We have conceptualized IPT at three levels: strategies, techniques, and therapeutic stance. IPT resembles many other therapies for the latter two, but it is distinct at the level of strategies.
The strategies of IPT occur in three phases of treatment. The first phase, usually the first 1-3 sessions, includes diagnostic evaluation and psychiatric history and sets the framework for the treatment. The therapist reviews symptoms, diagnoses the patient as depressed by standard criteria ( American Psychiatric Association, 1994), and gives the patient the sick role ( Parsons, 1951). The sick role may excuse the patient from overwhelming social obligations, but requires the patient to work in treatment to recover full function. During the initial session(s), the psychiatric history includes the interpersonal inventory, a review of the patient's current social functioning and current close relationships, their patterns and mutual expectations. Changes in relationships proximal to the onset of symptoms are elucidated: for example, the death of a loved one, children leaving home, worsening marital strife, or isolation from a confidant. This review provides a framework for understanding the social and interpersonal context of the onset and maintenance of depressive symptoms and defines the focus of treatment.