Interpersonal Psychotherapy for Posttraumatic Stress Disorder

Schedule sessions:
 Work out regular appointment times with your pa-
tient. The more you can provide a sense of safety and regularity, the 
better. If you know in advance that you (or the patient) will have in-
terruptions in the treatment, it’s preferable to spell them out ahead 
of time.
 2. 
Audiotape
: In our research, we audiotaped each session for supervi-
sory and adherence purposes. (In clinical practice, you are probably 
less likely to do this, but I leave the point in this manual to indicate 
that it can be done. Therapists sometimes fear patients would object 
to such a procedure, but we found that even highly mistrustful in-
dividuals with PTSD were willing to be taped once they understood 
the purpose of the taping, the confidentiality protections, etc. A re-
cording of a session is a far more accurate record than process notes 
and may be essential if you would like IPT supervision. Videotaping is 
even more informative and beneficial to adherence to technique than 
 
 

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Practical Issues 
139
audiotaping. If you plan to tape sessions, however, you should discuss 
this first, and have the patient sign an informed consent.) Place the 
digital tape recorder close to the patient and yourself, and turn off loud 
air conditioners and other background noise to ensure audibility of 
the tape. Turn the tape on 
before
 the patient enters the room, and do 
not turn it off until the patient has left.
Tapes will be reviewed in supervision and by independent evaluators to assure 
therapist adherence to treatment modality. You may reassure your patients that  
the recordings focus on 
you
, the therapist, rather than on the patient, and that 
they will be erased once these technical reviews have been taken.
 3. 
Give the patient an IPT handout.
 Some patients may find the IPT 
handout (see Appendix) a useful orientation for the treatment they are 
about to start.
 4. 
Write a progress note:
 After each session, write a brief clinical prog-
ress note. We discouraged study therapists from taking notes during 
sessions, as everything was being recorded anyway on audiotape, and 
notes distract patient and therapist from eye contact and what should 
be a direct interpersonal encounter in the session.
 5. 
Ratings:
 Tell the patient at the start of treatment that you will period-
ically ask questions (and/ or provide self- report questionnaires) to see 
how treatment is progressing. You and your patient both may benefit 
from knowing how the patient is progressing. Patients should be rated 
at regular intervals using assessments for PTSD and, if appropriate, 
comorbid diagnoses such as major depressive disorder (as they were 
in our study by independent evaluators at New York State Psychiatric 
Institute). For PTSD, you might administer the CAPS- 5 (Weathers 
et al., 2013a) or the self- report PCL- 5 (Weathers et al., 2013) at the 
initial evaluation, at mid- treatment (week 7), at the end of acute treat-
ment (week 14), and subsequently if treatment continues. For depres-
sion, the Hamilton Depression Rating Scale (Hamilton, 1960) or Beck 
Depression Inventory– II (BDI- II; Beck et al., 1996) can be used.
PROSCRIPTIONS: THINGS NOT TO DO
Our research study was very concerned with keeping the therapists who were 
conducting IPT, Prolonged Exposure, and Relaxation Therapy pure in their 
delivery, the three therapies distinct from one another. Hence, we cautioned 
IPT therapists to adhere to IPT and to avoid the techniques of the competing 
 

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140 
I P T   F O R   P T S D
therapies. If you are a therapist using this manual in a research study compar-
ing IPT to other treatments, this will remain true. Therapy should be recorded 
and evaluated to measure therapist adherence. Without such monitoring, 
there is no way to demonstrate that IPT therapists are doing IPT, and other 
therapists other therapies.
Even if you are not a research therapist, however, and are instead treating 
patients in clinical practice, the recommendations remain basically the same. 
Eclectic therapy tends to be weaker therapy: it loses its programmatic crisp-
ness, its thematic coherence (Markowitz & Milrod, 2015). Mixing IPT with 
other treatment elements may feel like you’re doing more, but sometimes less is 
more. Particularly in a brief psychotherapy, it’s important to convey organized 
principles to patients that they can understand and continue to use when they 
leave. If, six months after finishing treatment, your patient faces a difficult life 
situation, she or he is likely to fare better having a clear picture (interpersonal, 
cognitive, psychodynamic, or otherwise) of how to respond. Thus blending 
therapies may unintentionally breed confusion.
 1.