Interpersonal Psychotherapy for Posttraumatic Stress Disorder

Phase 1.
 In the 
initial phase
, generally sessions 1– 3 out of 12, the 
therapist introduces him-  or herself to the patient and begins to take 
a history. This generally includes using a rating scale to measure 
the target diagnosis: for example, the Hamilton Depression Rating 
Scale (Hamilton, 1960). In taking a history, the therapist focuses on 
interpersonal issues. Goals include:
 •  Getting a sense of who the patient is, how he or she functions, in 
an interpersonal context. How does the patient generally interact 
with others? Is the patient overly trusting, or mistrustful? How 
does he or she handle anger? (Many depressed and anxious 
patients suppress it as a “bad” feeling rather than expressing it.) 
Are there maladaptive (depressive) patterns in relationships?
 •  Taking  an 
interpersonal inventory
 of relationships, close and 
distant, starting with childhood but focusing on the present, 
where relationships can still be addressed. Who are the important 
people in the patient’s life? Who are actual or potential social 
supports? Who may contributing to the patient’s difficulties?
 •  If the patient has been in previous therapies, it is worth exploring 
how he or she felt in them. Did the patient ever object to anything 
a therapist said? If so, did the patient just think it, or say so? IPT 
therapists do not work in the transference, and the focus of IPT 
is generally outside rather than inside the office. Nonetheless, 
IPT therapists recognize the therapeutic alliance as crucial, and 
acknowledge the therapeutic relationship as a situation about 
which the patient can have and voice feelings. An IPT therapist 
might offer: “If anything makes you uncomfortable here, please 
bring it up. I’m not trying to bother you, and that’s just the sort of 
issue that it might be worth discussing” (Markowitz et al., 2007).
 •  Setting the time limit. IPT for depression is generally set at 12 
(or 8, or 16— but it’s important to choose a number and stick 
to it) weekly sessions. It’s not actually clear what an optimal 
psychotherapy “dosage” is— pharmacotherapy studies routinely 
 

---

44 
I P T   F O R   P T S D
have investigated dosage, but few psychotherapy studies have. The 
key point is to create a time frame to create an urgency to move 
the therapy forward.
 •  Giving the patient the medical model: depression is a treatable 
illness.
 •  Providing the formulation.
 •  Other logistics: generally scheduling sessions once a week, with 
contingencies for emergencies, anticipation of vacations, etc.