Differential Therapeutics

As a clinician, when might you think of using IPT? As a psychiatrist decides which antide-pressant medication to prescribe based on a patient's symptom constellation and research findings, so too should clinicians consider when to use IPT. The research to date supports that IPT works best for depressed patients who face distressing life events ranging from medical illness to job and relationship changes and conflicts. Patients with interpersonal deficits who report no recent life events or changes will probably fare better in CBT. Interpersonal therapy may also work well for patients with anxiety and personality disorders who report recent life events, but research is in these areas, although promising, is still in the early stages. Interpersonal therapy may be a good option for patients who want to augment their medication treatment with psychotherapy; given that IPT and pharmacotherapy share the medical model of depressive illness, IPT seems like a good fit, although further research in this area is needed. Additional moderating factors that predict treatment outcome in clinical trials were described earlier in the research section of this chapter.

The educational process for IPT in clinical practice requires further study. We do not know, for example, what levels of education and experience are required to learn IPT, or how much supervision an already-experienced psychotherapist is likely to require. The International Society for Interpersonal Psychotherapy (ISIPT) is currently debating how best to set standards for clinical practice of IPT, which doubtless varies from country to country. Recent meetings of the ISIPT indicated that the United Kingdom has advanced farther in developing specific guidelines for IPT training than elsewhere in the world and some countries are adopting the standards developed in the United Kingdom. Interpersonal therapy therapists in Britain have agreed on four-level set of accreditation standards for clinical training and practice that are essentially equivalent to those for researchers (Appendix A). These rigorous standards should ensure high quality of IPT in the United Kingdom.

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