Engaging Black youth in depression and suicide prevention treatment within urban schools: study protocol for a randomized controlled pilot.

BACKGROUND: Depression continues to be an ongoing threat to adolescent well-being with Black adolescents being particularly vulnerable to greater burdens of depression as well as lower mental health service utilization. Black adolescents are likely to have untreated depression due to social network influences, varied perceptions of services and providers, or self-stigma associated with experiencing depressive symptoms. Furthermore, if or when treatment is initiated, low engagement and early termination are common. To address this gap, a trial is being conducted to preliminarily test the effectiveness of an engagement intervention targeting Black adolescents with depression in school mental health services in New York City. METHODS: A total of 60 Black middle and high school adolescents displaying depressive symptoms are equally randomized (based on school site) to the treatment arms. Both trial arms deliver Interpersonal Psychotherapy for Depressed Adolescents (IPT-A), a time-limited, evidence-based treatment for depression. Additionally, one arm pairs IPT-A with a brief, multi-level engagement intervention, the Making Connections Intervention (MCI), involving adolescents, caregivers, and clinicians. Outcomes of interest are group differences in depression and suicide ideation, adolescent and caregiver engagement, and mental health service use. DISCUSSION: This trial will serve as an efficacy assessment of the MCI among a sample of Black adolescent students with depressive symptoms. Clinical and implementation results will be used to inform future research to further test the MCI intervention in a larger sample. TRIAL REGISTRATION: Registered by ClinicalTrials.gov on May 3, 2019, identifier: NCT03940508.

Effects of Therapeutic Alliance in Interpersonal Psychotherapy Among Adolescent Girls With Loss-of-Control Eating.

OBJECTIVE: Interpersonal psychotherapy (IPT) has been proposed for prevention of excess weight gain among adolescents with loss-of-control (LOC) eating. Mixed findings from a trial testing this conjecture warrant elucidation of potential outcome predictors. The therapeutic alliance (adolescent-facilitator emotional bond and task collaboration) may be important for IPT but has received little attention in weight-related interventions. This study evaluated associations of adolescent-reported therapeutic alliance during IPT with weight- and eating-related outcomes. METHODS: Secondary analyses of a randomized controlled trial were conducted to compare group IPT to health education (HE) for preventing excess weight gain among 113 girls (ages 12-17) with body mass index (BMI) at the 75th to 97th percentile and LOC eating. BMI and LOC eating were measured at baseline, 12 weeks (postintervention), and 1 year. Multilevel modeling was used to test associations between change in therapeutic alliance (from session 1 to session 12) and changes in weight- and eating-related outcomes (from postintervention to 1 year). Analyses were controlled for therapeutic alliance after session 1 and for baseline and postintervention outcome values; group assignment (IPT vs. HE) was a moderator. RESULTS: Increases in emotional bond were associated with decreased weight and with greater decreases in number of LOC eating episodes at 1 year in the IPT group (p<0.05) and with weight gain in the HE group (p<0.05). Greater task collaboration was related to greater weight gain at 1-year follow-up, regardless of group assignment (p<0.05). CONCLUSIONS: The association of therapeutic alliance during IPT with weight and LOC eating outcomes among adolescent girls merits further investigation.

Long-term outcomes of once weekly v. twice weekly sessions of cognitive behavioral therapy and interpersonal psychotherapy for depression.

BACKGROUND: Twice weekly sessions of cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for major depressive disorder (MDD) lead to less drop-out and quicker and better response compared to once weekly sessions at posttreatment, but it is unclear whether these effects hold over the long run. AIMS: Compare the effects of twice weekly v. weekly sessions of CBT and IPT for depression up to 24 months since the start of treatment. METHODS: Using a 2 × 2 factorial design, this multicentre study randomized 200 adults with MDD to once or twice weekly sessions of CBT or IPT over 16-24 weeks, up to a maximum of 20 sessions. Main outcome measures were depression severity, measured with the Beck Depression Inventory-II and the Longitudinal Interval Follow-up Evaluation. Intention-to-treat analyses were conducted. RESULTS: Compared with patients who received once weekly sessions, patients who received twice weekly sessions showed a significant decrease in depressive symptoms up through month 9, but this effect was no longer apparent at month 24. Patients who received CBT showed a significantly larger decrease in depressive symptoms up to month 24 compared to patients who received IPT, but the between-group effect size at month 24 was small. No differential effects between session frequencies or treatment modalities were found in response or relapse rates. CONCLUSIONS: Although a higher session frequency leads to better outcomes in the acute phase of treatment, the difference in depression severity dissipated over time and there was no significant difference in relapse.

