Interpersonal Psychotherapy for Adolescents

A Clinician’s Guide

Robert McAlpine, Anthony Hillin

• Publisher: Routledge
• Year: 2020
• Print ISBN: 9781482227178
• eBook ISBN: 9781000284614
• Topic: Medicine
• Subtopic: Nursing

Interpersonal psychotherapy for adolescents (IPT-A) is a comprehensive guide for clinicians. It will enable readers to add IPT-A to their clinical repertoire or to deepen their existing practice of IPT-A, using a time-limited, evidence-based intervention that is engaging for young people.

The guide outlines the structure, skills, and techniques of IPT-A, utilising real-life encounters in the therapy room that reflect the diverse nature of adolescents and young adults who present for therapy. It provides the reader with a bird's-eye view of how IPT-A works. It expands the range of IPT-A clinical tools, techniques, and models to assist the reader to work effectively with a wide range of clients. The book provides a new protocol for the psychological assessment of young people, acknowledging the importance of culture and spirituality alongside the biological, psychological, and social dimensions that have previously comprised assessment. The importance of the clinician forming a transitory attachment relationship with the client is emphasised throughout.

The target audience for this book is mental health clinicians, including psychologists, psychiatrists, social workers, mental health nurses, occupational therapists, general practitioners with a mental health focus, and students from these professions.

Part I

Introduction

1 Introduction and orientation to this guide

Contents

Welcome and introduction

Aims for the book

The authors

The target audience and how to use this book

Introducing the case studies

Locating IPT-A within a stepped care approach

Personalised treatment

Terminology

Overview of IPT-A

Assessment and formulation

The Initial Phase of IPT-A

The Middle Phase of IPT-A

The Consolidation Phase of IPT-A

Summary

References

Welcome and introduction

Welcome to Interpersonal Psychotherapy for Adolescents—A Clinician’s Guide. This introduction provides a brief overview of the content and layout of this book and offers some suggestions on how it can be used.

Interpersonal Psychotherapy for Adolescents (IPT-A) is an evidence-based intervention that is intrinsically engaging for young people and is generally straightforward for clinicians to learn. It teaches things about which young people are interested to learn: about themselves, relationships, emotions, and how to communicate effectively. It also teaches young people about their distress and symptoms and the connection between these and interpersonal issues. IPT-A develops interpersonal competencies that many young people are keen to acquire.

One of the key messages of IPT-A is that if clients can communicate their needs for closeness and support to others effectively, the likelihood of their attachment needs being met will increase. This is a revolutionary concept for some young people, especially those with a limited sense of their own ability to create the type of relationships they want. It will be life changing for many to discover ways that they may be able to proactively create and orchestrate the nature of their relationships and the quality of support available to them. IPT-A not only encourages this hopeful view of the possibility for successful relationships, it also teaches the required skills and provides the necessary support for young people to integrate these competencies in their important relationships.

Aims for the book

This book builds on the work of Mufson and others (Mufson et al., 1993, 2004), who initially developed IPT-A. The intervention is still relatively new, and clinical work subsequent to the publication of the original manuals provides the practice-based evidence to balance and enhance the evidence-based practice outlined in the research. (See Pu et al., 2017, for example, for a review of this research.)

This Clinician’s Guide aims to enhance the engaging nature of IPT-A to make this treatment even more accessible to a broad range of young people from early adolescence to early adulthood. There are several major new additions to IPT-A provided in this book:

1 We extend the biopsychosocial model to include the role of cultural and spiritual dimensions in assessment and treatment in IPT-A. These domains of experience can have a far-reaching effect on the interpersonal world of young people but are often overlooked in clinical practice (e.g., Proctor, 2011).

2 We demonstrate the assessment of attachment behaviours and how to adapt IPT-A to address the adolescent’s attachment style. A central aim of IPT-A is to improve interpersonal functioning by enhancing communication skills in significant relationships. Another way of stating this is “to assist clients to meet their attachment needs more effectively”. In addition, a sound understanding of attachment can greatly assist therapists to avoid colluding with the client’s dysfunctional and habitual ways of interacting that are interrupting their relationships and thus contributing to psychological distress and symptoms.

3 We expand the use of IPT-A to include young adults. The previous IPT-A literature focussed on 12- to 18-year-olds. Some young adults are better accommodated within an adolescent assessment and treatment framework for a number of reasons. The boundary between adolescence and young adulthood is somewhat arbitrary. The timing and particular dynamics of development and maturity play out in different ways, depending on a range of individual and external factors. For an increasing number of young people, independence, economic self-sufficiency and leaving their parent’s home is delayed well into the third decade of life. In many parts of the world, it is not uncommon for people in their twenties to continue to deal with life circumstances that were once associated predominantly with the second decade of life. For some of these young people, the accompanying developmental dynamics and the impact on their relationships continue well beyond 18 years.
For these reasons, and to ensure better continuity of care, some mental health services have moved away from a model of separate adolescent and adult services, which requires the transfer of cases at 18 years, to a youth mental health service model that provides care for an age range of 12 to 25.

4 We include the key roles of Continuation and Maintenance as core components of therapy included in a revised third phase of treatment, the Consolidation Phase. An important characteristic of IPT-A is its time-limited nature. It may not be appropriate, however, to terminate treatment for some young people solely because a prescribed number of sessions has been reached.

5 We substantially expand the range of IPT-A clinical tools and techniques. The techniques are integrated throughout the book, and the clinical tools are found throughout the book.

The authors

Rob and Anthony came to IPT-A with many years’ experience using other approaches to working with young people and adults. Our work in school settings, public mental health services, and private practice has encompassed a wide range of populations who are often reluctant to seek help from mental health services and who experience elevated risk of suicide, depression, or other adverse outcomes. This has included young people who are Indigenous, culturally and linguistically diverse, LGBTQIA,¹ homeless or living in out-of-home care, and those involved in the criminal justice system.

The challenge of making therapy accessible and engaging for a diverse range of young people has been central in our work. Our conviction in the value of IPT-A for a wide range of young people has been further reinforced by our work in different corners of the globe: Australasia, Europe, and USA. This has driven our desire to disseminate this developmentally engaging intervention.

The target audience and how to use this book

This book has been written for mental health clinicians, including psychologists, social workers, psychiatrists, mental health nurses, occupational therapists, psychotherapists, counsellors, general practitioners with a mental health focus, and students of these professions. It will also be useful for people who provide training and clinical supervision for these clinicians.

Some readers will want to work their way through each chapter. The book is also presented in a way that will enable the reader to dip into sections that may be of particular interest—for instance, when you want to prepare for a next session with a client. The contents are listed at the beginning of each chapter, together with subheadings and cross-referencing, to make it easy to locate particular information.

Introducing the case studies

Throughout the book, a suite of maj...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• List of clinical tools
• List of figures
• Acknowledgements
• Foreword
• Part I: Introduction
• Part II: The Initial Phase of IPT-A
• Part III: The Middle Phase of IPT-A
• Part IV: Consolidation Phase of IPT-A
• Part V: Closing thoughts
• Index