Recognizing that subthreshold symptoms for major depression impeded recovery of hospitalized elderly patients, Mossey et al. (1996) conducted a trial using a modification of
IPT called interpersonal counseling (IPC) (Klerman et al., 1987). Nonpsychiatric nurses treated geriatric, medically hospitalized patients with minor depressive symptoms for 10 1-hour sessions flexibly scheduled to accommodate the patient's medical status. Seventy-six hospitalized patients over age 60 who had subsyndromal depressive symptoms on two consecutive assessments were randomly assigned to either IPC or usual care (UC). A euthymic, untreated control group was also followed. Patients found IPC feasible and tolerable. Three-month assessment showed nonsignificantly greater improvement in depressive symptoms and on all outcome variables for IPC relative to UC, whereas controls showed mild symptomatic worsening. In the IPC and euthymic control groups, rates of rehospitalization were similar (11-15%), and significantly less than the subsyndromally depressed group receiving UC (50%). Differences between IPC and UC became statistically significant after 6 months on depressive symptoms and self-rated health, but not physical or social functioning. The investigators felt 10 sessions were not enough for some patients, and that maintenance IPC might have been useful.
The success of IPT in treating unipolar mood disorders has led to its expansion to treat other psychiatric disorders. Frank and colleagues in Pittsburgh have been assessing a behaviorally modified version of IPT as a treatment adjunctive to pharmacotherapy for bipolar disorder. They report on this adaptation elsewhere in this volume (Chapter 15) (Frank, 1991b; Frank et al., 1999; 2000a;b).
Furthermore, IPT is increasingly being applied to a range of nonmood disorders. There are intriguing applications of IPT as treatment for bulimia (Agras et al., 2000; Fairburn et al., 1993; Wilfley et al.,1993; 2000) and anorexia nervosa, social phobia (Lipsitz et al., 1999), post-traumatic stress disorder, and other conditions. Life events, the substrate of IPT, are ubiquitous, but how useful it is to focus on them may vary from disorder to disorder. There have been two negative trials of IPT for substance disorders (Carroll et al., 1991; Rounsaville et al., 1983), and it seems unlikely that an outwardly focused treatment such as IPT would be useful for such an internally focused diagnosis as obsessive compulsive disorder. In the continuing IPT tradition, clinical outcome research should clarify the question of its utility. IPT is also being modified for use in other formats—for example, as group therapy (Klier et al., 2001; Wilfley et al. 1993,2000; Zlotnick et al., 2001) and as a telephone intervention. Weissman (1995) developed an IPT patient guide with worksheets for depressed readers that may be used in conjunction with IPT.
In summary, IPT is one of the best tested psychotherapies, particularly for mood disorders, where it has demonstrated efficacy as both an acute and maintenance monotherapy and as a component of combined treatment for major depressive disorder. It appears to have utility for other mood and nonmood syndromes, although evidence for most of these is sparser. Monotherapy with either IPT or pharmacotherapy is likely to treat successfully most patients with major depression, so combined treatment should probably be reserved for more severely or chronically ill patients (Rush & Thase, 1999). How best to combine time-limited psychotherapy with pharmacotherapy is an exciting area for future research: when is it indicated, in what sequence, and for which patients?
Comparative trials have begun to reveal moderating factors that predict treatment outcome. The NIMH TIDCRP, which compared IPT and CBT, suggested factors that might predict better outcome with either IPT or CBT. Sotsky and colleagues (1991) found that depressed patients with low baseline social dysfunction responded well to IPT, whereas those with severe social deficits (probably equivalent to the "interpersonal deficits" problem area) responded less well. Greater symptom severity and difficulty in concentrating responded poorly to CBT. Initial severity of major depression and of impaired functioning responded best in that study to IPT and to imipramine. Imipramine worked most efficaciously for patients with difficulty in functioning at work, reflecting its faster onset of action. Patients with atypical depression responded better to IPT or CBT than to imipramine or placebo (Shea et al., 1999).
Barber and Muenz (1996), in a study of the TDCRP completers, found IPT more efficacious than CBT for patients with obsessive personality disorder, whereas CBT fared better for avoidant personality disorder. This finding did not hold for the intent-to-treat sample. Biological factors, such as abnormal sleep profiles on EEG, predicted significantly poorer response to IPT than for patients with normal sleep parameters (Thase et al., 1997). Frank and colleagues (1991) found that psychotherapist adherence to a focused IPT approach may enhance outcome. Moreover, sleep EEG and adherence, the first a biological and the latter a psychotherapy factor, had additive effects in that study. Replication and further elaboration of these predictive factors deserve ongoing study.
