title: National dissemination of interpersonal psychotherapy for depression in veterans: therapist and patient-level outcomes.
abstract: OBJECTIVE
  To evaluate the effects of training in and delivery of interpersonal psychotherapy (IPT) for depression throughout the U.S. Department of Veterans Affairs health care system on therapists' competency and patients' clinical outcomes.
  
  
  METHODS
  Participants included 124 therapists and 241 veteran patients. Therapists participated in a 3-day workshop followed by 6 months of weekly group consultation. Therapy session tapes were rated by expert IPT training consultants using a standardized competency rating form. Patient outcomes were assessed with the Beck Depression Inventory-II and the World Health Organization Quality of Life-BREF. Therapeutic alliance was assessed with the Working Alliance Inventory-Short Revised.
  
  
  RESULTS
  Of the 124 therapists receiving IPT training, 115 (93%) completed all training requirements. Therapist competence in IPT increased from their 1st patient to their 2nd for both initial (d = 0.36) and intermediate (d = 0.24) treatment phases. Of the 241 veteran patients treated with IPT, 167 (69%) completed ≥ 12 sessions. Intent-to-treat analyses indicated large overall reductions in depression (d = 1.26) and significant improvements in quality of life (d = 0.57 to 0.86) and the therapeutic alliance (d = 0.50 to 0.83).
  
  
  CONCLUSIONS
  National IPT training in the VA health care system was associated with significant increases in therapist competencies to deliver IPT, as well as large overall reductions in depression and improvements in quality of life among veterans, many of whom presented with high levels of depression. RESULTS support the feasibility and effectiveness of broad dissemination of IPT in routine clinical settings.
authors.affiliation: U.S. Department of Veterans Affairs Central Office.
authors.forename: Michael O
authors.initials: MO
authors.lastname: Stewart
authors.affiliation: U.S. Department of Veterans Affairs Central Office.
authors.forename: Susan D
authors.initials: SD
authors.lastname: Raffa
authors.affiliation: U.S. Department of Veterans Affairs Central Office.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Steele
authors.affiliation: U.S. Department of Veterans Affairs Central Office.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Miller
authors.affiliation: School of Social Work, Columbia University.
authors.forename: Kathleen F
authors.initials: KF
authors.lastname: Clougherty
authors.affiliation: Icahn School of Medicine at Mount Sinai.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Hinrichsen
authors.affiliation: U.S. Department of Veterans Affairs Central Office.
authors.forename: Bradley E
authors.initials: BE
authors.lastname: Karlin
mesh_terms: D000328:Adult; D000368:Aged; D003299:Cooperative Behavior; D003863:Depression / Q000628:therapy*; D003865:Major Depressive Disorder / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D011788:Quality of Life; D016896:Treatment Outcome; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data*