Interpersonal Psychotherapy - Strengths and Limitations

Strengths and Limitations

IPT is particularly accessible to patients who find dynamic approaches mystifying, or the ‘homework’ demands of Cognitive Behavioral Therapy (CBT) daunting. IPT has been specially modified for adolescents who may find CBT too much like school work, whereas IPT addresses relationships — a primary concern. IPT is abstemious in its use of technical jargon — a bonus for those who distrust ‘ psychobabble’. Fairburn (1997) reports that both patients and therapists in his bulimia studies expressed a preference for IPT over CBT. This may have implications for compliance and therapist morale.

For general psychiatrists the major limitation of IPT is that the model has not so far been modified for the management of psychoses. However, this is true of most psychotherapies. The CBT model requires such expertise for use with this patient group that it would be considered risky for a trainee to attempt its use without expert training and support.

In the case of treating depression, this therapy is time consuming and can take several years for a patient to fully recover. As with any face-to-face therapy, it is demanding of the individual in that effort must be made to attend the pre-arranged dates for the therapy sessions. Whereas effort isn't needed for 'homework' tasks, the therapy involves the reenactment of past negative feelings which, as well as creating a danger of emotional harm, does require more effort than is needed in CBT sessions. Studies, such as the one conducted by Paley et al. (2008), have found little different in the effectiveness between CBT and IPT. A meta-analysis by Robinson et al. (1990) found that CBT was superior to a no treatment control group, however, when compared to a placebo control group, there was no significant difference. If CBT and placebo therapies have similar effectiveness, and CBT and IPT have similar effectiveness, it is rational to presume that IPT and placebo therapies have similar effectiveness. Barkham et al. (1996) concluded after his experiment that both IPT and CBT showed a tendency for symptoms to recur, thus limiting the long term-effectiveness of these psychological therapies. Any study showing the success of such therapies often fail to take into account poor attrition rates, which are very common among psychological therapies as many patients drop out because they feel the therapy isn't working. If those that complete the therapies remain to complete them, they are more likely to be benefiting from it, thus when an average is taken of the success of the therapy (not including the patients that drop out) it appears to be more successful than it actually is.