural Therapy (CBT)
- Combination Therapy
- Common Factors
- Cost-effectiveness
- Depression and Depressive Symptoms
- Efficacy of Treatments
- Empathy
- Feedback and Progress Monitoring
- Group Psychotherapy
- Illness and Medical Comorbidities
- Interpersonal Psychotherapy (IPT)
- Long-term Outcomes
- Medications/Pharmacotherapy
- Miscellaneous
- Neuroscience and Brain
- Outcomes and Deterioration
- Personality Disorders
- Placebo Effect
- Practice-Based Research and Practice Research Networks
- Psychodynamic Therapy (PDT)
- Resistance and Reactance
- Self-Reflection and Awareness
- Suicide and Crisis Intervention
- Termination
- Therapist Factors
- Training
- Transference and Countertransference
- Trauma and/or PTSD
- Treatment Length and Frequency
August 2019
An Historical Review of Interpersonal Psychotherapy
Ravitz, P., Watson, P., Lawson, A., Constantino, M.J., Bernecker, S., Park, J., & Swartz, H.A. (2019). Interpersonal Psychotherapy: A scoping review and historical perspective (1974-2017). Harvard Review of Psychiatry, 27, 165-179.
Interpersonal Psychotherapy (IPT) focuses on relationships and emotions, and emphasizes stressful interpersonal loss, life changes, relationship disputes, and social isolation as the causes and maintenance factors related to depression and other disorders. The IPT is predicated on the importance of relationships for survival and the bidirectional links between depression and problems with relationships and social support. IPT was first manualized in 1974 and used as a comparison condition in studies of pharmacotherapy for depression. Contrary to expectations, IPT did just as well as antidepressant medication in early treatment trials, thus giving rise to an important new psychological treatment. This scoping review by Ravitz and colleagues summarizes the development of IPT over the past 40 years. The review identified over 1000 articles of IPT, 133 of which were randomized controlled trials. Following the initial trials in the 1970s, IPT was included in the Treatment of Depression Collaborative Research Program in the 1980s, funded by the National Institute of Mental Health in the United States. This was the largest trial of its kind whose results indicated that patients with high baseline depression did best with medications followed by IPT, whereas CBT did not show significant advantage over the placebo condition. The 1990s to the mid-2000s saw a precipitous increase in randomized controlled trials of IPT in which IPT was: compared to other therapies, compared to medications, and/or provided in combination with medications. In addition, treatment trials of group IPT were conducted in low- and middle-income countries. These studies led the World Health Organization to publish and disseminate a group IPT manual. More recent research in the past decade has seen IPT offered in different formats (individual, telephone, group, internet), for different populations (adolescents, perinatal women, late-life), and in a variety of low- and high-income countries. Currently, there is good research support for the efficacy of IPT for depression, eating disorders, bipolar disorder, PTSD, and anxiety.
Practice Implications
Relationships play an important role in determining health, disease, vulnerability, recovery, and resilience. Because of the universal importance of relationships, IPT is relevant to mental health care across cultures and populations. Therapists should consider the importance of relationship loss and grief, role transitions throughout the lifespan, persistent conflicts in relationships, and social isolation when treating patients with depression and other mental disorders.
November 2017
Psychotherapy for Depression Also Reduces Interpersonal Problems
McFarquhar, T., Luyten, P., & Fonagy, P. (2018). Changes in interpersonal problems in the psychotherapeutic treatment of depression as measured by the Inventory of Interpersonal Problems: A systematic review and meta-analysis. Journal of Affective Disorders, 226, 108-123.
Interpersonal problems are commonly reported by depressed people. Interpersonal problems are seen by many as both a cause of depressive symptoms and as a result of depression. Depression may be the result of lacking basic human needs like social supports, stable relationships, and intimacy. One of the most important ways of assessing interpersonal problems is with the Inventory of Interpersonal Problems (IIP). The IIP is based on a circumplex model of two independent dimensions: affiliation (friendliness vs hostility) and status (dominance vs submissiveness). Greater problems in any of these domains or any combination of these domains may lead to interpersonal distress that result in or are the result of depression. Many psychotherapies target interpersonal problems in their treatment of depression: Interpersonal Psychotherapy (IPT), Short Term Dynamic Psychotherapy (STDP), and Emotion Focused Therapy (EFT). In this meta-analysis, McFarquhar and colleagues evaluated whether psychotherapy for depression is related to changes in interpersonal distress and whether specific types of interpersonal problems at baseline are related to treatment outcomes for depression at post-treatment. The authors looked at both randomized and non-randomized trials of psychotherapy for adults with depression. They found 10 studies that met inclusion criteria, six of which were randomized controlled trials. Psychotherapy for depression resulted large positive changes in interpersonal problems (overall pre- to post-treatment ES g=0.74, 95% CI=0.56–0.93). Unfortunately, there were too few studies (k = 3) that met meta-analytic criteria to do an analysis of pre-treatment interpersonal distress as a predictor of depression outcomes. However, of 8 studies that looked at this question, six showed that higher interpersonal distress was associated with poorer outcomes for depression at post-treatment.
Practice Implications
Given that interpersonal problems both cause and are caused by depressive symptoms, targeting relationship difficulties (lack of social support, conflict in relationships, low intimacy, relationship avoidance) in psychotherapy should be a priority. This meta-analysis showed that interpersonal distress improves after psychotherapy for depression, and there was some evidence that higher interpersonal problems at the outset may reduce the effects of the therapy for depressive symptoms.