Group interpersonal psychotherapy (IPT-G) for borderline personality disorder: A randomized controlled study.

Recent evidence supported the notion that add-on group therapy should be provided to individuals with borderline personality disorder (BPD) who already undergo individual psychotherapy. The present 20 week-study was aimed to evaluate the efficacy of the adjunction of group interpersonal psychotherapy (IPT-G) to individual interpersonal psychotherapy adapted for BPD - revised (IPT-BPD-R) in comparison with individual IPT-BPD-R alone in a group of BPD patients. In addition, demographical and clinical characteristics that can be considered predictors of response to add-on group therapy were investigated. Forty-six patients were randomly assigned to 1) IPT-BPD-R plus IPT-G or to 2) IPT-BPD-R in the waiting list for IPT-G. Patients were assessed at baseline and after 20 weeks with: the Clinical Global Impression Scale, Severity item (CGI-S); the Social Occupational Functioning Assessment Scale (SOFAS); the Satisfaction Profile (SAT-P); the Borderline Personality Disorder Severity Index (BPDSI); the Modified Overt Aggression Scale (MOAS); the Childhood Trauma Questionnaire - Short Form (CTQ-SF); the Inventory of Interpersonal Problems (IIP-32); and the Reading the Mind in the Eyes Test (RMET). Statistical analyses included: ANOVA for repeated measures to compare score changes of the rating scales within groups (trial duration) and between groups (treatment modalities), and multiple regression analysis to identify which clinical factors are significantly and independently related to the difference of BPDSI score between baseline and week 20 (Δ BPDSI). The significance level was P ≤ 0.05. Both significant within-subjects effects (duration) and between-subjects effects (treatment modalities) were found for the following rating scales: MOAS; BPDSI items "feelings of emptiness", "outbursts of anger," and "affective instability"; RMET; SAT-P items "work" and "sleep, food, free time"; and IIP-32 scale "domineering/controlling". At the multiple regression analysis BPDSI item "impulsivity", RMET, and the subscale "socially inhibited" of the IIP-32 were significantly and independently related to Δ BPDSI score. In conclusion, the add-on of IPT-G produced higher improvement in core BPD symptoms, social cognition, a dysfunctional interpersonal style, and subjective quality of life. Subjects who were less impulsive, less socially inhibited, and with higher abilities in social cognition obtained greater benefits from the adjunction of group therapy. CLINICAL TRIALS REGISTRATION NUMBER: ACTRN12623000002684, Australian New Zealand Clinical Trials Registry (ANZCTR).

A randomized trial of two group-delivered transdiagnostic eating disorder treatments: Dissonance-based treatment versus interpersonal psychotherapy.

OBJECTIVE: Test whether a group-delivered dissonance-based transdiagnostic eating disorder treatment, Body Project Treatment (BPT), produces greater reductions in eating disorder symptoms and higher abstinence from eating disorder behaviors and remittance from eating disorder diagnoses than group-delivered transdiagnostic interpersonal psychotherapy (IPT). METHOD: Women with a range of eating disorders (N = 73) were randomized to 8-week group-implemented BPT or IPT and completed surveys and masked diagnostic interviews at pretest, posttest, and 6-month follow-up. RESULTS: Participants randomized to BPT versus IPT showed significantly greater reductions in eating disorder symptoms (d = -.75), pursuit of the thin ideal (d = -.87), anxiety symptoms (d = -.76), and social impairment (d = -.59) through 6-month follow-up. By end of treatment, participants randomized to the BPT versus IPT did not significantly differ on abstinence from binge eating and purging (49% vs. 40%, respectively) or remittance from eating disorder diagnoses (54% vs. 40%, respectively). Participants randomized to BPT versus IPT did not differ significantly in average session attendance (5.8 vs. 6.9, respectively) or average homework assignments completed (4.6 vs. 5.6, respectively). The within-condition reductions in eating disorder symptoms for BPT did not significantly differ when implemented in person versus via synchronous video telepsychiatry (d = -1.39 vs. -1.09, respectively), though these effects should be considered preliminary because of the small cell sizes. CONCLUSIONS: The evidence that BPT produces greater reductions in eating disorder symptoms, pursuit of the thin ideal, anxiety symptoms, and social impairment than IPT is encouraging because it provides some assurance that the effects are present equating for the effects of expectancies, demand characteristics, and nonspecific factors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A systematic review of interpersonal psychotherapy for postpartum depression.

