Casebook of Interpersonal Psychotherapy

Interpersonal psychotherapy (IPT) was officially described and “codified” in the 1970s and 1980s with the publication of what are now classic studies and a foundational book (1–3). Through decades of research, IPT has since been elevated to the anointed ranks of evidence-supported or evidence-based treatments. Therapists practicing IPT attend primarily to here-and-now issues, such as recent losses, interpersonal conflicts, role transitions (e.g., empty nesting, divorce, retirement), and interpersonal deficits (personality and communication difficulties). IPT fully respects biological, psychodynamic, and cognitive and behavioral influences and strategies. Featured techniques include education, exploration, interpretation, emotional ventilation, goal setting, and problem solving. Focusing on the psychological spaces in which most patients actually experience their problems, honoring and emphasizing the importance of the common and universal factors accounting for much of the favorable outcomes of psychotherapy, and fitting into an overall brief therapy time frame that many patients can actually accommodate, from my perspective, make IPT one of the most practical, holistic, and effective real-world psychotherapies.

The founding father of IPT, Gerald Klerman, was an outstanding, broad-based academic psychiatrist who, among other roles, variously served as research director at Massachusetts General Hospital, professor at Harvard, Yale, and Cornell universities, and head of the federal government's Alcohol, Drug and Mental Health Administration. He was also a prominent psychopharmacology researcher. Notably, IPT was originally crafted to serve as an active treatment control for studies designed to test and demonstrate the effectiveness of tricyclic antidepressants in the treatment of nonpsychotic unipolar depression in middle-aged adults. Intended to serve as a credible manualized psychotherapy treatment alternative, the initial formulation of IPT was heavily influenced by the work of Harry Stack Sullivan and John Bowlby, who focused on interpersonal issues and attachment in depression. Somewhat to the amazement of these investigators, the IPT control proved to be a reasonably robust intervention, leading to it being fleshed out and further developed as an independent treatment for depression.

Subsequent investigation has expanded these original studies far beyond their initial applications. In research conducted at Cornell and Columbia universities, the University of Pittsburgh, Washington University in St. Louis, and other centers in the United States and internationally, IPT has demonstrated effectiveness in a wide array of patient types, diagnoses, and problems. Some of these findings were previously drawn together in the Comprehensive Guide to Interpersonal Therapy (3).

Casebook of Interpersonal Psychotherapy was edited by two of the authors of the Comprehensive Guide to Interpersonal Therapy: John Markowitz, a professor at Columbia and Cornell universities, who, as a former student of Klerman's, became a principal researcher and standard bearer for IPT, and Myrna Weissman, a professor of epidemiology and psychiatry at Columbia University, one of the collaborating investigators in the original IPT research studies. The editors have made an exceptionally valuable contribution to the advancement of IPT, and, in my view, to the field of psychotherapy as a whole.

Since psychotherapy is what psychotherapists do, it is critical for those learning to perform psychotherapy to get as close as possible to observe the workings of master practitioners, looking, as it were, over their shoulders. Short of providing complete sets of videotapes or treatment transcripts for detailed study, the next best possibility is for seasoned practitioners to offer comprehensive descriptions of their treatments—boots on the ground. That is just what we are given in this book.

Although the 20 well-written, amply referenced case-based chapters in this book primarily deal with various types of depressive disorders, they also include bipolar disorder, eating disorders, posttraumatic stress disorder, social anxiety disorder, and borderline personality disorders. The chapters cover a wide variety of populations, from adolescents to the elderly, and include peripartum patients, low-income populations, and patients in developing countries. In addition to individual face-to-face psychotherapies, the authors elaborate on their applications of IPT in group formats and telephone-based therapies. The 39 contributing authors include psychiatrists and psychologists from numerous academic centers and private practice settings throughout the United States as well as international settings. The chapters are rich in detailed clinical vignettes, descriptions, reflections on moment-to-moment interactions, and clinical pearls.

In my view, all trainees and advanced clinicians wishing to learn IPT or to hone their general psychotherapy skills will stand to benefit considerably from reading and studying this welcome and edifying book. And, although I have been teaching IPT formally and informally to residents as well as to others for several decades, I know that from now on, I'll personally be using the Casebook of Interpersonal Psychotherapy to enrich my instruction.