Another exciting development is the use of neuroimaging studies to compare IPT and pharmacotherapy outcomes. In Sunderland, Martin et al. (2001), using SPECT, found that IPT and venlafaxine had overlapping but also differing effects on right posterior cingulate (IPT), right posterior temporal (venlafaxine), and right basal ganglia activation (both treatments). Brody et al. (2001) in Los Angeles reported slightly different but roughly analogous findings with positron-emission tomography (PET) scanning of patients treated with IPT and paroxetine.
Until very recently, IPT therapy was delivered almost entirely by research study therapists. As the research base of IPT has grown and it has become included in treatment guidelines, there has been a growing clinical demand for this empirically supported treatment. IPT training is now increasingly included in professional workshops and conferences, with training courses conducted at university centers in the UK, Canada, Continental Europe, Asia, New Zealand, and Australia, in addition to the USA. IPT is taught in a still small but growing number of psychiatric residency training programs in the USA (Markowitz, 1995) and has been included in family-practice and primary-care training. It was not, however, included in a recent mandate for psychotherapy proficiency of US psychiatric residency programs.
The principles and practice of IPT are straightforward. Yet, any psychotherapy requires innate therapeutic ability, and IPT training requires more than reading the manual (Rounsaville et al., 1988; Weissman et al., 1982). Therapists learn psychotherapy by practicing it. IPT training programs generally are designed to help already experienced therapists refocus their treatment by learning new techniques, not to teach novices psychotherapy. This makes sense, given its development as a focal research therapy: IPT has never been intended as a universal treatment for all patients, a conceptualization of psychotherapy that in any case seems naively grandiose in the modern era.
IPT candidates should have a graduate clinical degree (M.D., Ph.D., M.S.W., or R.N.), several years of experience conducting psychotherapy, and clinical familiarity with the diagnosis of patients they plan to treat. The training developed for the TDCRP (Elkin et al., 1989) became the model for subsequent research studies. It included a brief didactic program, review of the manual, and a longer practicum in which the therapist treated two to three patients under close supervision and monitored by videotapes of the sessions (Chevron & Rounsaville, 1983). Rounsaville et al. (1986) found that psychotherapists who successfully conducted an initial supervised IPT case often did not require further intensive supervision, and that experienced therapists committed to the approach required less supervision than others (Rounsaville et al., 1988). Some clinicians have taught themselves IPT with the IPT manual (Klerman et al., 1984) and peer supervision to guide them. For research certification, we recommend at least two or three successfully treated cases with hour for hour supervision of taped sessions (Markowitz, 2001).
There has been no formal certificate for IPT proficiency and no accrediting board. When the practice of IPT was restricted to a few research settings, this was not a problem, as one research group taught another in the manner described above. As IPT spreads into clinical practice, issues arise about standards for clinical training, and questions of competence and accreditation gain greater urgency. Training programs in IPT are still not widely available, as a recent US Surgeon General's report noted (Satcher, 1999). Many psychiatry residency and psychology training programs still focus exclusively on long-term psychodynamic psychotherapy or on CBT. In these programs, too, the lack of exposure to time-limited treatment has been noted (Sanderson & Woody, 1995).
The educational process for IPT in clinical practice requires further study. We do not know, for example, what levels of education and experience are required to learn IPT, or how much supervision an already experienced psychotherapist is likely to require. The International Society for Interpersonal Psychotherapy is currently debating how best to set standards for clinical practice of IPT, which doubtless varies from country to country. The UK is in better shape than most: IPT therapists in Britain have agreed on standards for clinical training and practice that are essentially equivalent to those for researchers. These rigorous standards should ensure high-quality IPT in the UK.
Agras, W.S., Walsh, B.T., Fairburn, C.G., Wilson, G.T. & Kraemer, H.C. (2000). A multicenter comparison of cognitive-behavioral therapy and interpersonal psychotherapy for bulimia nervosa. Arch Gen Psychiatry, 57, 459-466.
American Psychiatric Association (APA). (1994). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), 4th edn. Washington, DC: American Psychiatric Association.
Barber, J.P. & Muenz, L.R. (1996). The role of avoidance and obsessiveness in matching patients to cognitive and interpersonal psychotherapy: Empirical findings from the Treatment for Depression Collaborative Research Program. J Consult Clin Psychol, 64, 951-958.
