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.
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.