BACKGROUND: The current study endeavored to systematically integrate and quantitatively evaluate the effectiveness of interpersonal psychological interventions for postpartum depression patients. METHODS: Four electronic databases Pubmed, Embase, Cochrane and Web of Science were employed for literature retrieval, and the search time was from the inception of the database to May 30, 2022. Literature screening and data extraction were performed independently by two researchers. RESULTS: A total of 528 studies were screened, and 9 of them were finally included. There were 1012 subjects, 518 of them were assigned in experimental group and 494 in control. Evidence from interpersonal psychological interventions indicated that the data on postpartum depression, satisfaction with family, and social support in both groups after intervention included: depression score [MD = -2.80, 95%CI (-3.86 to -1.74), P < 0.05], satisfaction score [MD = 8.41, 95%CI (1.49 to -15.33), P < 0.05], and social support score [MD = 1.83, 95%CI (-2.10 to -5.76)] of postpartum depression patients. P values < 0.05 indicated substantial improvement as compared to control. LIMITATIONS: During the research process, it is impossible for the experimental group and the researchers to use double-blind trials simultaneously, which may present a Hawthorne effect, but this can be avoided by general psychological intervention for the control. CONCLUSIONS: Interpersonal psychotherapy could improve depression in patients with postpartum depression, but the appropriate intervention time was between 4 and 8 weeks, and it also improved satisfaction with family of patients, and the longer the intervention, the higher the satisfaction with the family.

Couple-based interpersonal psychotherapy for first-time parents: A process evaluation.

PURPOSE: First-time parents have an increased risk of depression during the transition to parenthood, which has long-term adverse effect on the infant development. Interpersonal psychotherapy (IPT) has been shown to effectively reduce postnatal depression. The objectives of this study were to explore first-time parents' perceptions of a couple-based IPT program and to identify positive and negative influences on the effectiveness of the intervention through a process evaluation. DESIGN AND METHODS: A process evaluation was conducted as part of a randomized controlled trial of a couple-based IPT program. A program satisfaction questionnaire was used to assess the participants' satisfaction with the structure, process and outcome of the program. Semi-structured telephone interviews were conducted with a purposive sample of 44 first-time parents who had received the couple-based IPT. The interview data were analyzed by thematic analysis. RESULTS: The qualitative findings showed that the parents perceived couple-based IPT as useful for enhancing their interpersonal relationship, emotional control and competence in child care. The successful implementation of the couple-based IPT program was influenced by its delivery by midwives, the interactive lessons used to engage the participants, the close fit of the teaching contents to the needs of first-time parents and the flexible program schedule and delivery mode. CONCLUSIONS: The process evaluation indicates that couple-based IPT is an acceptable and feasible intervention for first-time parents to facilitate a healthy transition to parenthood. PRACTICE IMPLICATIONS: The couple-based IPT can be used as an adjunct to standard care to promote perinatal health.

Randomized trial of brief interpersonal psychotherapy and cognitive behavioral therapy for depression delivered both in-person and by telehealth.