Beck, A.T. (1978). Depression Inventory. Philadelphia: Center for Cognitive Therapy.
Blom, M.B.J., Hoencamp, E. & Zwaan , T. (1996). Interpersoonlijke psychotherapie voor depressie: Een pilot-onderzoek. Tijdschr voor Psychiatr, 38, 398-402.
Brody, A.L., Saxena, S., Stoessel, P., et al. (2001). Regional brain metabolic changes in patients with major depression treated with either paroxetine or interpersonal therapy: Preliminary findings. Arch Gen Psychiatry, 58, 631-640.
Brown, C., Schulberg, H.C., Madonia, M.J., Shear, M.K. & Houck, P.R. (1996). Treatment outcomes for primary care patients with major depression and lifetime anxiety disorders. Am J Psychiatry, 153, 1293-1300.
Browne, G., Steiner, M., Roberts, J., et al. (2002). Sertraline and/or interpersonal psychotherapy for patients with dysthymic disorder in primary care: 6-month comparison with longitudinal 2-year follow-up of effectiveness and costs. J. Affect Disord, 68, 317-330.
Carroll, K.M., Rounsaville, B.J. & Gawin, F.H. (1991). A comparative trial of psychotherapies for ambulatory cocaine abusers: Relapse prevention and interpersonal psychotherapy. Am J Drug Alcohol Abuse, 17, 229-247.
Chevron, E.S. & Rounsavillle, B.J. (1983). Evaluating the clinical skills of psychotherapists: A comparison of techniques. Arch Gen Psychiatry, 40, 1129-1132.
DiMascio, A., Weissman, M.M., Prusoff, B.A., Neu, C., Zwilling, M. & Klerman, G.L. (1979). Differential symptom reduction by drugs and psychotherapy in acute depression. Arch Gen Psychiatry, 36, 1450-1456.
Elkin, I., Shea, M.T., Watkins, J.T., et al. (1989). National Institute of Mental Health Treatment of Depression Collaborative Research Program: General effectiveness of treatments. Arch Gen Psychiatry, 46, 971-982.
Fairburn, C.G., Jones, R., Peveler, R.C., Hope, R.A. & O'Connor, M. (1993). Psychotherapy and bulimia nervosa: Longer-term effects of interpersonal psychotherapy, behavior therapy, and cognitive behavior therapy. Arch Gen Psychiatry, 50, 419-428.
Feijo de Mello, M., Myczowisk, L.M. & Menezes, P.R. (2001). A randomized controlled trial comparing moclobemide and moclobemide plus interpersonalpsychotherapy in the treatment of dysthymic disorder. J Psychother Prac Res, 10, 117-123.
Foley, S.H., Rounsaville, B.J., Weissman, M.M., Sholomskas, D. & Chevron, E. (1989). Individual versus conjoint interpersonal psychotherapy for depressed patients with marital disputes. Int J Fam Psychiatry, 10, 29-42.
Frank, E. (1991a). Interpersonal psychotherapy as a maintenance treatment for patients with recurrent depression. Psychotherapy, 28, 259-266.
Frank, E. (1991b). Biological order and bipolar disorder. Presented at the meeting of the American Psychosomatic Society, Santa Fe, NM, March.
Frank, E., Kupfer, D.J., Perel, J.M., et al. (1990). Three-year outcomes for maintenance therapies in recurrent depression. Arch Gen Psychiatry, 47, 1093-1099.
Frank, E. Kupfer, D.J., Wagner, E.F., McEachran, A.B. & Cornes, C. (1991). Efficacy of interpersonal psychotherapy as a maintenance treatment of recurrent depression. Arch Gen Psychiatry, 48, 1053-1059.
Frank, E., Shear, M.K., Rucci, P., et al. (2000a). Influence of panic-agoraphobic spectrum symptoms on treatment response in patients with recurrent major depression. Am J Psychiatry, 157, 11011107.
Frank, E., Swartz, H.A., Mallinger, A.G., Thase, M.E., Weaver, E.V. & Kupfer, D.J. (1999). Adjunctive psychotherapy for bipolar disorder: Effects of changing treatment modality. J Abnorm Psychol, 108, 579-587.
Frank, E., Swartz, H.A. & Kupfer, D.J. (2000b). Interpersonal and social rhythm therapy: Managing the chaos of bipolar disorder. Biol Psychiatry, 48, 593-604.
