Interpersonal Psychotherapy
Introduction and Overview
A need for
conceptual framework

Conceptual frameworks help recognize
relational patterns and cognitive schemas

Treatment plans will be developed from the
conceptual frameworks
Historical context

Interpersonal Domain (Sullivan)

Sullivan keep away from Freud’s drive theory
(sexual and aggressive instincts)

Personality develops through repetitive
interactions with parents and others

personality as the collection of interpersonal
strategies to avoid anxiety and disapproval, and
maintain self-esteem.
Historical context

Cognitive Domain

Internal working model (Object Relations and
Attachment theory)




View of self and others
Emotional responsiveness and availability
Good parents vs. bad parents
Schemas (Cognitive Behavioral therapy)


Can be called maladaptive cognitive schemas, core beliefs,
or faulty expectations
Schemas: A cognitive structure for screening, coding, and
evaluating the stimuli.
Historical context

The familial/contextual domain
 Family system theory
 Internalize family roles (i.e., rescuer) as selfschemas
 Re-create family roles/patterns with others
 Faulty communication patterns
 Family rules
 Family myths
Core Concepts

1. The Process Dimension

The relationship b/w therapist and client is the
foundation of therapy

Understanding and intervening with what is going
on b/w therapist and client in their interaction.

Content vs. Process comments

A powerful tool for genuine understanding and
honest communication.
Core Concepts

2. Corrective Emotional experience




Identify maladaptive cognitive & interpersonal
patterns
Use “process comments” to clarify interpersonal
styles
Engage the client in work together to find a way to
change
Transfer the learning in therapy to others in clients’
lives.
Core Concepts

3. Client Response Specificity
 Definition: therapists need to tailor their
response to fit the specific needs of each
client.
 Flexible to modify interventions and
respond in new ways
 Match the needs for diverse clients
Interpersonal process approach









Establishing a Working Alliance (WA)
Honoring the client’s resistance
A internal focus for change
Responding to painful feelings
Familial and developmental factors
Inflexible interpersonal coping strategies
Interpersonal patterns and themes
An interpersonal solution
Resolution and change
Establishing a Working Alliance (WA)

The WA is a collaborative relationship


Empathic understanding is the foundation for WA



WA: agree on goals, collaborate on tasks, and establish a
bond relationship based on trust and acceptance
Genuine concern, respect, and non-judgmental attitude
Demonstrate understanding and identify patterns
Immediacy—working in moment

Using process comments to build WA
Honoring the client’s resistance




Identify resistance
 Help client identity when resistance is occurring
with a non-judgmental manner
Address reluctance to resistance
 Validate the protection aspects
 Do not repeat maladaptive patterns in session
Formulate working hypotheses
 What is the threat?
Respond to resistance
 Educate
 Explore the danger/identify the threat
A internal focus for change


Shifting to an internal focus
 A prerequisite for change
 Focusing clients inward
 Reluctance to adopt an internal focus
Placing the locus of change with clients
 Fostering clients’ initiative
 Avoiding a hierarchical relationship
 Supporting clients’ own autonomy and initiative
 Shared control in the therapist-client relationship
A internal focus for change


Helping clients in solving their own problems
 Providing a corrective emotional experience
Tracking clients’ anxiety
 Identifying signs of clients’ anxiety
 Approach clients’ anxiety directly
 Focus clients inward to explore their anxiety
Responding to painful feelings

Approach the clients’ feelings

Expand and elaborate clients’ affect

Identify the predominant affect

Hold client’s pain

Therapists’ factors for not responding to
clients’ feelings
Familial and developmental factors





Understand structural family relations-patterns
The family’s ability to respond to the child’s need for
both relatedness & separateness
Three styles of parenting: control and affection
 Authoritative - high control/high affection
 Authoritarian - high control/low affection
 Disengaged – low control/low affection
 Permissive – low control/high affection
Love withdrawal
Insecure attachment
Inflexible interpersonal coping strategies

Horney’s interpersonal model
Unmet development needs
Core Conflict or Anxiety
Inflexible interpersonal
coping style
Move
Toward
Others
please
Move
Away from
Others
avoid
Turning against self to block
core conflict
Move
Reject
Against
self
Others
intimidate
Reject
others
Elicit
Rejection
From
others
Interpersonal patterns and themes


How clients bring their problems into the
therapeutic relationship
 moving toward, moving against, or moving
away
 Testing Behavior
 Transference Reactions
Interpersonal balance
An interpersonal solution





Resolving problems through the interpersonal
process
Bring client’s conflicts into the therapeutic
relationship
Using the process dimension to facilitate
change
Providing a corrective emotional experience
Therapists’ initial reluctance to work with the
process dimension
Resolution and change

The working –through process
 Change relationship patterns with therapist
acquaintancessupportive othershistorical
figuresprimary others
 Therapist actively help clients
 Realistically anticipate others responses
 Provide corrective emotional experience
Resolution and change


Work through family-of origin work
 Internal focus for change
 Grief work
Plan for future:
 Orienting clients to listen to themselves
what they want to do, what they want to be,
and what they want to become
Resolution and change

Clients are ready to terminate when
 Clients report they consistently feel better &
can respond in more adaptive ways
 Client expand their old coping styles and don’t
reenact maladaptive relational patterns
 Others gives them feedback that they are
different

Accepting that the relationship must end
Resolution and change


Effective terminations: review-predict-practice
 Review what has changed
 Predict and make realistic plans for coping with
the problems which could come up
 practice to respond differently
Ending the relationship
 Say good-bye