IPT for Groups

Denise Wilfley, Ph.D.

IPT for groups was initially validated for binge eating disorder (Wilfley et al., 1998) and is currently used to treat a range of patient populations (e.g., the elderly, adolescents, veterans) and psychiatric disorders (e.g., PTSD, depression, and binge eating disorder).  Empirical results indicate improved outcomes following group IPT treatment for all of these groups. The group format is an ideal milieu to work on interpersonal problems and to develop interpersonal skills with other patients struggling with similar challenges.

To implement IPT in groups, clinicians should have a working knowledge of IPT theory and practice and of group psychotherapy and practice, as well as specific training in the concepts, strategies, and techniques of IPT.

There are several advantages of IPT administered via group modality. IPT capitalizes on the fact that groups, by definition, are interpersonal and therefore provide a natural delivery platform on which to apply the strategies of IPT.  Due to the range of social interactions that can occur in the group context, interpersonal skills developed in group therapy may be more readily transferable to participants’ social lives than those developed in one-on-one individual therapy. Furthermore, groups in which membership is based on diagnostic similarity (e.g., depression, binge eating, PTSD) offer a radically altered social environment for patients who have become isolated from others.  Group participation alone, therefore, may help patients break patterns of social isolation and self-stigmatization that contribute to the maintenance of the disorder. Additionally, the group context may help to normalize patients’ symptoms and alleviate concerns that they are alone in their psychiatric disorder.

IPT for groups employs the same basic structure and focus of individual IPT, though modified to capitalize on the group format.  Prior to group work, the therapist initially meets with each member for a pre-group individual meeting, with a focus on identifying target interpersonal problem areas through a standard diagnostic interview and administration of the interpersonal inventory, and to establish an explicit treatment contract to work on target problem areas.  The initial phase (sessions 1-5) of IPT for groups is devoted to managing negative feelings and developing positive group norms as group members test out and refine their individual target problem area(s).  In the intermediate phase (sessions 6-15), group members work toward common goals and practice newly acquired social skills inside and outside the group.  The final, termination phase of treatment (sessions 16-20) consolidates gains the group members have made during treatment and prepares them for the termination of the group.  While most effective in the format outlined above, IPT has proven useful under more constrained timelines as well, though group sessions must be highly structured in this model.

For more information, contact Dr. Denise Wilfley, Ph.D. (314-286-2079; wilfleyd@psychiatry.wustl.edu)

Bibliography

Wilfley, D.E., Frank, M.A., Welch, R., Spurrell, E.B., Rounsaville, B.J. (1998); Adapting Interpersonal Psychotherapy to a group format (IPT-G) for binge eating disorder: Toward a model for adapting empirically supported treatment; Psychotherapy Research; 8(4); 379-391

Wilfley DE, Mackenzie KR, Welch RR, Ayres VE, Weissman MM: Interpersonal Psychotherapy for Group. New York: Basic Books, 2000.