Frank, J. (1971). Therapeutic factors in psychotherapy. Am J Psychotherapy, 25, 350-361.
Gurman, A.S. & Kniskern, D.P. (1978). Research on marital and family therapy: Progress, perspective, and prospect. In S.B. Garfield & A.B. Bergen (Eds), Handbook of Psychotherapy and Behavior Change (pp. 817-902). New York: Wiley.
Hamilton, M. (1960). A rating scale for depression. J Neurol Neurosurg Psychiatry, 25, 56-62.
Hirschfeld, R.M.A., Klerman, G.L., Clayton, P.J., et al. (1983). Assessing personality: Effects of the depressive state on trait measurement. Am J Psychiatry, 140, 695-699.
Klein, D.F. & Ross, D.C. (1993). Reanalysis of the National Institute of Mental Health Treatment of Depression Collaborative Research Program general effectiveness report. Neuropsychopharma-cology, 8, 241-251.
Klerman, G.L., Budman, S., Berwick, D., et al. (1987). Efficacy of a brief psychosocial intervention for symptoms of stress and distress among patients in primary care. Med Care, 25, 1078-1088.
Klerman, G.L., DiMascio, A., Weissman, M.M., Prusoff, B.A. & Paykel, E.S. (1974). Treatment of depression by drugs and psychotherapy. Am J Psychiatry, 131, 186-191.
Klerman, G.L. & Weissman, M.M. (1993). New Applications of Interpersonal Psychotherapy.
Washington, DC: American Psychiatric Press.
Klerman, G.L., Weissman, M.M. Rounsaville, B.J. & Chevron, E.S. (1984). Interpersonal Psychotherapy of Depression. New York: Basic Books.
Klier, C.M., Muzik, M., Rosenblum, K.L. & Lenz, G. (2001). Interpersonal psychotherapy adapted for the group setting in the treatment of postpartum depression. J Psychother Prac Res, 10, 124-131.
Kocsis, J.H., Frances, A.J., Voss, C., Mann, J.J., Mason, B.J. & Sweeney, J. (1988). Imipramine treatment for chronic depression. Arch Gen Psychiatry, 45, 253-257.
Lipsitz, J.D., Fyer, A.J., Markowitz, J.C. & Cherry, S. (1999). An open trial of interpersonal psychotherapy for social phobia. Am J Psychiatry, 156, 1814-1816.
Markowitz, J.C. (1994). Psychotherapy of dysthymia. Am J Psychiatry, 151, 1114-1121.
Markowitz, J.C. (1995). Teaching interpersonal psychotherapy to psychiatric residents. Acad Psychiatry, 19, 167-173.
Markowitz, J.C. (1998). Interpersonal Psychotherapy for Dysthymic Disorder. Washington, DC: American Psychiatric Press.
Markowitz, J.C. (2001). Learning the new psychotherapies. In M.M. Weissman (Ed.), Treatment of Depression: Bridging the 21st Century (pp. 281-300). Washington, DC: American Psychiatric Press.
Markowitz, J.C. & Swartz, H.A. (1997). Case formulation in interpersonal psychotherapy of depression. In T.D. Eels (Ed.), Handbook of Psychotherapy Case Formulation (pp. 192-222). New York: Guilford.
Markowitz, J.C., Klerman, G.L., Perry, S.W., Clougherty, K.F. & Mayers, A. (1992). Interpersonal therapy of depressed HIV-seropositive patients. Hosp Comm Psychiatry, 43, 885-890.
Markowitz, J.C., Kocsis, J.H., Fishman, B., et al. (1998). Treatment of HIV-positive patients with depressive symptoms. Arch Gen Psychiatry, 55, 452-457.
Markowitz, J.C., Leon, A.C., Miller, N.L., Cherry, S., Clougherty, K.F. & Villalobos, L. (2000). Rater agreement on interpersonal psychotherapy problem areas. J Psychother Pract Res, 9, 131-135.
Markowitz, J.C., Svartberg, M. & Swartz, H.A. (1998). Is IPT time-limited psychodynamic psychotherapy? J Psychother Prac Res, 7, 185-195.
Martin, S.D., Martin, E., Rai, S.S., Richardson, M.A. & Royall, R. (2001). Brain blood flow changes in depressed patients treated with interpersonal psychotherapy or venlafaxine hydrochloride. Arch Gen Psychiatry, 58, 641-648.
Mossey, J.M., Knott, K.A., Higgins, M. & Talerico, K. (1996). Effectiveness of a psychosocial intervention, interpersonal counseling, for subdysthymic depression in medically ill elderly. J Gerontol, 51A, M172-M178.
