Psychotherapy. You know, I spend a lot of time talking about it here, and it’s no wonder — it’s an effective treatment modality that too many people simply aren’t even considering. Much less using.
Psychotherapy research is less likely to be biased than other types of treatment research, too, because researchers tend not to be treatment providers nor have any direct (or even indirect) financial incentives in the outcomes of their research. Sure, there remains the “publication bias” that affects all research, but generally speaking, I tend to trust psychotherapy research data more than I do most psychiatric medication research.
So I was interested to read a recent meta-analysis on a specific form of psychotherapy called interpersonal psychotherapy for the treatment of depression. Its treatment focus is on the relationships of the person who is coming into treatment — whether they be family, romantic, friends, or others.
Interpersonal psychotherapy doesn’t get as much press or attention as other popular forms of psychotherapy (such as cognitive behavior therapy), so fewer practitioners use it and fewer consumers know of it.
But is it effective? Here’s what the researchers found out.
Interpersonal psychotherapy (IPT) is considered a structured and time-limited therapy. That is, there is a certain framework for therapy to take place in (it’s not just the client showing up to the therapist’s office and talking endlessly about the past week’s concerns), and it is specifically time-limited, not endless. Generally time-limited means the goals of therapy should be reached within a specific time period, often somewhere between 6 months and 2 years (with most people falling inbetween those two extremes).
Interpersonal therapy has been examined in many previous research studies and controlled trials. So much so, in fact, that numerous professional practice guidelines have recommended IPT as a treatment of choice for unipolar depressive disorders.
The authors of the current study (Cuijpers et al., 2011) searched research bibliographical databases for randomized controlled trials comparing IPT with no treatment, usual care, other psychological treatments, and pharmacotherapy as well as studies comparing combination treatment using pharmacotherapy and IPT. Maintenance studies were also included.
The researchers found 38 IPT studies that included 4,356 patients who met all inclusion criteria.
The overall effect size (Cohen’s d) of the 16 studies that compared IPT and a control group was 0.63 (95% confidence interval [CI]=0.36 to 0.90), corresponding to a number needed to treat of 2.91. This is considered a medium to large effect size — significant enough to consider it an effective depression treatment.
Ten studies comparing IPT and other psychological treatments showed a nonsignificant differential effect size of 0.04. This means that when compared to other forms of psychotherapy, all were found to be roughly equally effective.
Combination treatment — that is, the use of psychiatric medications along with IPT — was not more effective than IPT alone, although the researchers argued that, “the paucity of studies precluded drawing definite conclusions.” And significantly, combination maintenance treatment with pharmacotherapy and IPT was more effective in preventing relapse than pharmacotherapy alone (odds ratio=0.37; 95% CI=0.19 to 0.73; number needed to treat=7.63).
There is no doubt that IPT efficaciously treats depression, both as an independent treatment and in combination with pharmacotherapy.
The researchers concluded, “IPT deserves its place in treatment guidelines as one of the most empirically validated treatments for depression.”
Indeed it does. Interpersonal therapy is an effective treatment method to address depression in people — with or without medication.
Reference
Pim Cuijpers, Anna S. Geraedts, Patricia van Oppen, Gerhard Andersson, John C. Markowitz, and Annemieke van Straten. (2011). Interpersonal Psychotherapy for Depression: A Meta-Analysis. Am J Psychiatry. DOI: 10.1176/appi.ajp.2010.10101411
Image courtesy of Chato B. Stewart.
5 comments
Thanks for the detailed review~ I will use this and the article with students and their stats. So often they feel that learning stats is irrelevant to their potential career as counsellers.
When are researchers and practitioners going to realize that psychotherapy and counseling effectiveness is primarily due to extra-therapeutic and relationship factors, not techniques and theories per se?
When we hear about “depression†we associate this word with mental illness. However, contrary to what the drug peddling psychiatrists say about it, depression is not an illness; it’s a human condition. It’s the opposite of joy, so it is part of an emotional spectrum with extremes at both ends. Morever, when we look at the buzz words dealing with depression in the realm of popular psychology such as, “self esteemâ€, “self worthâ€, “self imageâ€, “self loveâ€, “self Loathingâ€, etc., we can get that this entire area of study is about ego-centrism. There is no room in this private domain for anyone else. Moreover, the way our society deals with this subject as a whole even encourages narcissism. Therefore, barring any chemical or hormonal imbalances which doctors can correct, the person suffering from chronic bouts of depression needs to focus on the needs of others. The best therapy is a program that encourages people to be more altruistic and less self-centered.
Moshe, I’m sure you’ve never been depressed. Otherwise you would not write down such words. A lot of people become depressed, just bacause they always were altruistic and because they forgot themselves. They lived for another. And your solution to depression is ‘learn them to be altruistic and less self-centered’???
Learn them to care for themselves (instead of being there always for others), learn them to respect their limits and how they can make that others respect their limits too!
Well, I understand what Moshe is saying and I would agree with it. I know that when I was dealing with severe major depression (4 hospitalizations during those years) I withdrew from everyone and had way too much time to ruminate over my life which just reinforced the despair. I do think there is something very healing about being brought out of the self absorption by being encouraged to get involved in some kind of volunteer work (not too many hours that create a lot of pressure, but something other than lying in bed). Obviously being over scheduled and giving too much of self leads to stress and resentment, but doing volunteer work that would feel meaningful can really turn a person’s life around.
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