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PSYC3082 > Wk 12 - Interpersonal therapy > Flashcards

Wk 12 - Interpersonal therapy Flashcards

1
Q

Why/how was IPT developed? (x4)

A

As a manualised depression treatment
For use as control against CBT in huge clinical trial
Comparing also with medication and placebo
Turned out to be great in itself

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2
Q

What was hypothesised to drive the change seen by IPT clients in trial comparing it to meds/CBT? (x1)

A

Chang in social circumstances and relationships

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3
Q

According to Weissman, Markowitz and Kerman, how does IPT work? (x2)

A

Medical model of depression

Link between depressed mood and interpersonal relationships

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4
Q

According to Weissman, Markowitz and Kerman, what does IPT focus on? (x3)
And its goals? (x1)

A

Modifying disrupted interpersonal relationships or
Expectations about those relationships
Trying to fix up conflicts, separations - transition to improve mood
Symptom relief

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5
Q

What are 6 characteristics of IPT?

A

Time limited (eg 12 – 16 weeks)
Focused rather than open-ended
Current interpersonal relationships
Interpersonal not intrapsychic (not transference)
Interpersonal not cognitive
Personality is recognised but not a focus

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6
Q

Why do people (inaccurately) try to lump IPT with psychoanalysis? (x1)
What is one important diff?

A

Emphasis on attachment styles

Doesn’t go into specifics of personality

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7
Q

What are the historical contributions to IPT of Meyer and Sullivan?

A

Interpersonal school founded by both
Meyer (1957) psychobiological theory emphasised current interpersonal experiences
Sullivan (1953) linked psychiatry with sociology, anthropology and social psychology

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8
Q

How does Interpersonal theory view human nature? (x5)

A

Relationship is primary
Focus on how individuals form, maintain, form problems in, and end relationships
Instinctual drive to interpersonal relationships –
Attachment organises behaviour in them
Attachment behaviour most evident when individual is distressed

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9
Q

What are three theoretical underpinnings of IPT?

A

Attachment theory: basis for relationship difficulties
Communication theory: how maladaptive patterns can lead to difficulties
Social theory: understanding social context and effects of networks

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10
Q

Explain Bowlby’s Secure attachment style for kids and adults (x4, x3)

A

Separate from parents to explore;
Returns if anxious;
Return of parent met with positive response;
Clearly prefers parents to strangers.

Trusting lasting relationships;
Good self esteem;
Seek social support when stressed.

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11
Q

Explain Bowlby’s Ambivalent attachment style for kids and adults (x3, x3)

A

Wary of strangers;
Greatly distressed by separation from parent;
May not be comforted by return

Reluctant to become close to others;
May worry partner doesn’t love them;
Distraught when a relationship ends.

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12
Q

Explain Bowlby’s Avoidant attachment style for kids and adults (x3, x3)

A

Avoid parents;
Doesn’t seek comfort from parents;
Little preference parents/strangers

May have problems with intimacy;
Invests little emotion relationships;
Unable/willing to share thoughts/feelings with others.

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13
Q

Insecure attachment styles are vulnerable to… (x1)

A

Depression

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14
Q

How does communication theory relate to attachment in IPT? (x2)

A

Attachment = template on which specific communication occurs
Better/worse ways of communicating attachment needs - avoidant aren’t sharing/getting met

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15
Q

What are two central tasks in IPT?

A

Communication analysis - finding the details of what’s going wrong
Skills building - social, interpersonal skills role played and then practiced in RL

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16
Q

How does social theory relate to IPT/depression? (x4)

A

Isolation/ social dysfunction causal in psychological distress
And, depressed tend to decrease in social functioning
Spectrum of responses to interpersonal stressors
Intervening in interpersonal relationships will improve functioning

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17
Q

What happens (in IPT model) if interpersonal crisis either reaches subthershold intensity, or suprathreshold but with sufficient social support? (x1)

A

Resolution

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18
Q

What happens (in IPT model) if interpersonal crisis reaches suprathreashold intensity, and person has insufficient social support? (x3)

A

Attachment needs unmet
Maladaptive communication of needs
Interpersonal problems/symptoms

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19
Q

What is therapist’s role in IPT? (x7)

A

Active
Client advocate, supportive, directive (unlike PCT)
Gathers information
Educative
Modelling secure attachment and good communication patterns
Safe background for change

No transference analysis

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20
Q

What is the client’s rollin IPT? (x4)

A

Active/collaborative
Ultimate responsibility for topics to be discussed
To discuss relationships with others openly
Explore feelings about those relationships

21
Q

What are the goals of IPT? (x5)

A

Not insight but change, eg:
Improvement in interpersonal relationships or
Change in expectations
Symptom relief - reduced depression, increased relationship comfort
Improvement in social networks - esp in transitions

22
Q

What is involved in the initial, intermediate and termination sessions of IPT? (x2, x1, x3)

A

Diagnostic evaluation and framework for treatment
Treatment contract

Addressing key problem areas

Consolidation
Relapse prevention
Termination

23
Q

What is the purpose of having client adopt a ‘sick role’ during initial sessions of IPT? (x5)

A 
From medical model...
Removes blame from client
Conveys hope
Normalises the problem
Identifies problem as time-limited
24
Q

What is included in an interpersonal inventory in IPT? (x5)

A 
All significant relationships
History of problematic relationships
Social support
Communication problems
Problems with expectations in relationships - what are they? Getting met?
25
Q

What are four interpersonal problem areas addressed by IPT?

Are these mutually exclusive?

A

Grief (complicated bereavement)
Role disputes
Role transitions
Interpersonal deficits

No - but if too much overlap/no clear area use latter as focus

26
Q

What are 6 key techniques in IPT?

