Review of the book Clinician’s Quick Guide to Interpersonal Psychotherapy

Abstracts

This book is aimed at those professionals who provide mental health services. According to its preface, it was written based on a method of psychotherapeutic treatment developed over a 30-year period and called interpersonal psychotherapy (IPT). This method was initially aimed at major depression, but later it was adapted to other complex psychiatric disorders such as borderline personality. The objective of this work was to be an easy to read quick reference book, providing descriptions of the methods used to approach and manage clinical cases, based on the assumption that professionals (readers) have knowledge of psychotherapy and skills to manage people diagnosed with mood or anxiety disorders. It is worth emphasizing that although none of the works by Carl Rogers are mentioned in this book, its content is very similar to Rogers’s theory, except for the section regarding mood disorders, which is addressed in a thorough manner, including the approach to be used within each context. Rogers is considered to be the pioneer in the use of interpersonal relationship as a pedagogical and psychotherapeutic resource. The book was very well written, considering both the didactic and scientifi c point of view, that is, it is easy to read and understand, mentioning articles published in very important journals for the scientifi c and academic community.

Short psychotherapy; mental health care; interpersonal relationships

O livro é direcionado aos diversos profi ssionais que atuam na assistência em saúde mental e, segundo seu prefácio, a obra é resultado de 3 décadas de desenvolvimento de um método de tratamento psicoterapêutico, inicialmente para depressão maior, denominado psicoterapia interpessoal (TIP); posteriormente, passou a ser aplicado em outros transtornos psiquiátricos complexos, como o transtorno de personalidade borderline. A obra tem o objetivo de ser um guia de fácil leitura e consulta, descrevendo os métodos de abordagem e condução dos casos clínicos, mas já partindo do pressuposto de que os profi ssionais (leitores) possuem conhecimento e habilidade nos fundamentos da psicoterapia e no manejo de pessoas com diagnósticos como transtornos do humor ou ansiedade, por exemplo. Cabe aqui frisar que embora não haja referência a nenhuma obra de Carl Rogers, considerado o precursor do relacionamento interpessoal como recurso pedagógico e psicoterapêutico, esta obra apresenta enorme semelhança com a teoria desse autor, mas não em relação às indicações a determinados transtornos como os do humor, as quais são feitas de forma completa, também especifi cando em cada contexto a abordagem a ser usada. O livro é muito bem elaborado, tanto do ponto de vista didático como científi co, ou seja, é um livro de fácil leitura e compreensão e com referências a artigos de periódicos de grande relevância no meio acadêmico e científico.

Psicoterapia breve; assistência em saúde mental; relações interpessoais

BOOK REVIEW

Clinician's Quick Guide to Interpersonal Psychotherapy

Marcos Hirata Soares*

* Mestre, Docente, Centro de Ciências da Saúde, Departamento de Enfermagem da Universidade Estadual de Londrina (UEL), Londrina, PR, bRAZIL.

^{Correspondence}

Originally published in 2007, the Clinician's Quick Guide To Interpersonal Psychotherapy was translated into Portuguese and launched in Brazil by Editora Artmed in 2009. The book is directed at the various professionals working in the mental health field, and, according to its preface, is the result of three decades' work on the development of a psychotherapeutic method known as interpersonal psychotherapy (IPT). Initially devised for the management of major depression, IPT was later applied to other complex psychiatric disorders, such as borderline personality disorder.

The book seeks to establish itself as an easy-to-read guide and a handy reference, describing methods for approaching and managing clinical cases, but assumes that professionals (readers) are knowledgeable and skilled in the fundamentals of psychotherapy and in the management of patients diagnosed with conditions such as mood or anxiety disorders.

The authors also point out that IPT may be used with or without concomitant medication, and may be taught to people with lower-level training. The foremost application of IPT is in mood disorders arising at various stages of the patient's life, such as pregnancy, adolescence, or old age. IPT is one of the forms of psychotherapy recommended by the American Psychiatric Association for such cases.

As far as its theoretical foundations are concerned, IPT views depression as having multiple causes, with its symptoms generally arising in association with a particular life event. From the IPT point of view, the clinical picture of depression is made up of symptoms, factors related to the patient's social and interpersonal life, and his or her personality. Therefore, understanding the patient's interpersonal context-that is, issues occupying the patient's "here and now"-is the main focus of IPT; emphasis is also placed on people viewed as being important in the patient's life at the time of illness, allowing the patient to evaluate his or her life and affect at that particular moment and helping the patient take charge of his or her life context.

The authors further note that IPT does not seek to uncover sources or explanations for the patient's negative feelings or behaviors, analyze the patient's childhood or interpret his or her dreams; instead, it aims to help patients gain a deeper understanding of themselves by helping them explore options and develop resources to interact with the environment in a productive and satisfactory manner.

The therapist's initial task is to, in no more than three sessions, establish a diagnosis by analyzing the patient's clinical history and applying psychometric scales. Once a diagnosis has been defined, the therapist moves on to psychoeducation, explaining the health issue to the patient and clearing up any myths on his or her disorder. From the IPT standpoint, the main problem areas are grief, role disputes and role transitions, and interpersonal deficits.

The establishment of a diagnosis and recognition of the patient's interpersonal issues mark the start of the treatment planning process, in which the therapist will present information on the symptoms (as pinpointed by clinical history) and life events associated with the patient's depression, proposing a time frame for therapy, discussing the expected results and how the patient may achieve improvement in his or her condition. The therapist establishes a treatment contract with the patient.

In the following phase, known as the middle phase, therapy begins with a search for information on the latest events in the patient's life, their relation to the interpersonal context, and the extent to which they affected the patient. This sequence forms the core of IPT intervention. The therapist focuses on mood and interpersonal interaction, helping the patient realize the connection between them and become comfortable with new strategies aimed at providing improved psychosocial functioning.

Actual session time is used to discuss feelings and take action to modify the patient's perception of them. Various techniques are used toward this end, such as non-directive exploration, direct evocation, encouragement of affect, clarification, communication and decision analysis, role-play, and the interpersonal relationship itself. Furthermore, in other chapters, the book specifies approaches to grief, interpersonal disputes, role transitions, and interpersonal deficits associated with the context of depression.

As for the end of therapy, the minimum duration is established as six weekly sessions, which may extend to 36 monthly encounters, with the goals of strengthening the patient's sense of competence and independence and discussing the continuity of treatment by other means, such as psychiatric care (should symptoms remain) or referral to another type of psychotherapeutic intervention.

It is worth noting that, although the book makes no reference to the work of Carl Rogers, considered the forefather of the use of interpersonal relationships as an educational and psychotherapeutic resource, a striking similarity with Rogers's theory is readily apparent; however, this resemblance does not extend to the indication of IPT in certain disorders, such as those in the mood spectrum, which is handled comprehensively and includes specific advice on the approach to be used in each context.

The book is very well organized, both from the educational and from the scientific standpoint; in other words, it is easy to read and understand and cites articles published in journals of significant academic and scientific renown.

Received in 09/10/2009.

Accepted in 23/10/2009.

No conflicts of interest declared concerning the publication of this book review.

• 1. Weissman MM, Markowitz JC, Klerman GL. Psicoterapia Interpessoal: guia prático do terapeuta. Porto Alegre: Artmed; 2009.

Publication Dates

• Publication in this collection
  28 July 2010
• Date of issue
  2010