ABSTRACT
Introduction Acute Treatment with Interpersonal Psychotherapy (IPT) comes to a conclusion, not a termination. Rather than using the traditional psychoanalytic model in which ‘termination’ is a complete severing of the therapeutic relationship, the completion of Acute Treatment with IPT simply signifies the conclusion of a specific intensive phase of treatment. In IPT this does not signify the end of the therapeutic relationship – in fact, it is often agreed that the patient and therapist will have therapeutic contacts in the future, and provision is specifically made for these. Clinical experience has consistently demonstrated that a longitudinal therapeutic relationship is beneficial for most patients, and this is also clearly supported by empirical evidence. Not only are many of the major psychiatric disorders (such as depression and anxiety disorders) relapsing and remitting in nature, there is also clear evidence that provision of IPT as a maintenance treatment after recovery from depression is helpful in preventing relapse.1,2 Because of the therapeutic benefit of maintenance treatment and the evidence supporting its utility, the therapist is obligated to discuss continuing Maintenance Treatment with all patients treated with IPT.a
Concluding Acute Treatment Clinical experience and empirical evidence both make clear that IPT should be conceptualized as a two-phase treatment, in which a more intense Acute Treatment focuses on resolution of immediate symptoms and distress, and a subsequent Maintenance Phase follows with the intent of preventing relapse and maintaining productive interpersonal functioning. There are both theoretical and practical reasons for keeping Acute Treatment with IPT time-limited. The time limit theoretically may be effective in generating change, as it is often hypothesized that having an end point helps drive the patient to work more rapidly on improving her communication skills and on building a more effective social network. It should be noted, however, that despite the tempting intuitive conclusion that this is helpful with some patients, there is in fact no data supporting this claim.3
