Relatively little practiced in France, interpersonal psychotherapy nevertheless shows promising results in people suffering from depression. Coming straight from the United States, this short-term therapeutic method aims to reestablish secure links between the patient and their social environment. How does this form of psychotherapy work? What models is it based on?
1. Indications for interpersonal psychotherapies
Theorized and developed by American psychiatrists Gerald Klerman and Eugene Paykel at the end of the 1960s, interpersonal psychotherapy is today one of the therapeutic methods whose effectiveness has been tested by several studies. Like cognitive-behavioral therapy, interpersonal therapies have largely demonstrated their usefulness in the treatment of patients affected by a characterized depressive episode. Over the years, the field of intervention of this psychotherapy has expanded to other pathologies:
- personality disorders: borderline personality disorder, avoidant personality disorder, dependent personality disorder, etc.;
- anxiety disorders: agoraphobia, social phobia, panic disorder, etc.;
- bipolar disorder;
- post-traumatic stress disorder;
- pervasive developmental disorders: autism spectrum disorders, etc.;
- eating disorders: anorexia, bulimia, binge eating disorder, etc.
2. Principles of interpersonal psychotherapies
Based on the observation that the depressive state generally includes the notion of difficult interpersonal relationships, the theorists of this psychotherapy have focused their action on the reconstitution of the patient’s current attachment links with those around him, so as to make them more solid. The objective is to stabilize the mood of the depressed person (euthymia) by specifically identifying the origins of these relational problems which can – sometimes – be undetected by the patient himself. It could be, for example, conflicts with one’s parents, a deficit in social relationships which leads to isolation, pathological mourning or even a complicated role transition such as the fact of become a parent or teenager. Interpersonal psychotherapy is defined as a short therapy since it generally lasts 12 to 16 sessions. It focuses solely on the present moment even if it does not seek to avoid the impact of the past on the patient’s life. The latter must be an actor in his therapy, supported by a fully invested therapist.
3. Techniques used in interpersonal psychotherapies
To be fully effective, the implementation of interpersonal psychotherapy must combine – most often – different techniques, in order to specifically respond to the patient’s personal problems and to re-establish solid interpersonal links. Among these techniques, we find (according to the Psychotherapy Center affiliated with the Pavillon Albert-Prévost):
- Open exploration: based on general and open questioning, this technique gives the patient the possibility of directing the discussion by choosing the subjects that they consider relevant.
- Directive exploration: questioning, more precise and less general than in open exploration, pursues a specific objective. This may involve, for example, determining the symptoms presented by the patient.
- Clarification: the therapist reformulates the patient’s words in order to promote the latter’s awareness of the issues he has just exposed.
- The use of affect: the therapist encourages the patient to express his affects, that is to say what he feels or his state of mind, when discussing certain subjects. This expression then allows us to better understand and manage problematic affects.
- Communication analysis: this technique is based on the detailed analysis of a conflict situation to which the patient has been exposed. It makes it possible to detect possible communication problems that could deteriorate the patient’s interpersonal relationships, and in fact, impact their mood.
- Behavior modification: these various techniques help the patient to better choose their methods of action or decision in the context of their social relationships. More appropriate solutions are proposed and tested, for example, within the framework of role-playing games.
4. Progress of interpersonal psychotherapies
Interpersonal psychotherapies take place in three distinct phases:
- the initial phase during which an interpersonal inventory, an assessment of the symptoms presented as well as a therapeutic contract are carried out;
- the intermediate phase during which the patient identifies his problems and implements work to reestablish solid attachment bonds;
- the final phase focused on the end of the relationship and therapeutic care.
Sources
- Interpersonal psychotherapy in the treatment of major depression: a mini-practice guide, Jean Leblanc, Rahel Wolde-Giorghis and Minh Thi Nguyen, Psychotherapy Center affiliated with Pavillon Albert-Prévost, 2019
- Principles of Interpersonal Therapy, Interpersonal Therapies Training Institute
- Interpersonal therapy: Presentation, French Association of Interpersonal Therapy