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Book Forum: Childhood and Adolescence Issues   |    
Interpersonal Psychotherapy for Depressed Adolescents, 2nd ed.
RICHARD BALON, M.D.
Am J Psychiatry 2005;162:1232-1232. doi:10.1176/appi.ajp.162.6.1232
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By Laura Mufson, Kristen Pollack Dorta, Donna Moreau, and Myrna M. Weissman. New York, Guilford Publications, 2004, 315 pp., $36.00.

We seem to lack good, proven treatments for adolescent depression. The use of antidepressants in adolescent depression has been a bit discredited lately due to the controversies about their efficacy in adolescent depression and their questionable, yet possible, association with suicidal ideation. Thus, many are looking for alternative treatments to be used for depressed adolescents.

Interpersonal psychotherapy, a brief, time-limited psychotherapy, was originally developed by the late Gerald Klerman and his co-workers for the treatment of nonbipolar, nonpsychotic, depressed adult outpatients. Interpersonal psychotherapy postulates that, regardless of its etiology, depression is intertwined with the person’s interpersonal relationships. The goals of interpersonal psychotherapy are to decrease depressive symptoms and enhance communication skills in significant relationships. Since there are similarities between adult and adolescent depression, it was only a question of time before interpersonal psychotherapy would also branch into the area of adolescent depression. The adolescent modification of interpersonal psychotherapy was developed by the authors of this book and Gerald Klerman in the early 1990s (1). The main modifications, compared with adult interpersonal psychotherapy, include a discussion of a specific type of role transition for adolescents that is due to family structural change and the addition of a parent component to the treatment protocol. It is still mostly a 12-week-long psychotherapy for 12–18-year-old adolescents with weekly face-to-face sessions interspersed with telephone contacts.

The goals of the second edition of this book, according to the authors, were to provide a general overview of the current treatment practices for adolescent depression, to introduce the experienced adolescent therapist to the theoretical and practical application of the adolescent modification of interpersonal psychotherapy, and to update the original modification for adolescents of the interpersonal psychotherapy manual (1) with a decade of experience in using this technique.

The book is divided into three parts. Part 1 is a general overview of adolescent depression, which includes discussions of the nature of depression in adolescents, current psychosocial treatments for adolescent depression, and the origins and developments of interpersonal psychotherapy for depression. Part 2, Application of Interpersonal Therapy for Depressed Adolescents, is the actual detailed adolescent modification of interpersonal psychotherapy treatment manual for the clinician. It goes over the three phases of interpersonal psychotherapy (initial, middle, termination) and discusses the four problem areas (grief, interpersonal role disputes, role transitions, interpersonal deficits). The text is interspersed with numerous communication examples and very concrete scripts of what to say in specific situations.

Part 3, Special Issues in Treating Adolescents, discusses clinical situations such as patient-initiated disruptions to treatment, parental depression, nonnuclear families, the suicidal patient, and crisis management. It also deals with the use of medication in conjunction with the adolescent modification of interpersonal psychotherapy as well as current and future research in this treatment. Part 3 also includes a comprehensive description of an adolescent patient treated with modified interpersonal psychotherapy. There are three appendixes—the Interpersonal Inventory, a guide on how to query about relationships, and a session checklist for the adolescent modification of interpersonal psychotherapy. The chapters in the clinical part of the book have a similar structure and contain many clinical vignettes.

Even though this book is intended for a fairly narrow audience—therapists trained in treating adolescents—many other clinicians dealing with children and adolescents will find it useful. It will help clinicians to review important clinical issues in the area of communication and interpersonal relationships. It may also help some to take the first training step in this treatment modality—most parts of the book are very simple and easy to follow. Many fellows in child and adolescent psychiatry and their teachers would find it to be a good teaching text for the adolescent modification of interpersonal psychotherapy.

I believe the authors fulfill the goals of this book and provide us with a solid, clinically oriented, updated manual for the adolescent modification of interpersonal psychotherapy, based on years of their personal experience in using this modality. This book seems to be the manual for interpersonal psychotherapy for depressed adolescents.

Mufson L, Moreau D, Weissman MM, Klerman GL: Interpersonal Psychotherapy for Depressed Adolescents. New York, Guilford, 1993
 
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References

Mufson L, Moreau D, Weissman MM, Klerman GL: Interpersonal Psychotherapy for Depressed Adolescents. New York, Guilford, 1993
 
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