Prepare a 3 page paper that outlines the definition of the therapy, relevant research, potential conflicts and the effectiveness of the therapy on specific patient groups. Discuss the value and drawbacks of this therapy. Why is it important to understand how different therapies are conducted?
Interpersonal Therapy: Bipolar Disorder Or Depression
The Wolrd Health Organization states that, globally, more than 264 million people of all age brackets suffer from depression. This mental health disorder is detrimental to a person’s overall wellbeing and may, to a severe extent, lead to disability. As noted by Charlotte and Lisa (2017), depression that persists for longer than two weeks can result in noticeable problems in a patient’s ability to maintain personal relationships, participate in previously enjoyable social activities and meet work and school obligations. Due to the multiple adversities associated with depression, several evidence-based psychosocial treatments, such as interpersonal therapy (IPT), have been proposed to help alleviate patients’ conditions and mitigate the development of risk factors linked to the disorder.
Definition of the Therapy
Several studies have been conducted regarding interpersonal IPT, leading to the development of a standard description of the psychotherapy. Most notably, Klerman et al. describe IPT as time-limited psychotherapy (cited by Lipsitz & Markowitz, 2013). This description is also seconded by Markowitz, who adds that IPT is a 10-12 weekly sessions diagnosis-focused psychotherapy (cited by Onu et al., 2016). Fundamentally, IPT involves brief psychological counseling conducted within 12-16 weeks, whose focus is to build supportive relationships for patients and help them overcome depression.
As a psychosocial treatment, IPT follows certain phases to help yield positive outcomes among patients. According to scholars, the initial phase of the therapy is evaluation, which involves diagnosing the patient’s syndrome and conducting an interpersonal inventory (Lipsitz & Markowitz, 2013). This step enables the therapist and the patient to review the latter’s past and current relationships and identify the existing interpersonal problem. The second phase, providing case formulation, involves the identification and definition of the target diagnosis (Lipsitz & Markowitz, 2013). This stage of IPT is vital as it enables the therapist to identify the category in which the interpersonal problem falls within- grief, role transition, role dispute, or interpersonal deficits. After diagnosis, the patient and the therapist ultimately agree on a treatment plan.
Relevant Research
Several studies subscribe to the theory that psychological and social factors cause depression. These factors may include interpersonal problems such as stigma and life changes (Asrat et al., 2020). Similarly, scholars believe that the most triggering factors of depression can be understood within IPT, as mainly social problems are the focus of treatment (Asrat et al., 2020). Therefore, the belief that depression is a mental health problem occurring in the social context renders the study of IPT as a treatment option for depression relevant.
Effectiveness of the Therapy on Specific Patients
Clinical studies conducted over the years provide empirical evidence that supports the effectiveness of IPT on patients diagnosed with depression. For example, a case study examining symptom change in treating a 22-year-old-Caucasian female college student presenting anxious and depressive symptoms with IPT showed significant and sustained reductions in depressive symptoms at the end of the session (Mahan et al., 2018). The treatment involved an 18-session treatment, which was coupled with mindfulness skills training. Similarly, a systematic review conducted by Hees et al. (2013) showed that IPT reduced depressive symptoms better than usual care and waitlist condition. Overall, the empirical evidence for IPT’s effectiveness in treating depression among patients of all ages is an ideal foundation for its implementation in the nursing context, to help alleviate the symptoms of depression among patients.
Potential Conflict of the Therapy
Although the breadth of clinical application of IPT has increased over the years, there still exists a potential conflict on its applicability among patients with complex depressive symptoms. As noted, IPT is a time-limited, 12-16 weekly session psychotherapy. Arguably, patients with complex depressive symptoms and other comorbidities may require more sessions to reduce depressive symptoms, thus posing a potential limitation to the treatment option. Besides, Ravitz et al. (2011) note that no treatment works for everyone, and even when delivered with fidelity to guidelines, some patients do not improve sufficiently with IPT. The potential conflict in the use of IPT among more complex patients necessitates further research to test the effectiveness of the treatment in the target group.
Value and Drawbacks of the Therapy
Like other treatment methodologies, IPT adds value to patients, but it is also subject to some drawbacks that can compromise the outcomes of the therapy. The utilization of the treatment adds value by alleviating depressive symptoms and improving interpersonal functioning by working through problems related to grief, isolation, and conflict in relationships while providing support for patients (Ravitz et al., 2011). Fundamentally, IPT helps restore the patient’s ability to function optimally in the social context. However, the nature of the therapy, attachment-focused, acts as a significant drawback to its effectiveness. As noted by scholars, attachment patterns are a predictor of the IPT treatment response and outcome (Ravitz et al., 2011). Notably, patients with high levels of attachment anxiety may take long to stabilize, a problem that may be compounded by the limited span of the therapy. Therefore, a therapist should significantly address the drawbacks of the treatment before its adoption among patients.
Importance of Understanding How Different Therapies are Conducted
As is evident from this research, IPT shows efficacy in reducing depressive symptoms among patients. However, nurses must understand how different therapies are conducted to ensure that they are implemented appropriately to yield positive outcomes. It is worth noting, unlike IPT, some treatments, such as psychodynamic psychotherapy, are not structured. Therefore, understanding how each therapy is conducted can help facilitate effective implementation, leading to optimization of the patient outcomes.
References
“Depression” (2020, January 30). World Health Organization. https://www.who.int/news-room/fact-sheets/detail/depression
Asrat, B., Lund, C., Ambaw, F., & Schneider, M. (2020). Adaptation of the WHO group interpersonal therapy for people living with HIV/AIDS in Northwest Ethiopia: A qualitative study. PLOS ONE, 15(8), 1-20. https://doi.org/10.1371/journal.pone.0238321
Charlotte, D., & Lisa, L. (2017). Not just feeling blue: Major depressive disorder. Nursing, 15(5), 26-32. https://doi.org/10.1097/01.NME.0000521805.31528.75
Hees, MLJM, Rotter, T., Ellermann, T., & Evers, SMAA (2013). The effectiveness of individual interpersonal psychotherapy as a treatment for major depressive disorder in adult outpatients: A systematic review. BMC Psychiatry, 13(22), 1-10. https://doi.org/10.1186/1471-244X-13-22
Lipsitz, J.D., & Markowitz, J.C. (2013). Mechanisms of change in interpersonal therapy (IPT). Clinical Psychology Review, 33(8), 1134-1147. https://dx.doi.org/10.1016%2Fj.cpr.2013.09.002
Mahan, R.M., Swan, S.A., & Macfie, J. (2018). Interpersonal psychotherapy and mindfulness for the treatment of major depression with anxious distress. Clinical Case Studies, 17(2), 104-119. https://doi.org/10.1177%2F1534650118756530
Onu, C., Ongeri, L., Bukusi, E., Cohen, C.R., Neylan, T.C., Oyaro, P., … & Meffert, S.M. (2016). Interpersonal psychotherapy for depression and posttraumatic stress disorder among HIV-positive women in Kisumu, Kenya: Study protocol for a randomized controlled trial. Trials, 17(64), 1-8. https://doi.org/10.1186/s13063-016-1187-6
Ravitz, P., McBride, C., & Maunder, R. (2011). Failures in interpersonal psychotherapy (IPT) factors related to treatment resistance. Journal of Clinical Psychology, 67(11), 1129-1139. https://doi.org/10.1002/jclp.20850