AI developers are beginning to claim that their products have empathy and that this improves their ability to succeed at various tasks, including medical advice and psychotherapy. This chapter argues that AIs can succeed in these practical tasks just as well without real cognitive empathy, affective empathy, or compassion, but they still need an appearance of empathy and motivation to help.

This chapter outlines the ‘history’ of the development and testing of Interpersonal Psychotherapy (IPT), one of the first time-limited, manualised, evidence-based psychological treatments for depression. This overview places the inception of IPT in greater context of social history and changes in best practices in the field of psychiatry. This chapter also highlights the career of Dr. Gerald Klerman, the primary developer of IPT, and the legacy of research in IPT that was largely continued by Dr. Myrna Weissman, his collaborator and spouse. In reviewing the history of IPT, this chapter provides a broad overview of the components of the intervention, it’s adaptations for different clinical populations and settings and the research studies that have established IPT as an evidence-based psychological treatment for the past 50 years. Hence, this chapter is an excellent overview of the very detailed chapters that will follow in the book. The chapter ends with a discussion of future directions and challenges for disseminating IPT to wider clinical providers and populations in the upcoming decade.

This chapter provides a brief overview of empirical research supporting the efficacy and effectiveness of Interpersonal Psychotherapy (IPT). The chapter frames the discussion of IPT’s research base into three areas that may be most relevant to mental health providers and therapists: (1) Is IPT an effective psychological treatment for depression? (2) For which clients is IPT most effective?, and (3) What are the treatment mechanisms by which IPT produces symptom reduction and improves clients’ functioning? In this manner, the first question is addressed through the review of recent meta-analyses that focus on IPT alone or in relation to other evidence-based psychological interventions. The next question focuses on personalised approaches to matching clients with IPT based upon presenting problems or individual strengths. The last question addresses a deeper understanding of active treatment components in IPT that produce changes in clients’ symptoms and functioning and can be used to increase treatment effectiveness. The chapter concludes that IPT is an effective treatment for depression and more research is needed to advance our understanding of personalising treatment interventions for clients and how IPT produces changes in symptoms and interpersonal functioning.

IPT for eating disorders was initially adapted for Bulimia Nervosa and has since been applied to otherapplied to other eating disorders including Anorexia Nervosa and Binge Eating Disorder. In this chapter, we discuss the conceptual rationale of applying IPT to support individuals with eating disorders, focusing on a theoretical model by Rieger and colleagues positing that difficulties with interpersonal relationships and associated negative social evaluation trigger poor self-esteem and negative affect, which in turn precipitates eating disorder symptomatology. The main goal of IPT for eating disorders is to positive interpersonal interactions so that self-esteem and positive affect can be developed without dependence on eating disorder symptomology. In this chapter we provide an overview of the structure of treatment, and an outline of clinical adaptations made to the original treatment model, as well as the historical context for differences in IPT for eating disorders protocols. We also provide a clinical scenario to demonstrate some of the specific considerations and techniques to support the use of IPT with individuals experiencing an eating disorder. Finally, the chapter provides an overview of the research for using IPT-based applications for treating different eating disorder presentations and considerations for future research.

This chapter describes Frank and colleagues’ adaptation of IPT for bipolar disorder known as Interpersonal and Social Rhythm Therapy (IPSRT) and is guest authored by two prominent IPSRT experts, Drs Danielle Novick and Holly Swartz. In this chapter, they describe the rationale and adaptations made to the original treatment model to address aspects of mood dysregulation central to bipolar disorder. They describe aspects of working with clients to monitor and address social rhythms, such as maintaining consistent sleep–wake schedules, routine activity and engagement with social support networks, to stabilise their mood and prevent future episodes. Novick and Swartz also include a detailed case study with examples of the Social Rhythm Metric (SRM-II), a mood and activity monitoring checklist and the mood and illness timeline and conclude with a brief review of the research evidence supporting the efficacy of IPSRT for the treatment of bipolar disorder.

This chapter describes Interpersonal Psychotherapy (IPT) for adults with social and generalised anxiety and the rationale and adaptations made to the original IPT model to address anxiety symptoms within an interpersonal framework. Initially developed by Lipsitz and Markowitz, IPT for anxiety focuses largely on exploring the interpersonal contexts associated with clients’ anxiety and similarly to working within the focal/problem area of interpersonal sensitivities, encouraging clients’ use of strategies for increasing their engagement with others and expanding their social experiences. In addition to outlining the structure and focus of each phase of treatment, this chapter includes a detailed case study of applying the IPT model to treating an adult with social anxiety disorder. Lastly, this chapter summarises how the adaptation of IPT for social and generalised anxiety has been expanded upon by Markovitz and colleagues to treat post-traumatic stress disorders in adults.

