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Failures in interpersonal psychotherapy (IPT): factors related to treatment resistances
Author(s) -
Ravitz Paula,
McBride Carolina,
Maunder Robert
Publication year - 2011
Publication title -
journal of clinical psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.124
H-Index - 119
eISSN - 1097-4679
pISSN - 0021-9762
DOI - 10.1002/jclp.20850
Subject(s) - interpersonal psychotherapy , psychotherapist , psychology , interpersonal communication , attrition , depression (economics) , alliance , clinical psychology , fidelity , interpersonal relationship , pharmacotherapy , psycinfo , psychiatry , medline , medicine , randomized controlled trial , social psychology , surgery , electrical engineering , dentistry , political science , law , economics , macroeconomics , engineering
Interpersonal psychotherapy (IPT) is an effective treatment for depression across the lifespan and across cultures. However, even when delivered with fidelity, some patients drop out and others do not improve sufficiently. Attention to IPT treatment attrition, dropout, nonresponse, or failure can elucidate its limitations and the opportunities to improve its effectiveness. Studies of factors known to moderate and negatively predict IPT depression treatment response are reviewed along with recommended modifications to improve outcomes. Although the risk of treatment failure always exists, it is possible to enhance treatment effectiveness by attending to the therapeutic alliance, strategically addressing depression, and adapting IPT to patient characteristics. These include adding pharmacotherapy, extending the course of treatment, and targeting specific symptoms or interpersonal vulnerabilities. Case examples illustrate several of these points. © 2011 Wiley Periodicals, Inc. J Clin Psychol: In Session 67:1–11, 2011.