Mechanisms of change in interpersonal therapy (IPT)

• Published in: Clinical psychology review 2013-12, Vol.33 (8), p.1134-1147
• Main Authors: Lipsitz, Joshua D., Markowitz, John C.
• Format: Article
• Language: English
• Subjects: Humans; Interpersonal; Interpersonal Relations; Interpersonal therapy; IPT; Mechanisms; Mediators; Mood Disorders - psychology; Mood Disorders - therapy; Psychotherapy; Psychotherapy - methods; Social Support; Treatment Outcome
• ISSN: 0272-7358; 1873-7811
• DOI: 10.1016/j.cpr.2013.09.002

Although interpersonal therapy (IPT) has demonstrated efficacy for mood and other disorders, little is known about how IPT works. We present interpersonal change mechanisms that we hypothesize account for symptom change in IPT. Integrating relational theory and insights based on research findings regarding stress, social support, and illness, IPT highlights contextual factors thought to precipitate and maintain psychiatric disorders. It frames therapy around a central interpersonal problem in the patient's life, a current crisis or relational predicament that is disrupting social support and increasing interpersonal stress. By mobilizing and working collaboratively with the patient to resolve this problem, IPT seeks to activate several interpersonal change mechanisms. These include: 1) enhancing social support, 2) decreasing interpersonal stress, 3) facilitating emotional processing, and 4) improving interpersonal skills. We hope that articulating these mechanisms will help therapists to formulate cases and better maintain focus within an IPT framework. Here we propose interpersonal mechanisms that might explain how IPT's interpersonal focus leads to symptom change. Future work needs to specify and test candidate mediators in clinical trials. We anticipate that pursuing this more systematic strategy will lead to important refinements and improvements in IPT and enhance its application in a range of clinical populations. •Interpersonal therapy (IPT) is informed by relational theory and research on stressors and social support.•IPT sees psychiatric disorders as precipitated and maintained by crises or predicaments in the interpersonal context.•Resolving a central interpersonal problem in IPT is thought to activate four interpersonal change mechanisms.•Resolving the problem a) enhances social support and b) reduces interpersonal stress.•Facilitating this change entails c) processing of emotions and d) improving interpersonal skills.