Family-based interpersonal psychotherapy (FB-IPT) is a developmental adaptation of Interpersonal Psychotherapy for Depressed Adolescent (IPT-A) and an evidence-based psychological intervention for treating depression in preadolescent children between the ages of 8–12. This chapter describes the developmental issues related to early-onset depression in children 12 and younger, and the interpersonal risk and protective factors that contribute to depressive symptoms in preteens. This chapter outlines the structure and goals of the 14-session intervention, as well as the developmental adaptations in FB-IPT, including increasing the frequency of parent and parent–child meetings, expanding the limited sick role for parents and adding a set of Parent Tips, an increased focus on comorbid anxiety symptoms and adding visuals to the mood rating scale, communication analysis and decision analysis. A detailed case study utilising FB-IPT with a depressed preadolescent and parent demonstrates the real-life application of this psychological treatment and highlights common challenges in implementing FB-IPT. The chapter wraps up with a discussion of the clinical studies that have supported the development and preliminary efficacy of FB-IPT and suggestions for future directions and areas of dissemination.

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.

This chapter reviews the use of Interpersonal Depression (IPT) in treating perinatal depression or depression related to pregnancy or the birth of a child or other issues in the postpartum period. Written by guest author and experienced psychologist, Dr Lilian Wanless, this chapter describes the biological, psychological and social issues related to the adaptation to pregnancy, the experience and aftermath of labor and delivery and challenges of parenting a newborn. Although the original structure and clinical strategies in the original IPT model are retained, Wanless describes how particular aspects of IPT, most notably the focal/ problem area of Role Transitions, can be effectively employed to help reduce depression and increase adjustment of mothers in the perinatal period. Wanless provides a rich clinical case description, illustrating how therapist conduct IPT with women experiencing depression in the perinatal period. The chapter concludes with a review of the empirical base of research studies examining the efficacy and implementation of IPT and future directions for the dissemination of IPT for perinatal depression.

Interpersonal Psychotherapy (IPT) employs some clinical techniques and strategies overlapping with other psychological therapies, such as maintaining a therapeutic alliance and using open-ended questions, and some that are more unique to IPT. This chapter highlights both groups of techniques and how they align with the principles and structure of IPT. A fundamental principle of IPT is exploring the bidirectional link between mental health symptoms and interpersonal events. This is translated into specific techniques throughout all phases of IPT to draw attention to these connections. This is supported by a primary focus on affect in IPT, where it is the therapist’s role to track and explore a client’s emotional experience and their impact on the emotional experiences of others. In this chapter, we describe specific IPT techniques including the use of communication analysis, role play and decision analysis and their use within the middle phase of IPT. We consider how these techniques are used in parallel with a therapeutic stance that is active, curious and avoids ‘jargon’; alongside more generic therapeutic techniques including open-ended questions, clarification and the role of the therapeutic relationship.

The first developmental adaptation of IPT was Dr. Laura Mufson and colleagues’ Interpersonal Psychotherapy for Depressed Adolescents (IPT-A). This seminal adaptation retained the structure and focus of the adult model of IPT, while a range of clinical strategies the developmental competencies and interpersonal issues common with adolescents. This chapter describes the original model of IPT-A as specified by Mufson and colleagues but also includes its relationship to a growing body of knowledge of adolescent development, including the intersection between neurological development and interpersonal changes that take place during adolescence. A case study illustrates the use of IPT-A techniques across phases of treatment and identifies many of the practical considerations of implementing this treatment model, based on our real-world experience of using IPT-A and working clinically with adolescents. The chapter concludes with a summary of the most current research on the efficacy and effectiveness of IPT-A that has established this evidence-based treatment as an enduring and thriving adaptation of IPT.

