Interpersonal Therapy Puts Focus on Relationships: Model Targets Problem Area with Aim of Teasing out Destructive, Constructive Relationship Contributors

Article excerpt

VANCOUVER, B.C. -- Interpersonal therapy for adolescents--a "new kid on the block" for treating adolescent depression--puts relationships in the spotlight as a way to help teenagers get their lives back on track.

The guiding principle behind interpersonal therapy for adolescents (IPT-A) is straightforward, Lorraine Hathaway said at a conference sponsored by the North Pacific Pediatric Society.

"It relies on the notion that depression occurs in the context of relationships ... [which] can either trigger symptoms or exacerbate the depression. Depression itself can also affect relationships, so there's an interaction."

IPT-A was developed by Dr. Laura Mufson at Columbia University in New York. Performed in 12 semistructured sessions, the model focuses on a problem area (grief, role transition, role disputes, interpersonal deficits), with the aim of teasing out destructive and constructive relationship contributors and building skills that make relationships better.

"This makes sense to teenagers. They like it," said Ms. Hathaway, MSW, a contributor to a mood and anxiety symposium sponsored by faculty members of the University of British Columbia and British Columbia Children's Hospital in Vancouver. Ms. Hathaway is coleading an IPT-A education project with Dr. Elizabeth Hall, a adolescent psychiatrist.

Dr. Susan Baer, an adolescent psychiatrist with the UBC Mood and Anxiety Disorders Clinic, said IPT is a new option among evidence-based strategies that can be used to treat adolescent depression, along with cognitive-behavioral therapy and medication.

Clinicians should be aware of it and, with training, can direct it themselves, Dr. Baer said.

"What's nice about this treatment is it takes basic, good counseling skills and clinical skills, and puts an overlay on them. It uses what you already know if you're a person used to talking to kids, and working with and counseling kids," Ms. Hathaway said.

In interpersonal therapy, the therapist assists the adolescent in drawing a "depression circle," topped by a precipitating event that has an impact on relationships and feelings. At the bottom of the circle are the individual's depression symptoms, which in turn, also are driven by and feed into events.

Next, the adolescent conducts an "interpersonal inventory" within concentric circles that represent the closeness of relationships. Which friends and family members are helpful? …