Mufson, L., Moreau, D. & Weissman, M.M. (1993). Interpersonal Therapy for Depressed Adolescents. New York: Guilford.
Mufson, L., Weissman, M.M., Moreau, D. & Garfinkel, R. (1999). Efficacy of interpersonal psychotherapy for depressed adolescents. Arch Gen Psychiatry, 56, 573-579.
O'Hara, M.W., Stuart, S., Gorman, L.L. & Wenzel, A. (2000). Efficacy of interpersonal psychotherapy for postpartum depression. Arch Gen Psychiatry, 57, 1039-1045.
Parsons, T. (1951). Illness and the role of the physician: A sociological perspective. Am J Orthopsy-chiatry, 21, 452-460.
Paykel, E.S., DiMascio, A., Haskell, D. & Prusoff, B.A. (1975). Effects of maintenance amitriptyline and psychotherapy on symptoms of depression. Psychol Med, 5, 67-77.
Reynolds, C.F. III, Frank, E., Perel, J.M., et al., (1999). Nortriptyline and interpersonal psychotherapy as maintenance therapies for recurrent major depression: A randomized controlled trial in patients older than fifty-nine years. JAMA, 281, 39-45.
Rossello, J. & Bernal, G. (1999). The efficacy of cognitive-behavioral and interpersonal treatments for depression in Puerto Rican adolescents. J Consult Clin Psychol, 67, 734-745.
Roth, A. & Fonagy, P. (1996). What Works for Whom?: A Critical Review of Psychotherapy Research (p. iv). New York: Guilford.
Rothblum, E.D., Sholomskas, A.J., Berry, C. & Prusoff, B.A. (1982). Issues in clinical trials with the depressed elderly. J Am Geriatr Soc, 30, 694-699.
Rounsaville, B.J., Chevron, E.S., Weissman, M.M., Prusoff, B.A. & Frank, E. (1986). Training therapists to perform interpersonal psychotherapy in clinical trials. Compr Psychiatry, 27, 364-437.
Rounsaville, B.J., Glazer, W., Wilber, C.H., Weissman, M.M. & Kleber, H.D. (1983). Short-term interpersonal psychotherapy in methadone-maintained opiate addicts. Arch Gen Psychiatry, 40, 629-636.
Rounsaville, B.J., O'Malley, S.S., Foley, S.H. & Weissman, M.M. (1988). The role of manual-guided training in the conduct and efficacy of interpersonal psychotherapy for depression. J Consult Clin Psychol, 56, 681-688.
Rounsaville, B.J., Weissman, M.M., Prusoff, B.A. & Herceg-Baron, R.L. (1979). Marital disputes and treatment outcome in depressed women. Compr Psychiatry, 20, 483-490.
Rush, A.J. & Thase, M.E. (1999). Psychotherapies for depressive disorders: A review. In M. Maj & N. Sartorius (Eds), Depressive Disorders: WPA Series Evidence and Experience in Psychiatry (pp. 161-206). Chichester: Wiley.
Sanderson, W.C. & Woody S. (1995). Manuals for empirically validated treatments: A project of the Task Force on Psychological Interventions. Vol. 48. Washington, DC: Division of Clinical Psychology, American Psychological Association. Clin Psychol, 48, 7-11.
Satcher, D. (1999). Surgeon General's Reference: Mental Health: A Report of the Surgeon General. Rockville, MD: US Department of Health and Human Services.
Schulberg, H.C. & Scott, C.P. (1991). Depression in primary care: Treating depression with interpersonal psychotherapy. In C.S. Austad & W.H. Berman (Eds), Psychotherapy in Managed Health Care: The Optimal Use of Time and Resources (pp. 153-170). Washington, DC: American Psychological Association.
Schulberg, H.C., Block, M.R., Madonia, M.J., et al. (1996). Treating major depression in primary care practice. Arch Gen Psychiatry, 53, 913-919.
Schulberg, H.C., Scott, C.P., Madonia, M.J. & Imber, S.D. (1993). Applications of interpersonal psychotherapy to depression in primary care practice. In G.L. Klerman & M.M. Weissman (Eds), New Applications of Interpersonal Psychotherapy (pp. 265-291). Washington, DC: American Psychiatric Press.
