Interpersonal Psychotherapy for Adolescents

Dr Rob McAlpine PhD MAPS and Anthony Hillin  B Soc Stud (SW), M Adol MH

Interpersonal Psychotherapy for Depressed Adolescents was developed originally in 1993, then revised in 2004 (Mufson et al 2004)[i]. IPT for Adolescents is an adaptation of IPT, and has demonstrated efficacy and effectiveness in several clinical trials[ii] [iii] [iv], including in school-based settings[v] [vi] [vii] and by well-supervised clinicians with no prior training in IPT[viii].

IPT for Adolescents is designed for use with young people aged about 12-18 years who have an acute onset major depression.  The three primary goals are: (1) to decrease the depressive symptoms; (2) to improve the interpersonal problems associated with the onset of the depressive episode; and (3) to help clients strengthen their social support networks.

In order to address the developmental issues of adolescents IPT for Adolescents differs from IPT in a number of ways including:

  • It is often briefer,
  • It may involve parents or care givers
  • In addition to the three problem areas of Grief and Loss, Interpersonal Disputes and Role Transition, IPT for Adolescents includes a fourth problem area of Interpersonal Gaps.

The collaborative and educational nature of IPT is developmentally engaging for many adolescents. These aspects are emphasised by developing clients’ emotional and relationship literacy, increasing their understanding of depression, enhancing their social skills, and by developing their ability to communicate their attachment needs to others.

Other adaptations of IPT for adolescents have been developed or have been trialled. These include:

  • IPT for bipolar disorder (based on Interpersonal and Social Rhythm Therapy – IPSRT)[ix]
  • IPT for depression comorbid with anxiety[x]
  • Family-based IPT (FB IPT, for 9-12yrs)[xi]
  • IPT Skills Training (group indicated preventative program)[xii]
  • IPT for Groups (IPT in a group setting)[xiii]
  • Intensive IPT for depressed adolescents with suicidal risk[xiv].

References:

[i] Mufson, L, Dorta, K, Moreau, D, & Weissman, M. (2004) Interpersonal Psychotherapy for Depressed Adolescents, Second Edition, The Guildford Press, New York.

[ii] Mufson, L., Moreau, D., Weissman, M., Wickramaratne, P. et al. (1994) Modification of interpersonal psychotherapy with depressed adolescents (IPT-A): Phase I and II studies. Journal of the American Academy of Child & Adolescent Psychiatry. Vol.33(5), pp 695-705.

[iii] Mufson, L . and Fairbanks, J (1996) Interpersonal psychotherapy for depressed adolescents: A one-year naturalistic follow-up study. Journal of the American Academy of Child & Adolescent Psychiatry. Vol.35(9), pp1145-1155.

[iv] Mufson, L., Weissman, M., Moreau, D. and Garfinkel, R. (1999) Efficacy of interpersonal psychotherapy for depressed adolescents. Archives of General Psychiatry. Vol.56(6), pp573-579.

[v] Mufson, L., Dorta, K., Wickramaratne, P.,Nomura, Y., Olfson, M. and Weissman, M. (2004) A Randomized Effectiveness Trial of Interpersonal Psychotherapy for Depressed Adolescents. Archives of General Psychiatry. Vol.61(6), pp577-584.

[vi] Pasquinelli, S. J. (2009).The efficacy of treating adolescent depression with Interpersonal Psychotherapy for Adolescents (IPT-A) in the school setting. Dissertation Abstracts International Section A: Humanities and Social Sciences. Vol.70(6-A), pp. 1924.

[vii] Gunlicks-Stoessel, M., Mufson, L., Jekal, A. Turner, B. (2010). The impact of perceived interpersonal functioning on treatment for adolescent depression: IPT-A versus treatment as usual in school-based health clinics. Journal of Consulting and Clinical Psychology. Vol.78(2), pp 260-267.

[viii] Santor, D.and Kusumakar, V (2001) Open trial of interpersonal therapy in adolescents with moderate to severe major depression: Effectiveness of novice IPT therapists. Journal of the American Academy of Child & Adolescent Psychiatry. Vol.40(2), pp 236-240.

[ix] Crowe, M., Inder, M., Joyce, P., Moor, S., Carter, J. and Luty S. (2009) A developmental approach to the treatment of bipolar disorder: IPSRT with an adolescent. Journal of Clinical Nursing; 18(1):141-9

[x] Young, J., Mufson, L. And Davies, M (2006a) Impact of comorbid anxiety in an effectiveness study of interpersonal psychotherapy for depressed adolescents Journal of the American Academy of Child and Adolescent Psychiatry, 45:8 904-912.

[xi] Deitz, L., Mufson, L. Irvine, H. and Brent, D. (2008) Family-based interpersonal psychotherapy for depressed pre-adolescents: An open-treatment trial. Early Intervention in Psychiatry Vol2(3) 154-161.

[xii] Young, J.F., Mufson, L., and Davies, M. (2006b) Efficacy of Interpersonal Psychotherapy-Adolescent Skills Training: an indicated preventive intervention for depression. J Child Psychol Psychiatry. 47(12):1254-62.

[xiii] Mufson, L., Gallagher, T., Dorta, K. and  Young, J (2004) A Group Adaptation of Interpersonal Psychotherapy for Depressed Adolescents. American Journal of Psychotherapy. Vol.58(2), pp 220-237.

[xiv] Tang, T-C., Jou, S-H., Ko, C-H., Huang, S-Y and Yen, C-F (2009) Randomised study of school-based intensive interpersonal psychotherapy for depressed adolescents with suicidal risks and parasuicide behaviours. Psychiatry and Clinical Neuroscience, 63, 463-470.