PsychEd Episode 42: Interpersonal Psycho...

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers interpersonal psychotherapy (IPT) with Dr. Paula Ravitz, an Associate Professor of Psychiatry at the University of Toronto and Senior Clinician-Scientist at the Lunenfeld-Tanenbaum Research Institute of Mt Sinai Hospital. Dr. Ravitz held the Morgan Firestone Psychotherapy Chair at the Mount Sinai Hospital from 2011 to 2021 and is a past president of the International Society of Interpersonal Psychotherapy.

The learning objectives for this episode are as follows:

By the end of this episode, you should be able to…

1. Define interpersonal psychotherapy
2. Describe the core principles and phases of IPT
3. Become familiarized with some psychological theories underpinning IPT
4. List some patient selection considerations for IPT
5. Describe the efficacy and evidence base for IPT 
6. Understand how IPT is practically carried  out 
7. Briefly compare and contrast IPT to other common psychotherapies

Guest: Dr. Paula Ravitz (paula.ravitz@sinaihealthsystem.ca)

Hosts: Jake Johnston and Sena Gok

Audio editing by: Jake Johnston

Show notes by: Jake Johnston

Interview Content:

• Introduction - 00:00
• Learning objectives - 02:10
• Definition/overview of IPT - 02:53
• Core principles and phases - 07:20
• Psychological theories - 19:30
• Patient selection considerations - 24:42
• Contraindications - 35:57
• Evidence base and history - 38:10
• Practical components of IPT - 43:57
• Maintenance IPT - 59:52
• IPT vs other psychotherapies - 62:56 
• Closing comments - 71:17
• Online IPT course - 74:30

Resources:

• Summary of IPT written in layman's terms: https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/interpersonal-psychotherapy
• The International Society of Interpersonal Psychotherapy (ISIPT) has a helpful overview of IPT and helpful resources for finding more information and IPT training opportunities: https://interpersonalpsychotherapy.org/
• ‘Psychotherapy Essentials to Go’ book series mentioned during episode:  https://www.penguinrandomhouse.ca/series/CNL/psychotherapy-essentials-to-go
• The online IPT curriculum is now available as a University of Toronto, Faculty of Medicine-sponsored open-access online course through Coursera, that is free for learners to audit - https://www.coursera.org/learn/learn-ipt

References:

• Bernecker, S. L., Coyne, A. E., Constantino, M. J., & Ravitz, P. (2017). For whom does interpersonal psychotherapy work? A systematic review. Clinical psychology review, 56, 82–93. https://doi.org/10.1016/j.cpr.2017.07.001
• Chaimowitz, G., Weerasekera, P., & Ravitz, P. (2021). Psychotherapy in Psychiatry. The Canadian Journal of Psychiatry, 66(11), 999–1004. https://doi.org/10.1177/07067437211040958
• Cuijpers, P., Donker, T., Weissman, M. M., Ravitz, P., & Cristea, I. A. (2016). Interpersonal Psychotherapy for Mental Health Problems: A Comprehensive Meta-Analysis. The American journal of psychiatry, 173(7), 680–687. https://doi.org/10.1176/appi.ajp.2015.15091141 
• Dennis, C. L., Grigoriadis, S., Zupancic, J., Kiss, A., & Ravitz, P. (2020). Telephone-based nurse-delivered interpersonal psychotherapy for postpartum depression: nationwide randomised controlled trial. The British journal of psychiatry : the journal of mental science, 216(4), 189–196. https://doi.org/10.1192/bjp.2019.275 
• Elkin, I., Shea, M. T., Watkins, J. T., Imber, S. D., Sotsky, S. M., Collins, J. F., Glass, D. R., Pilkonis, P. A., Leber, W. R., & Docherty, J. P. (1989). National Institute of Mental Health Treatment of Depression Collaborative Research Program. General effectiveness of treatments. Archives of general psychiatry, 46(11), 971–983. https://doi.org/10.1001/archpsyc.1989.01810110013002
• Klerman, G. L., Dimascio, A., Weissman, M., Prusoff, B., & Paykel, E. S. (1974). Treatment of depression by drugs and psychotherapy. The American journal of psychiatry, 131(2), 186–191. https://doi.org/10.1176/ajp.131.2.186 
• MacQueen, G. M., Frey, B. N., Ismail, Z., Jaworska, N., Steiner, M., Lieshout, R. J., Kennedy, S. H., Lam, R. W., Milev, R. V., Parikh, S. V., Ravindran, A. V., & CANMAT Depression Work Group (2016). Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 6. Special Populations: Youth, Women, and the Elderly. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 61(9), 588–603. https://doi.org/10.1177/0706743716659276
• Parikh, S. V., Quilty, L. C., Ravitz, P., Rosenbluth, M., Pavlova, B., Grigoriadis, S., Velyvis, V., Kennedy, S. H., Lam, R. W., MacQueen, G. M., Milev, R. V., Ravindran, A. V., Uher, R., & CANMAT Depression Work Group (2016). Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 61(9), 524–539. https://doi.org/10.1177/0706743716659418
• Ravitz, P., & Watson, P. (2014). Interpersonal Psychotherapy: Healing with a Relational Focus. FOCUS, 12(3), 275-284. https://doi.org/10.1176/appi.focus.12.3.275
• Ravitz, P., Watson, P., Lawson, A., Constantino, M. J., Bernecker, S., Park, J., & Swartz, H. A. (2019). Interpersonal Psychotherapy: A Scoping Review and Historical Perspective (1974-2017). Harvard review of psychiatry, 27(3), 165–180. https://doi.org/10.1097/HRP.0000000000000219
• Swartz, H. (2021). Interpersonal Psychotherapy (IPT) for depressed adults: Indications, theoretical foundation, general concepts, and efficacy. UpToDate. Accessed 2021-10-12.

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