The theoretical orientation of Interpersonal Psychotherapy (IPT) focuses on the contribution of an individual’s interpersonal and social context to the development and maintenance of mental health difficulties. We describe a selection of contemporary theories that underpin IPT, attachment theory, mentalisation and contemporary interpersonal theory. Attachment theory examines the early interpersonal experiences between a parent and young child that build internal working models of relationships that influence many of the interpersonal issues examined in a course of IPT. Mentalisation is founded in attachment theory and has been referred to as the capacity to cognitively represent or imagine others’ needs, desires, feelings, beliefs, goals and purposes to interpret human behaviour. The capacity to mentalise is thought to develop through attachment relationships but is able to increased through self-awareness and curiosity about others’ mental states. IPT may improve depression by increasing a client’s ability to mentalise in their interpersonal interactions. inally, Interpersonal Communication theory extends our understanding of ‘here and now’ communication in dyadic interpersonal relationships. We go on to consider how specific IPT techniques may provide the structure and experience for a client to break down these cycles of communication with others.

Brief IPT (IPT-B) is an abbreviated version of IPT and is designed to deliver an effective course of IPT in eight sessions. The overall structure of IPT is preserved, but therapists deliver a full course of psychotherapy in fewer sessions. The initial phase of IPT is reduced from three to two sessions, and only a single session is allotted for the ending phase. Thus, 8-session IPT-B has a defined beginning, middle and end but proceeds more rapidly than a standard course of IPT. In the United States, IPT-B was developed to meet the needs of non-treatment seeking populations unable to participate in a full course of IPT, including depressed mothers of psychiatrically ill children and depressed pregnant women on low incomes. In Scotland, IPT-B was developed for deployment in clinical settings such as primary care. Emerging clinical applications of IPT-B include its use in general psychiatric samples and delivery via telehealth. We also describe the structure and components of IPT-B including changes made to the standard IPT model to shorten its duration. We summarise empirical evidence supporting the efficacy of IPT-B and provide a case vignette to illustrate the application of IPT-B in the real world.

With its focus on role transitions, grief, interpersonal disputes and loneliness, IPT is a relevant psychological treatment modality for older adults who present with depression and common situations that arise with the ageing process. In its application with older adults, the IPT treatment model is retained without any significant changes to the original protocol but significant and important contextual issues must be understood and examined by the practicing therapist. This chapter outlines general issues pertaining to ageing that factor into the assessment task for the Initial Phase of IPT, inform the choice of a focal/problem area in the Middle Phase and guide the implementation of IPT skills and strategies with older adults. Importantly, research has shown that IPT can be easily and successfully applied to depressed older people to alleviate their depressive symptoms and contribute to improved interpersonal functioning and quality of life.

The key techniques and strategies used during the initial phase of IPT to assess and develop an interpersonal formulation are described. IPT uses a timeline and an interpersonal inventory to expand the assessment of a client’s interpersonal events before, during and after the onset of the current episode of depression and identifies both the stressors and resources in a person’s interpersonal network. Assessment is described as a process that builds the therapeutic relationship through exploration, collaboration and compassionate understanding. As a result, sharing and co-constructing the interpersonal formulation can be powerful for clients, as many experience being truly heard and understood. This supports the development of a robust therapeutic platform, creating treatment goals and contracting for middle phase IPT work where clients actively bring in content aligned with the formulation and focus/problem area. In IPT, the assessment and development of an interpersonal formulation are essential elements whereby there is a shared understanding of a client’s difficulties through examination of their interpersonal relationships, social context and emotional experiences. The formulation in IPT acts as a map for the therapeutic process and guides the interventions to enable a specific targeting of interpersonal issues designed to alleviate emotional distress.

An evaluation of existing treatment practices for depression shows that they do not represent effective ways of treating this disorder. For instance, there is no definitive epidemiological evidence that antidepressants would be beneficial as a depression treatment. Moreover, antidepressants can have many side effects. The so-called monoamine hypothesis – according to which depression is caused by a lack of serotonin or other neurotransmitters in the brain – is outdated. Psychotherapy is only marginally more effective than placebo treatments, and this difference is below cut-offs for clinical significance. As there are different subtypes and underlying causes of depression, the same treatment is not expected to work for every patient. Classifying depression into subtypes based on evolutionary psychiatry is a novel approach – so novel that the effectiveness of specific treatments for all different subtypes of depression has not yet been tested. This chapter summarizes current knowledge on possible subtype-specific treatments for depression. Grounded in an evolutionary psychoneuroimmunological framework, the chapter emphasizes the importance of identifying the triggers, functions, and biological pathways underlying each depressive episode. By aligning treatment strategies with individual etiology and pathogenesis, this approach aims to improve treatment outcomes, reduce chronicity, and move toward more precise and intelligent depression interventions.