And what has been added, having been excluded in original trials? (x1)

A 
Clarification and directives
Encouragement of affect
Communication analysis
Problem solving
Role playing
Use of the therapeutic relationship

Homework - need RL practice

27
Q

What are the aims of ‘clarification and directives’ in IPT? (x2)
Which may use techniques of… (x5)

A

Restructure and feedback client’s material
Increase awareness of what actually communicated

Open/closed questions
Clarification 
Paraphrasing and reflecting 
Receptive and empathic listening
Receptive silence
28
Q

What are the aims of ‘encouragement of affect’ in IPT? (similar to experiencing in emotion focussed…) (x1)
Which may use techniques of… (x4)

A

Facilitate recognition, acceptance, expression of painful affect

Using affect to bring about change:
Negotiate behaviour change with others
Delay expression or acting on affect until calm
Revise thinking about affect-laden topics

29
Q

What is involved in ‘communication analysis’ in IPT? (x4)

A

Clients encouraged to “put everything into words”
Communication discussed in interpersonal context
Reconstruction of interpersonal events
Therapist as role model

30
Q

What are common communication difficulties? (x3)

A

Ambiguous, indirect non-verbal communication as substitute for open confrontation
Incorrect assumption that one has communicated clearly and been understood
Silence, closing off communication

31
Q

What is involved in ‘problem solving’ in IPT? (same as CBT) (x5)

A 
ID problem 
Explore perceptions and expectations
Brainstorming/analysis of consequences
Implementation
Monitoring of attempted solution
32
Q

What are the aims (x2) and tasks (x2) of ‘role playing’ in IPT?

A

Assist client to develop different points of view and
Understanding communication patterns

Practising and reinforcing communication
Ask clients to play themself and also the other person

33
Q

What is grief/complicated bereavement in IPT terms?

A

“Normal” grief = full awareness of the reality of death;
Symptoms usually resolve in 2 -4 months
Complicated bereavement =
delayed/failure to mourn; or “over-grieving”
Many stages described in dealing with loss

34
Q

What are the symptoms of (x4) and goals (x2)of IPT when working with grief? (x2)

A

Sadness,
Disturbed sleep,
Agitation,
Decreased day-to-day functioning

Facilitate mourning
Help find new activities and relationships

35
Q

What are the tasks in IPT when working with grief? (x5)

A 
Relate timeline of symptoms to loss
Exploration of circumstances of loss and
Of actual relationship with deceased 
Generation of associated affect/promoting its acceptance 
Helping client make new attachments
36
Q

What are interpersonal disputes in terms of IPT? (x2)

Which may be at one of which three stages?

A

Conflict with significant others
Differing expectations of roles

Negotiation – active attempts to change things
Impasse – stalled negotiations
Dissolution – considering ending the relationship

37
Q

How does IPT go about addressing interpersonal disputes? (x4)

A

Identify stage of dispute
Modify communication patterns
Reassess expectations of relationship - realistic?
Assist patient to communicate their needs

38
Q

What tasks might be involved in addressing addressing interpersonal disputes in IPT? (x3)

A

Parallels in other relationships -patterns, e.g. parental relationship
Encourage and model direct communication
Role playing

39
Q

What role transitions are associated with depression? (x4)

A

Couple become parents
Adolescent leaving home
Healthy person having serious illness or accident
Older adult retiring from work

40
Q

What difficulties commonly arise during role transitions? (x4)

A

Loss of social support/network
Management of emotions - fear, anger
Need new repertoire of social skills
Diminished self esteem

41
Q

What are the goals of IPT when dealing with role transitions? (x4)

A

Facilitate mourning of old role/acceptance of new
Help client see new role as less negative
Help gain mastery
Developing new attachments and supports

42
Q

What are 5 IPT techniques for helping with role transition issues?

A 
Relate symptoms to recent life change 
Explore affect - loss
Review old and new role in positive and negative light
Identify challenges of new role
Problem solve and implement solutions
43
Q

What is covered by ‘interpersonal deficits’ in IPT terms? (x5)
And when would you choose this area as your focus?

A

Can occur in social phobia
Avoidance/anxiety in social relationships
Lacking social skills
Problems initiating/sustaining relationships
Describes consistent style of attachment or personality (cf acute social stressor)

Not common - if other problem areas present focus on those

44
Q

What are the goals of IPT when dealing with interpersonal deficits? (x3)

A

Reduce isolation
Assess strengths realistically
Begin extending social repertoire

45
Q

What are three strategies for dealing with interpersonal deficits in IPT?

A

Review past significant relationships
Problem solving with positive reinforcement
Communication analysis and role play

46
Q

What is involved in the termination process of IPT? (x4)

A

Reinforcement of gains
Acknowledgement of sense of loss/grief/transition
Normalising feelings about termination
Managing post-therapy contacts

47
Q

What is the empirical support of IPT (from NIMH Treatment of Depression Study) (x3)
And what is its use under the current APA guideline for depression?

A

= to medication for mild/moderate
Better than placebo
And better than CBT for severe

Women especially may respond better to IPT followed by meds for non-responders

48
Q

What disorders other than depression has IPT been applied to? (x7)

A 
Postpartum depression 
Dysthymia, and + alcohol 
HIV patients 
Bipolar disorders 
Bulimia nervosa
Social phobia 
Comorbid anxiety and depression in adolescents
49
Q

What are the limitations of IPT? (x4)

A

Still don’t know…
Who is best suited for IPT vs other treatments?
Manualised treatment vs clinical judgement
Necessary elements of IPT?
Level of training required for effective delivery?

PSYC3082 (12 decks)

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