Shea, M.T., Elkin, I., Imber, S.D., et al. (1992). Course of depressive symptoms over follow-up: Findings from the National Institute of Mental Health Treatment for Depression Collaborative Research Program. Arch Gen Psychiatry, 49, 782-794.
Shea, M.T., Elkin, I. & Sotsky, S.M. (1999). Patient characteristics associated with successful treatment: Outcome findings from the NIMH Treatment of Depression Collaborative Research Program. In D.S. Janowsky (Ed.), Psychotherapy Indications and Outcomes (pp. 71-90). Washington, DC: American Psychiatric Press.
Sholomskas, A.J., Chevron, E.S., Prusoff, B.A. & Berry, C. (1983). Short-term interpersonal therapy (IPT) with the depressed elderly: Case reports and discussion. Am JPsychother, 36, 552-566.
Sloane, R.B., Stapes, F.R. & Schneider, L.S. (1985). Interpersonal therapy versus nortriptyline for depression in the elderly. In G.D. Burrows, T.R. Norman & L. Dennerstein (Eds), Clinical and Pharmacological Studies in Psychiatric Disorders (pp. 344-346). London: John Libbey.
Sotsky, S.M., Glass, D.R., Shea, M.T., et al. (1991). Patient predictors of response to psychotherapy and pharmacotherapy: Findings in the NIMH Treatment of Depression Collaborative Research Program. Am J Psychiatry, 148, 997-1008.
Spinelli, M. (1997). Manual of interpersonal psychotherapy for antepartum depressed women (IPT-P). Available through Dr Spinelli, Columbia University College of Physicians and Surgeons, New York.
Stuart, S. & O'Hara, M.W. (1995). IPT for postpartum depression. J Psychother Prac Res, 4, 18-29.
Sullivan, H.S. (Ed.) (1953). The Interpersonal Theory ofPsychiatry. New York: W.W. Norton.
Thase, M.E., Buysse, D.J, Frank, E., et al. (1997). Which depressed patients will respond to interpersonal psychotherapy? The role of abnormal EEG profiles. Am J Psychiatry, 154, 502-509.
Thase, M.E., Fava, M., Halbreich, U., et al. (1996). A placebo-controlled, randomized clinical trial comparing sertraline and imipramine for the treatment of dysthymia. Arch Gen Psychiatry, 53, 777-784.
Weissman, M.M. (1995). Mastering Depression: A Patient Guide to Interpersonal Psychotherapy. Albany, NY: Graywind Publications. Currently available through the Psychological Corporation, Order Service Center, P. O. Box 839954, San Antonio, TX 78283-3954, USA; Tel. 1-800-2280752, Fax 1-800-232-1223.
Weissman, M.M., Klerman, G.L., Paykel, E.S., Prusoff, B.A. & Hanson B. (1974). Treatment effects on the social adjustment of depressed patients. Arch Gen Psychiatry, 30, 771-778.
Weissman, M.M., Klerman, G.L., Prusoff, B.A., Sholomskas, D. & Padian, N. (1981). Depressed outpatients: Results one year after treatment with drugs and/or interpersonal psychotherapy. Arch Gen Psychiatry, 38, 52-55.
Weissman, M.M., Markowitz, J.C. & Klerman, G.L. (2000). Comprehensive Guide to Interpersonal Psychotherapy. New York: Basic Books.
Weissman, M.M., Prusoff, B.A., DiMascio, A., Neu, C., Goklaney, M. & Klerman, G.L. (1979). The efficacy of drugs and psychotherapy in the treatment of acute depressive episodes. Am J Psychiatry, 136, 555-558.
Weissman, M.M., Rounsaville, B.J. & Chevron, E.S. (1982). Training psychotherapists to participate in psychotherapy outcome studies: Identifying and dealing with the research requirement. Am J Psychiatry, 139, 1442-1446.
Wilfley, D.E., Agras, W.S., Telch, C.F., et al. (1993). Group cognitive-behavioral therapy and group interpersonal psychotherapy for the nonpurging bulimic individual: A controlled comparison. J Consult Clin Psychol, 61, 296-305.
Wilfley, D.E., MacKenzie, R.K., Welch, R.R., Ayres, V.E. & Weissman, M.M. (2000). Interpersonal Psychotherapy for Groups. New York: Basic Books.
Zlotnick, C., Johnson, S.L., Miller, I.W., Pearlstein, T. & Howard, M. (2001). Postpartum depression in women receiving public assistance: Pilot study of an interpersonal-therapy-oriented group intervention. Am J Psychiatry, 158, 638-640.
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