Behavior Modification Therapy for Depression. Interpersonal Psychotherapy

Behavior Modification Therapy for Depression: Interpersonal Psychotherapy

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Abstract

The last few years have demonstrated the need for an evidence-based practice in psychology, especially in relation to social interventions. Both sociologists and psychologists have looked into various theoretical and practical strategies for treatment of patients suffering from various clinical conditions. Epidemiologic data illustrates that depression, a common condition for adults, is one of the most demanding and debilitating disorders in terms of treatment. The recurrent nature of depression requires an effective, evidence-based social work intervention strategy to prevent the reoccurrence of the disorder. Several types of interventions have been identified in treating depression with the most perceptible intervention method being interpersonal psychotherapy. Accordingly, the effectiveness of interpersonal psychotherapy as treatment for depression makes it the most preferred social intervention strategy for depression.

Key Words: Depression, Interpersonal Psychotherapy

Introduction

Proper medical management of depression has proved to be a difficult task, with most patients suffering from depression having a hard time recovering from the disorder. Statistics on depression illustrate that over 2 million adults in America are diagnosed with depression annually. The number of patients who succumb to this disorder is even higher, with most depression cases resulting to mortality. For that reason, a number of empirically supported treatment options have been developed to help curb the effects of depression on patients. Treatment for depression ranges from a combination of medication to psychotherapeutic interventions, with most of the cases involving the use of both (Thase & Friedman, 1999). These treatment options have been widely practiced all over the world, with the choice of treatment depending on the effectiveness of treatment. However, because of the different patient responses to treatment, researchers have not identified one specific treatment method for depression. For that reason, psychologists and other medical practitioners are forced to pick one treatment method for their patients. Accordingly, two main treatment options have been identified as the most effective social intervention strategies for depression.

These treatment interventions include interpersonal psychotherapy and behavioral cognitive therapy. These two social intervention strategies have been accredited with effective treatment of depression. More specifically, interpersonal psychotherapy fares well in the treatment of depression, as compared to other treatment for the disorder (Thase & Friedman, 1999). This treatment intervention has a delayed effect on depression, which is good for treating the recurrent disorder, thus preventing a relapse of depression. In addition to this, interpersonal psychotherapy can work for both acute depression to severe depression, thus its effectiveness in treatment.

This paper examines interpersonal psychotherapy as a social intervention strategy for depression. The paper draws attention to the theoretical foundation of this social intervention and quantity and quality of literature available on this intervention. In addition to this, the paper also looks into the intervention techniques used in interpersonal psychotherapy, as well as, the effectiveness of the intervention on patients.

Interpersonal Psychotherapy

Interpersonal psychotherapy is a social intervention strategy that is primarily focused on the patient’s social roles and interpersonal relationships (Stuart & Robertson, 2003). It is a short but highly effective treatment option for problems related to social functioning, especially when treating psychiatric problems such as depression. With interpersonal psychotherapy, medical practitioners explores the patients’ issues with other people, as a way of identifying the causes of depression in the patients. The goal with this intervention strategy is to identify and modify interpersonal problems for the reduction of depression in patients. As an intervention strategy, interpersonal psychotherapy involves three main phases, all of which are designed to reduce the effects of depression on the patients, if not stoppage of depression. The first phase of interpersonal psychotherapy involves the exploration of the patient’s interpersonal problems. The therapist takes full charge of this phase, and the strategy here is to identify the possible social problems that have resulted to the patient’s depressive state. This will help build a history of the patient, which is necessary for the identification of possible social problems. The second phase of this treatment involves allowing the patient to talk about his social problems, as a way of identifying the patient’s perception of the causes of depression (Thase & Friedman, 1999). Accordingly, the patient leads this phase, and the main goal in this phase is to encourage change. Throughout this stage, both the therapist and the patient are expected to maintain focus for the treatment for better results during treatment. The last phase of interpersonal psychotherapy involves the participation of both the therapist and the patient, and it involves the identification of the achievements during training. Because it is a short term intervention treatment strategy for disorders such as depression, interpersonal psychotherapy usually involves a number of sessions, in most cases 20 sessions, with the focus of these sessions being the identification of the causes of depression in patients.

