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Human Nature Review 2002 Volume 2: 523-524 ( 21 November )
URL of this document http://human-nature.com/nibbs/02/weissman.html
Comprehensive Guide to Interpersonal Psychotherapy
by Myrna M. Weissman, John C. Markowitz, and Gerald L. Klerman
New York, Basic Books. 2000.
Reviewed by Eduardo Keegan, Professor of Clinical Psychology and the Psychotherapies, School of Psychology, University of Buenos Aires, Buenos Aires, Argentina.
The aim of this book is to provide a complete overview of current research and applications of interpersonal psychotherapy (IPT). The authors are in fact pioneers of this approach, born in the late 1960s as an exploratory treatment for major depression. Interpersonal psychotherapy is essentially the creation of Gerald Klerman, who passed away in 1992 but left such a mark in the field that Weissman and Markowitz have considered it fair to include him as a third author.
The book represents an update and expansion of the well-known manual of IPT published in 1984. Contemporary to A. T. Beck’s Cognitive Therapy for Depression, the IPT manual for the treatment of major depression represented the commitment of his first author, Gerald Klerman, to evidence-based psychological interventions. In a context that increasingly favored medication and questioned psychotherapy, Beck and Klerman succeeded in proving that psychological interventions could be efficacious and efficient, and frequently the treatment of choice for the most common of all mental disorders.
In almost two decades, the scope of IPT has increased significantly, and that becomes immediately evident when reading the contents of this guide. Eight interventions are described just in the field of mood disorders. These include interpersonal therapy for recurrent major depression (maintenance treatment or IPT-M), dysthymic disorder (IPT-D), depressed adolescents (IPT-A), late-life depression, depressed patients with marital disputes (IPT-CM), bipolar disorder, depressed HIV-positive patients (IPT-HIV), and depressed ante- and postpartum patients. The classic intervention for major depression is depicted in the first part of the book, which includes an updated and revised version of the 1984 manual.
This chapter reveals the many challenges posed to the clinician by mood disorders: different populations with different clinical presentations, chronic, acute and recurrent disorders, depressed patients with marital discord. In the best tradition of IPT, a treatment created to compensate for the many shortcomings of antidepressant therapy in the 1960s, these interventions aim at refining the efficacy of the approach for increasingly specific clinical situations or populations.
The third part is dedicated to substance abuse, eating and anxiety disorders. IPT has been applied to bulimia nervosa without significant modifications by Christopher Fairburn in Oxford, England, with positive results. A group form of IPT (IPT-G) has also been used to treat eating disorders, while the efficacy of the treatment for anorexia nervosa has not been established yet. Other applications in progress include IPT for body dysmorphic disorder, somatization disorder, depression following myocardial infarction, depressed patients with physical disabilities, primary insomnia and borderline personality disorder.
As for anxiety disorders, the guide mentions interventions for social phobia, panic disorder and post-traumatic stress disorder. These studies are in their initial stage, but the applications for social phobia have shown positive efficacy data.
Interpersonal psychotherapy has not proven to be efficacious for the treatment of substance abuse disorders, but this negative outcome, the authors highlight, makes the testing procedures more credible.
One interesting part of the book is that dedicated to new treatment formats -group, telephone and patient guided- and other cultural contexts. It not only provides information about researchers all over the world but also acknowledges the impact of cultural issues in psychotherapy.
The book preserves some practical aspects of the 1984 handbook: clear description of interventions, a summary of common problems and an integrative case example that gives a global impression of IPT. Every section includes a synopsis of the research carried out so far and the efficacy data available.
The style and edition of the book are austere and professional. I have the impression that Gerald Klerman would be quite happy to see the considerable achievements of modern interpersonal psychotherapy depicted in this low-key, factual manner. Readers interested in evidence-based psychological treatments will surely appreciate that too.
In sum, this is a very good book that will be of interest for researchers and clinicians, particularly for those working in the field of mood disorders.
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© Eduardo Keegan.
Keegan, E. (2002). Review of Comprehensive Guide to Interpersonal Psychotherapy by Myrna M. Weissman, John C. Markowitz, and Gerald L. Klerman. Human Nature Review. 2: 523-524.