Klerman interpersonal therapy: what it is and how it works

Klerman’s interpersonal therapy it is a therapeutic procedure which, although initially intended for depression, has been shown to be effective for several disorders.

His approach is mainly interpersonal, focused on relationships with patients. Let’s take a closer look at how he manages to improve people’s well-being and what current he can relate to.

    What is Klerman interpersonal therapy?

    Klerman Interpersonal Therapy is a brief treatment, originally designed to treat depression, which focuses on the psychosocial and interpersonal issues of the patient seeking treatment, taking aspects of the medical model. This therapy was developed in 1969 at Yale University by Gerald Klerman and Myrna Weissman, who were conducting a study on the effectiveness of antidepressants in patients depending on whether or not they were receiving psychological and pharmacological treatment.

    Interpersonal therapy, as the name suggests, focuses on analyze the relationship between the patient’s pathology and the psychosocial context in which he livesIn other words, how you relate to others. This treatment gives more importance to the way the patient lives in the present than to focusing on his past, without ignoring it. It takes into account how the social environment acts as a support and recovery network for the patient.

    Being a therapy based on the medical model, adapting to the field of clinical psychology, it makes it possible to combine with the psychopharmacological approach to disorders, in particular major depression. It is also indicated for patients who have not received any treatment before.

    psychological approach

    The approach behind this therapy is eclectic, that is, it is based on postulates of various currents., Such as psychoanalysis, cognitive behavioral therapy and humanism, not fully encompassed in any of them. It must also be said that being a pluralist approach, part of which is also applicable in countless socio-economic and cultural contexts.

    It takes psychoanalytic aspects of the interpersonal theory of Stack Sullivan, as well as aspects of the tilt theory of Bowlby, who was also a psychoanalyst. Tilt theory provides an understanding of the patient’s relationship issues, taking into account their affection style formed in childhood and how this affects them in their daily functioning.

    Despite all these points, Klerman’s interpersonal therapy moves away from psychoanalytic theories of personality, and he does not intend to formulate one that links the patient’s personality traits to his symptomatology. It also does not seek, and related to cognitive behavioral therapy, to tackle negative thought patterns, false attributions and cognitive distortions.

    The goal of Klerman’s interpersonal therapy is to improve the patient’s communication skills, both interpersonal and intrapersonal, and develop a social support network with realistic expectations of how the patient will cope with the distress.

      Treat disorders

      During the process, the therapist takes an active role, full of hope and support, but which is not neutral. Disorders are treated at the following three levels.

      • symptoms
      • Social and interpersonal relationships of the patient
      • explicit conflicts

      It should be noted that this is primarily intended for people who suffer from a depressive disorder more than any other type, although adaptations to Klerman interpersonal therapy allow this method to be adapted to other diagnostic labels.

      In therapy, they work with certain cognitions of the patient, but not with the intention of completely extinguishing. This aspect is also not treated in a structured way, i.e. no detailed protocols or self-registration are used as homework. Although some behavioral techniques can be added, such as routine desensitization or exposure therapy, they are not typically used.

      As for the person’s life, Klerman’s interpersonal therapy it focuses on four areas that may be at the root of their relationship problems:

      • Duel after losing a loved one.
      • Conflicts in meaningful relationships, including relationships with oneself.
      • Difficulties adapting to changes in life.
      • Difficulties breaking out of social isolation.

      Thus, once the main difficulties of the patient related to his psychological problems have been detected, it is possible to encourage the development of social and communicative skills.

      Duration and phases of treatment

      As already mentioned, Klerman interpersonal therapy is brief treatment, that is, it means that the therapeutic process takes place in a small number of sessions. This type of treatment involves a high degree of structuring sessions, which are meant to be performed on average between 12 and 16 weeks, and typically last around 40 to 50 minutes. These sessions are conducted individually.

      Therapy is generally developed by following the following three phases.

      1. Initial or diagnostic phase

      It is consistent with the first three therapy sessions, during which the patient explains his symptoms and social problems which may or may not be the triggering and sustaining factor of these problems.

      The therapist makes an intermediate diagnosis, which will allow him to focus on the course of therapy and see what needs to be done to improve the patient’s well-being.

      2. Intermediate or targeted phase

      It goes from the fourth to the tenth session. During this period, the therapist it takes a more in-depth look at the problems the patient suffers from.

      It is at this stage that the therapist assesses the need to subject the patient to pharmacological treatment, in addition to evaluating the response he gives in relation to the psychological treatment applied to him.

      3. Last phase or final phase

      These are sessions 11 and 12, or more in case the treatment is stretched a bit. It mainly consists of educate the patient to maintain the improvement achieved during treatment.

      clinical applications

      Klerman’s interpersonal therapy it has been shown to be particularly effective for what was originally developed: depression. It has since been modified for use in other mental disorders, such as addiction or eating disorders.

      It should be noted that, although mainly in the clinic, this therapy is used with the intention of being brief, no more than 16 weeks, sometimes it is chosen to apply it as a maintenance treatment as they have recurring depression.

      Regardless, this therapy has been shown to be effective in several psychological disorders, apart from major depression:

      • Bulimia nervosa.
      • Bipolar disorder.
      • Postpartum depression.
      • Cyclothymia.

      It is worth noting that although it was originally designed to be applied to adults, adaptations have been made for the elderly and adolescents. Applied to children, it assumes that disorders such as depression arise in contexts in which the child has a dysfunctional relationship with referral adults or caregivers.

      Bibliographical references:

      • Heerlein, A. (2002). Interpersonal psychotherapy in the treatment of major depression. Chilean Journal of Neuro-Psychiatry, 40 (1), PP. 63-76.

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