Theoretical Foundation

Interpersonal relations and events are not the immediate causes of depression, but the interpersonal component of the disorder makes it an issue that demands the use of interpersonal psychotherapy for treatment. In terms of the theoretical foundation of this social intervention strategy, interpersonal psychotherapy is primarily designed to address interpersonal issues. Theoretically, it is founded on the belief that interpersonal relationships and events affects individuals in a number of ways, and for that reason, could be the cause of depression. These interpersonal events range from interpersonal roles transition, conflict, and even cases of complicated grief. These events may lead to depression in patients, thus the need for interpersonal psychotherapy as an intervention strategy (Thase & Friedman, 1999). Interpersonal psychotherapy assumes that a severe psychosocial stressor, coupled with inadequate social support is likely to lead to depression in individuals. This, therefore, implies that, unlike popular belief, difficulties in interpersonal relationships may be concomitant factors for the occurrence of depression in patients. According to Stuart and Robertson, this social intervention strategy has two main theoretical targets (Stuart & Robertson, 2003). At the outset, interpersonal psychotherapy draws on interpersonal conflict and transition in the patient’s social setting. This aims at improving communication, as well as, readjusting the patient’s expectation during and after the intervention. In addition to this, interpersonal psychotherapy facilitates proper utilization of social support networks for crisis management (Stuart & Robertson, 2003). In essence, interpersonal psychotherapy focuses on the treatment of current and existing issues, as opposed to, developmental issues.

Literature

There exists a considerable amount of literature on the use of interpersonal psychotherapy for the treatment of disorders such as depression. Literature on this intervention strategy dates back to the late 1980s proving that this intervention strategy is effective and efficient for patients suffering from depression (Markowitz, 2003). More specifically, literature on interpersonal psychotherapy provides the required information on the effectiveness of this treatment for patients. For example, Arean & Cook compare the use of interpersonal psychotherapy and other paradoxical treatment options for depression, and the findings from this study expound of the use of this intervention treatment by therapists (Arean & Cook, 2002). In terms of quality, the literature on interpersonal psychotherapy as an intervention strategy does not fall short of academic eminence. The information provided regarding interpersonal psychotherapy is based on findings from research studies conducted by professionals or students in the field. This, in turn, illustrates the validity and reliability of the intervention strategy in practice.

Intervention Techniques

Interpersonal psychotherapy involves the utilization of four main techniques of social intervention. These techniques include clarification, supportive listening, communication analysis, and encouragement of affect. Clarification involves the questioning of patients so as to identify and clarify existing emotional problems, as well as, biases. This technique helps the therapist uncover the patient’s existing emotional problems for the identification of causative social problems. Supportive listening, on the other hand, is a technique that involves listening with minimal but meaningful interjections by the therapist. This technique is specifically designed to encourage the patient in identifying the causes of depression, as well as, the necessary procedures for the prevention of this. Communication analysis is a technique whereby the therapists engages the client in various aspects of communication, so as to gauge the patient’s ability to communicate in their individual social settings.

This technique allows the therapist to identify any communication problems that the patient might have, as well as, the different methods of dealing with this. The last and most useful technique of interpersonal psychotherapy is encouragement of affect, which involves the promotion of the effects of this treatment for the patient. Put simply, it is whereby the therapists encourages the patient to engage in the activities suggested during the therapy sessions. This allows the development of a positive attitude for the patient, as well as, encouraging the patient to improve their social relationships. Therapists have the option of choosing the best technique for their patients, and this is usually dependent on the patient’s response to treatment. Once the therapist identifies the patient’s needs, he or she can use one of the above-mentioned techniques to help the patient deal with their depression.

Effectiveness

The effectiveness of interpersonal psychotherapy has been a highlight for a number of individual and aggregated studies and analyses. Accordingly, the efficiency and effectiveness of the use of this intervention strategy for the treatment of depression is of pooled data from various controlled studies of patients suffering from depression. The effectiveness of interpersonal psychotherapy for the treatment of depression has been measured in two main ways, including, as individual treatment, as well as, combination of interpersonal psychotherapy with other treatment options for depression (Thase & Friedman, 1999). All the studies carried out illustrate that interpersonal psychotherapy is the best social intervention strategy for the treatment of patients suffering from depression. For example, in their study on interpersonal psychotherapy, O’Hara et. al., compare the effectiveness of interpersonal psychotherapy as an individual form of treatment for depression against other treatment options (O’Hara et al., 2000).

Conclusion

As a social intervention strategy, interpersonal psychotherapy is the best practice model for the treatment of depression. This assumption bases on the research studies and findings by a number of individuals such as de Mello et al., who tested the effectiveness of this intervention treatment on a number of psychiatric disorders such as neurotic depression and dysthymia. Such findings illustrate the efficacy of this treatment on depression, making it the most preferred treatment intervention for patients suffering from depression.

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