Interpersonal therapy of depression is a procedure specifically designed to intervene on depressive disorders. It is based on an earlier postulate of the thinking of psychiatry, known in the United States as interpersonal psychiatry.
Interpersonal psychiatry began with the work of Adolf Meyer and Harry Stack Sullivan. It incorporates some ideas of social psychiatry. She also revisits the conceptions of the social roles of the Chicago School.It is not, however, an application to depressive disorders of the general principles of interpersonal psychiatry. Indeed, this intervention was constructed from a number of evidence from five areas of research. These areas highlight the importance of interpersonal events in depressive disorders.
What is interpersonal depression therapy?
Interpersonal Depression Therapy is psychotherapy focused on the psychosocial and interpersonal issues of the person seeking treatment. This therapy does not derive directly from psychoanalysis, behavioralism or cognitive therapy. However, she uses some of the concepts of these currents. It thus contributes to increasing the interpersonal skills of the patient and his mastery of his own psychosocial context.
So we can say that the interpersonal therapy of depressionis an essentially eclectic therapeutic tool.Indeed, it emphasizes the links between the pathology and the psychosocial context.It also gives more importance to the present than to the past.
The interpersonal therapy of depression examines the patient's personal relationships in the present and intervenes in the formation of symptoms. It also intervenes in the social dysfunction associated with the current or other depressive episode.
Interpersonal depression therapy is not a form of cognitive-behavioral therapy. Indeed, its purpose is not to confront models of negative thought, cognitive distortions or false attributions.
In the interpersonal therapy of depression, thepsychosocial refers primarily to the different roles played by a patient and his or her environmental interactions. The role is understood here as the meeting place between the individual way of being and what is presented to others.
The different roles and relationships can be modified byemotional or professional overload, conflict and loss. The alteration due to overload tends to decrease the forces. Conflicts tend to generate anxiety and losses from depression.
The losses to be treated in interpersonal psychotherapy are usually bereavement, divorce or unemployment. We assume, in the interpersonal therapy of depression, that the appearance of the disorder already modifies the psychosocial and interpersonal context of the patient.
The practice of interpersonal depression therapy
For interpersonal therapy, thedepression offers three levels of approach. These three levels would be:
- Social and interpersonal relationships of the patient.
- Explicit conflicts
Interpersonal therapy of depressiondoes not consider personality traits or existential and anthropological factors as important. Its basic mission is therefore to relieve the patient's symptoms. To help him develop strategies to cope with his social and interpersonal difficulties.
Interpersonal therapy of depression therefore focuses on the current situation of the patient. The past counts, but only to better understand the interactive style of each patient. Thus, the therapeutic space accorded to the past does not exceed the space accorded to the present.
This therapy works with the patient's cognitions, but not in a structured way. It does not use detailed protocols or tasks and self-recordings to be done at home. Some behavioral techniques such as systematic desensitization, exposure therapy, or cognitive distortion analysis may be considered, but are not generally included.
Interpersonal therapy of depression is based on the medical model
Interpersonal therapy of depression finds its foundation in the medical model. It may or may not be accompanied by antidepressants and other psychotropic medications. Thus, this type of therapy, in its original form,is a form of brief psychotherapy. One session per week is carried out over 3 to 6 months. Each session lasts between 40 and 50 minutes.
Changes in content and duration, which tends to be prolonged, have been introduced due to new applications of interpersonal depression therapy. Its duration can therefore be greater than 6 months.Interpersonal therapy of depression develops in three phases :
- Initial or diagnostic phase: from the first to the third session.
- Intermediate or focused phase : from the fourth to the tenth session.
- Last phase or final phase : from the eleventh to the twelfth session.
The number of sessions per phase is approximate.Interpersonal therapy of depression advocates flexibility as a general rule. Thus, the therapist assesses the need for medication based on the severity of symptoms, clinical history, response to treatment, and patient preferences. The patient is educated through the information inherent in diagnosis and treatment.
In this therapeutic setting,strategies and goals are important. The techniques are to a lesser extent. This is what sets it apart from other therapies designed to treat depression.
The interpersonal therapy of depression enjoys great prestige. It is also widely accepted in the complex field of treatment of depressive disorders. Moreover, studies show thatThis is an alternative or a valid supplement for the acute, prolonged or maintenance treatment of major depression.