About Interpersonal Psychotherapy for Adolescents (IPT-A)

About Interpersonal Psychotherapy for Adolescents (IPT-A)

What is IPT-A?

Interpersonal psychotherapy for depressed adolescents (IPT-A) is a time-limited (12–16 sessions) individual psychotherapy for adolescents ages 12–18 who are suffering from depression. IPT-A was adapted from interpersonal psychotherapy for depressed adults.[1] While IPT-A recognizes that genetic, biological, and personality factors play a role in the development of depression, the focus of IPT-A is on how relationship issues are related to the onset or ongoing occurrence of depressive symptoms.

The goals of IPT-A are to:

  • help adolescents to recognize their feelings and think about how interpersonal events or conflicts might affect their mood;
  • improve communication and problem-solving skills;
  • enhance social functioning and lessen stress experienced in relationships; and
  • decrease depressive symptoms.

Is IPT-A just for adolescents?

Yes. IPT-A was specifically developed as an outpatient treatment for teens ages 12–18 who are suffering from mild to moderate symptoms of a depressive disorder, including major depressive disorder, dysthymia, adjustment disorder with depressed mood, and depressive disorder not otherwise specified. It is not indicated for those who are bipolar, acutely suicidal or homicidal, psychotic, intellectually disabled, or actively abusing substances. For children younger than 12, IPT-A has been adapted to include more parental involvement in a model called family-based interpersonal psychotherapy (FB-IPT), and there is preliminary evidence for its use with preadolescents ages 8–12 years.[2] Depending on the situation and individual, mental health professionals might also recommend cognitive behavioral therapy or medication.[4] Regardless of age, it’s always important to discuss symptoms, needs, and concerns with a mental health professional to identify the best treatment approach for the individual and situation.

What is involved in IPT-A?

Therapy sessions take place once a week, for 12 weeks, with each session lasting about 45–60 minutes. In addition to meeting with the teen, therapists might also meet with parents or guardians for 1–3 sessions as needed. Each session of therapy has a very specific focus. Therapy is divided into three phases:

Initial Phase (Sessions 1–4)

During this first phase, the IPT-A therapist discusses depression with the teen and his/her parent(s), including discussing the teen’s own experiences or feelings of depression. The therapist explains the focus of IPT-A on relationships and the reciprocal relationship between mood and relationships, as well as the goals of treatment. As part of the psychoeducation about depression, the therapist also gives the teen a “limited sick role,” which means that the therapist identifies depression as a medical illness, while encouraging the teen to take an active role in getting better. The therapist encourages both the teen and parent(s) to recognize that depression affects motivation, and yet the road to recovery involves working to try to keep up with daily activities, such as schoolwork and chores, while acknowledging that performance might not be up to the same standards as prior to feeling depressed. They are helped to understand that doing these activities will get easier, and performance will improve as the teen begins to feel better. The therapist conducts what’s called an “interpersonal inventory,” in which the therapist and teen discuss the teen’s most important relationships, looking for strengths and problems in communication and problem-solving skills. The therapist works closely with the teen to help identify the significant relationship that is either contributing to or helping to maintain the depression and then develop new skills to help resolve the identified problems that might be affecting his or her interactions within this relationship. The patient and therapist might discuss how difficult interactions (struggles) influence relationships with family members, peers, and others in his or her life. Finally, the patient and therapist establish a “treatment contract,” a clear statement of an area of focus, goals, and expectations for treatment.

Middle Phase (Sessions 5–9)

During the middle phase, the therapist and teen continue to delve into the identified problem area. The therapist works with the teen or adolescent on recognizing specific difficulties within the identified problem area. They talk about how certain events or things the teen and/or other people say and do can trigger negative symptoms and feelings. The therapist helps the teen with communication tips and problem-solving strategies, identifying ways to communicate and resources (including other people) that can be used to more successfully solve problems. They practice using skills that can help the teen to better navigate challenging interpersonal circumstances.

Termination Phase (Sessions 10–12)

During the termination phase, or wrap-up, the teen and therapist talk about feelings the teen might have about ending treatment and the progress the teen has made. They talk about the skills that the teen learned in therapy that were most helpful and the goals that were accomplished. The therapist encourages the teen to think about future difficult or stressful events and how he or she might use the newly learned skills in these future situations. The therapist, teen, and parent also review together whether additional treatment is recommended and how the parent can continue to support the teen’s use of these newly learned skills.

Does IPT-A work?

Scientific research has shown IPT-A to be effective as a type of treatment for mild to moderate adolescent depression. Research studies comparing IPT-A to the individual therapy adolescents usually receive in community outpatient clinics have shown that adolescents treated with IPT-A demonstrated fewer depressive symptoms and better social and global functioning post-treatment than treatment-as-usual conditions.[5],[6],[7] For teens with moderate to severe depression, research has shown that a combination of cognitive behavioral therapy and medication works best.[8],[9]

What types of professionals provide IPT-A and where?

Professionals with a master's or doctoral degree in clinical or counseling psychology or a master's in social work who receive training in IPT-A are qualified to provide IPT-A.  IPT-A is typically conducted in:

  • an outpatient clinic;
  • a private therapist’s office; or
  • a school-based clinic setting.

[1] Weissman, M. M., Markowitz, J. C., & Klerman, G. L. (200). A comprehensive guide to interpersonal psychotherapy. Albany: Basic Books.

[2] Dietz, L., Weinberg R., Brent, D., & Mufson, L. (2015). Family-based interpersonal psychotherapy (FB-IPT) for depressed preadolescents: Examining efficacy and potential treatment mechanisms. Journal of the American Academy of Child and Adolescent Psychiatry, 54(3), 191–199.

[3] Dietz, L. J., Mufson, L., Irvine, H., & Brent, D. A. (2008). Family-based interpersonal psychotherapy (FB-IPT) for depressed preadolescents: A pilot study. Early Intervention in Psychiatry, 2, 154–1611.

[4] Flouxetine is the only medication currently approved for treating depression in children under age 12. Please see Antidepressant Medications for Children and Adolescents: Information for Parents and Caregivers.

[5] Mufson, L., Dorta, K. P., Wickramaratne, P., Nomura, Y., Olfson, M., & Weissman, M. M. (2004). A randomized effectiveness trial of interpersonal psychotherapy for depressed adolescents. Archives of General Psychiatry, 61(6), 577–584.

[6] Mufson, L., Weissman, M. M., Moreau, D., & Garfinkel, R. (1999). Efficacy of interpersonal psychotherapy for depressed adolescents. Archives of General Psychiatry, 56(6), 573–579.

[7] Rossello, J., & Bernal, G. (1999). The efficacy of cognitive-behavioral and interpersonal treatments for depression in Puerto Rican adolescents. Journal of Consulting and Clinical Psychology, 67(5), 734.

[8] TADS Team. (2007). The Treatment for Adolescents with Depression Study (TADS): Long-term effectiveness and safety outcomes. Archives of General Psychiatry, 64(10), 1132.

[9] Vitiello, B. (2009). Combined cognitive-behavioral therapy and pharmacotherapy for adolescent depression. CNS Drugs, 23(4), 271–280.

Jazmin Reyes-Portillo, PhD, is an Assistant Professor of Clinical Psychology in the Division of Child & Adolescent Psychiatry at Columbia University Medical Center. She works as a clinical psychologist in the Youth Anxiety Center Washington Heights Clinic providing diagnostic assessments; individual, group, and family therapy; parent-training; and school consultations. Dr. Reyes-Portillo’s areas of interest include the treatment of youth depression and anxiety, as well as the use of technology to improve mental health services for youth.