Interpersonal Psychotherapy for Posttraumatic Stress Disorder

Course of Treatment.
 At baseline, her PSS- 
SR score was 89, 
 
a severe score (maximum = 119). Initial sessions introduced the IPT approach, 
assessed symptoms, and provided psychoeducation about PTSD as well as de-
pression. The therapist emphasized the impact of both illnesses on her social 
and work relationships and overall functioning. The therapist took an 
inter-
personal inventory
 assessing current and past relationship patterns and began 
helping Deborah identify how her traumatic experiences and PTSD symp-
toms interfered with her interpersonal interactions and social and profes-
sional relationships.
Deborah’s parents divorced when she was one year old, and her mother re-
married when she was three. They moved around a lot with the stepfather and 
his sons before settling in Texas when she was a teenager. Deborah told her 
mother about the abuse shortly after it ended. Her mother was sympathetic and 
asked if she wanted to see a counselor. Deborah reported feeling angry, as she 
felt her mother “put it on me to take care of myself.” Her mother did not tell the 
stepfather for another year, and the stepbrothers were never punished. At the 
time of the evaluation, she reported feeling angry at her mother for not stand-
ing up for her more, not insisting that the stepbrothers be punished, and for 
maintaining a close relationship with the stepfather. Deborah reported that she 
was reluctant to return to Texas for holidays or visits because she did not want 
to see her stepbrothers and feared that her mother would not keep them away 
from the house. She had no communication with the stepbrothers on her own.
Her biological father, described as verbally abusive, she currently spoke to 
once a year. She had lived with her father for about a year in her early teens, but 
he was verbally abusive and intrusive, often opening her mail. She felt upset 
with her mother for sending her to live with someone who her mother knew 
could harm her.
Deborah reported that growing up she “couldn’t make friends.” She “had 
difficulty fitting in.” Her mother moved her around a lot, so she had to switch 
schools sometimes in mid- semester. She reported having attended a large, lib-
eral arts college where she began forming female friendships that she had since 
maintained. She stated she was heterosexual, yet had no romantic relation-
ships with men. She felt nervous around guys and formed a reputation in col-
lege for being “cold and uninterested” in dating. After graduation, she moved 
to New York City and began working in public relations. She reported that her 
boss had been overly critical of her work and told Deborah that she was “rude 
and condescending.” She wanted to leave the job and had been looking at posi-
tions elsewhere. Deborah reported feeling uncomfortable with people she did 
not know and socially awkward at parties. She would occasionally go out with 
a colleague from work, but said her closest friends, from college, lived outside 
New York. She reported feeling easily angered but that she couldn’t express 
 

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I P T   F O R   P T S D
her anger directly. She would instead act irritable and complain to third par-
ties about how she felt. She avoided crowds and crowded subways for fear of 
men getting too close to her. She reported that she used to enjoy dance classes 
and cooking but had not been participating in pleasurable activities in the few 
months prior to her evaluation.
The therapist gave Deborah 
the sick role
, explaining that she suffered from 
PTSD and depression, and provided psychoeducation about their symptoms. 
The therapist emphasized that these illnesses were not her fault, and were treat-
able. In addition, the therapist gave her copies of pages describing PTSD and 
depression from 
DSM- IV
. In the following session, Deborah expressed with 
relief that, until that discussion and reading about PTSD, she had thought her 
symptoms were “just weird about me— now I realize I have symptoms— there 
is an explanation.” The therapist linked the recrudescence of Deborah’s symp-
toms to her conflicts with her mother and unhappiness at work, framing the