title: Failures in interpersonal psychotherapy (IPT): factors related to treatment resistances.
abstract: Interpersonal psychotherapy (IPT) is an effective treatment for depression across the lifespan and across cultures. However, even when delivered with fidelity, some patients drop out and others do not improve sufficiently. Attention to IPT treatment attrition, dropout, nonresponse, or failure can elucidate its limitations and the opportunities to improve its effectiveness. Studies of factors known to moderate and negatively predict IPT depression treatment response are reviewed along with recommended modifications to improve outcomes. Although the risk of treatment failure always exists, it is possible to enhance treatment effectiveness by attending to the therapeutic alliance, strategically addressing depression, and adapting IPT to patient characteristics. These include adding pharmacotherapy, extending the course of treatment, and targeting specific symptoms or interpersonal vulnerabilities. Case examples illustrate several of these points.
authors.affiliation: University of Toronto, Joseph and Wolf Lebovic Health Complex, Mt. Sinai Hospital, Department of Psychiatry, 600 University Avenue, room 930, Toronto, Canada. pravitz@mtsinai.on.ca
authors.forename: Paula
authors.initials: P
authors.lastname: Ravitz
authors.forename: Carolina
authors.initials: C
authors.lastname: McBride
authors.forename: Robert
authors.initials: R
authors.lastname: Maunder
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D002605:Character; D003131:Combined Modality Therapy; D003142:Communication; D015897:Comorbidity; D003431:Cross-Cultural Comparison; D003674:Defense Mechanisms; D003866:Depressive Disorder / Q000208:ethnology / Q000523:psychology / Q000628:therapy*; D005006:Ethnicity / Q000523:psychology; D005260:Female; D006679:HIV Seropositivity / Q000208:ethnology / Q000523:psychology; D006801:Humans; D007398:Interpersonal Relations; D008016:Life Change Events; D008223:Lymphoma / Q000523:psychology; D008297:Male; D009769:Object Attachment; D011369:Professional-Patient Relations; D013811:Psychotherapeutic Processes; D011613:Psychotherapy / Q000379:methods*; D012944:Social Support; D017211:Treatment Failure
chemical_list: D000928:Antidepressive Agents