In this chapter, we examine how the basic principles and structure of IPT have evolved, and how fundamental treatment components and strategies have become refined or expanded with dissemination are outlined. We look through the lens of a practicing IPT therapist and illustrate the orientation, framework and implementation of IPT for contemporary application. Interpersonal Psychotherapy (IPT) is a time-limited (16–20 session), evidence-based psychological therapy which focuses on mood and interpersonal relationships. IPT recognises the significance of life events, particularly those involving interpersonal relationships, which often coincide with the onset of an episode of depression. The therapy is structured around three key principles: (1) a clear focus on interpersonal issues exploring and addressing interpersonal difficulties as they relate to a person’s emotional distress, concentrating on present relationships, (2) the identification of one of four main focus/problem areas, grief, role transitions, interpersonal role disputes or interpersonal sensitivities and (3) treatment structured into three phases – Beginning (1–4); Middle (5–12) and Ending (13–16). IPT sets clear goals to alleviate the presenting symptoms and improve interpersonal functioning. The IPT therapist helps clients to explore emotions, understand patterns in relationships and develop strategies to address the identified problem.

The chapter describes the history, mechanisms and phases of drug treatment of antipsychotics including at-risk mental states (ARMS), first-episode psychosis (FEP), maintenance, treatment-resistant schizophrenia (TRS) and ultra-resistant psychosis. Specific treatments of schizoaffective disorder, catatonia and affective comorbidities of psychosis target negative symptoms and cognition. Rapid tranquilisation is described: general principles, de-escalation, routes of administration and medication selection. Management of organic psychotic disorders is discussed: general principles and specific conditions, epilepsy, Huntington’s, stroke, drug-induced, autoimmune encephalitis, inflammatory, CNS infections, thyroid disorders and traumatic brain injury. Side effects are elaborated: somnolence and sedation; hyperprolactinaemia and sexual dysfunction; motor, cardiac, metabolic and anticholinergic side effects; and also diabetes and impaired glucose tolerance and clozapine-specific side effects. Finally, potential drug interactions are explored.