Interpersonal Psychotherapy of Depression: A Brief, Focused, Specific Strategy

As many have already said, this is a classic work in the field of psychotherapy. If you want to be a clinical/counseling psychologist or other mental health practitioner who is well grounded in empirically supported approaches to psychotherapy, I highly recommend this work. I believe that an interpersonal framework can provide an excellent complement to cognitive-behavioral approaches. This is a classic work in the field. One caveat: this book is geared toward professionals. The lay-reader will likely find it boring.

This is the how-to-do-it text for interpersonal therapy (IP). It's directed at fellow professionals rather than the general public In fact the last page suggests that you can learn to do IP just by reading the book, if you started off as an experienced therapist. A caveat is that the authors say they found that those who did best on a written examination based on the book were (in the authors' opinion) the worst therapists. IP is based on Harry Stack Sullivan's theories, so you could be a Sullivanian interpersonal therapist without being a Klermanian IP. The Sullivanian theory was that our personality is made up of the way we react to other people. We start off with an empty slate and then people start communicating with us us and we communicate back. All mental illness was due to something wrong in the way we relate to people. Klerman et al don't make a great deal of the theory. Their therapy (only meant for mild depression) consists of talking to patients about how they communicate. This casts a wide net and many therapists who just sit and chat with their patients will recognize the style. Underlying subconscious motives are probed for to some extent. Depressed people must be holding back their real feelings and not communicating freely. Letting it all hang out and saying what you mean is the key to happiness. They differentiate themselves from Beck (the cognitive therapy man)by only seeking to change behavior in relation to significant people in the patient's life, but this covers a wide field. In fact a difficulty for advocates of IP is distinguishing themselves from just being nice sympathetic listeners willing to talk about problems (which is not such a terrible thing to be). They make is sound more scientific at times by means of empty polysyllabic phrases such as "clarification of emotional states, improvement of interpersonal communication, and testing of perceptions and performance through interpersonal contact." This sort of stuff makes the book hard going in parts. The therapy is supposed to be short-term, and one useful chapter of the book is a summary of the rival short-term psychotherapies. Interpersonal therapy is supposed to be better than the others because of having been tested in controlled trials. This is really the major selling point and it's one that is difficult to evaluate here. You have to check the journals. The results of the controlled trials are controversial and are more equivocal than the book indicates (It was published in 1984). Some careful and impartial evaluators have suggested that it all comes back to what Jerome Frank said years ago in "Persuasion and Healing" namely that the character and experience of the therapist is more important than the school of thought.

In regards to the first review (Interpersonal???), Klerman is the original developer of ITP. You aren't going to get any closer to "true" ITP than this. Teyber, Kiesler, and the other interpersonal dynamic writers (e.g., Ehrenberg, Levenson)are really just neo-Klerman. This is a great book.

This is basically a "how-to" manual detailing one of the few "empirically validated treatments" for major depression - i.e., a treatment that really, truly helps. Interpersonal Psychotherapy (IPT) is as effective as either Beck's cognitive therapy or antidepressant medications. Since every therapist encounters depression on a regular basis, how can you justify ignorance of this (short-term!) approach? The book is readable and well organized; someone already trained in psychodynamic psychotherapy could probably improve clinical practice based on the book along, though specialized training would surely be helpful as well. The approach makes sense to patients, too!