BACKGROUND: Expert consensus guidelines recommend Cognitive Behavioral Therapy (CBT) and Interpersonal Psychotherapy (IPT), interventions that were historically delivered face-to-face, as first-line treatments for Major Depressive Disorder (MDD). Despite the ubiquity of telehealth following the COVID-19 pandemic, little is known about differential outcomes with CBT versus IPT delivered in-person (IP) or via telehealth (TH) or whether working alliance is affected. METHODS: Adults meeting DSM-5 criteria for MDD were randomly assigned to either 8 sessions of IPT or CBT (group). Mid-trial, COVID-19 forced a change of therapy delivery from IP to TH (study phase). We compared changes in Hamilton Rating Scale for Depression (HRSD-17) and Working Alliance Inventory (WAI) scores for individuals by group and phase: CBT-IP (n = 24), CBT-TH (n = 11), IPT-IP (n = 25) and IPT-TH (n = 17). RESULTS: HRSD-17 scores declined significantly from pre to post treatment (pre: M = 17.7, SD = 4.4 vs. post: M = 11.7, SD = 5.9; p < .001; d = 1.45) without significant group or phase effects. WAI scores did not differ by group or phase. Number of completed therapy sessions was greater for TH (M = 7.8, SD = 1.2) relative to IP (M = 7.2, SD = 1.6) (Mann-Whitney U = 387.50, z = -2.24, p = .025). LIMITATIONS: Participants were not randomly assigned to IP versus TH. Sample size is small. CONCLUSIONS: This study provides preliminary evidence supporting the efficacy of both brief IPT and CBT, delivered by either TH or IP, for depression. It showed that working alliance is preserved in TH, and delivery via TH may improve therapy adherence. Prospective, randomized controlled trials are needed to definitively test efficacy of brief IPT and CBT delivered via TH versus IP.

Effect of Problem Area on Outcomes Among Adolescents Treated With Interpersonal Psychotherapy for Depression.

OBJECTIVE: Interpersonal psychotherapy for adolescents (IPT-A) aims to treat depression by addressing one of four problem areas: grief, role disputes, role transitions, or interpersonal deficits. This study compared the characteristics of adolescents by problem area and evaluated the impact of problem area on outcomes. METHODS: Forty adolescents (ages 12-17) participated in a randomized trial of adaptive treatment strategies that included IPT-A. RESULTS: Adolescents with role disputes were younger than adolescents with interpersonal deficits or role transitions and had worse expectations for therapeutic alliance than those in the transitions group. Adolescents with interpersonal deficits had higher attachment avoidance than those in the transitions group. Posttreatment, adolescents in the transitions group had more severe depression and social adjustment problems than those in the deficits group and more social adjustment problems than those in the disputes group. CONCLUSIONS: This preliminary study's findings suggest that differing IPT-A problem areas may affect prognosis.

Pilot Study of Group Interpersonal Psychotherapy for Depression Among Young People With Chronic Illness.

OBJECTIVE: Interpersonal psychotherapy (IPT) is an evidence-based treatment for depression, demonstrating efficacy with adolescents and young adults. Social support is proposed to be an important treatment component and may be helpful for adolescents and young adults with chronic illness. The authors sought to assess the feasibility of delivering IPT to this population and to examine changes in depressive symptoms and perceived social support. METHODS: An open-label feasibility trial of group-based IPT was conducted for adolescents and young adults with chronic illness (N=17). The 12-session group IPT was concurrent with group members' individual psychotherapy, and group IPT was focused on providing support in navigating interpersonal challenges related to the participants' chronic illness. Participants completed questionnaires assessing depressive symptoms and social support before treatment, midtreatment (6 weeks), and after treatment (12 weeks). Generalized estimating equation models, adjusted for repeated measures, were used to assess changes in depressive symptoms and social support over the course of treatment. RESULTS: Deidentified clinical examples illustrated how IPT was practiced in a community mental health setting. Evidence for the feasibility of group IPT was mixed. Although participants had poor session attendance, there was a significant decrease in depressive symptoms (ß=-2.94, 95% CI=-5.30 to -0.59, p=0.014) and a significant increase in perceived social support (ß=4.24, 95% CI=0.51 to 7.98, p=0.026) by the end of treatment. CONCLUSIONS: IPT may help address depressive symptoms and enhance social support among adolescents and young adults with chronic illness. Further research and adaptation are needed to address feasibility challenges in delivering group IPT to this population.

Telephone-delivered Interpersonal Psychotherapy: a systematic review.

BACKGROUND: The aim of this paper is to review evidence on Interpersonal Psychotherapy (IPT) administered via telephone (IPT-T). METHODS: We conducted a systematic review of studies published between January 1, 1990 and June 30, 2020, assessing the efficacy of IPT administered by phone, using PubMed. RESULTS: Originally, we found 60 papers; the final selection led to 13 papers. Six studies were performed using a randomized clinical trial methodology (6/13, 46.2%), three were prospective open-label not randomized studies (3/13, 15.7%), three were pilot studies (3/13, 23.1%), and one was a feasibility/acceptance study (1/13, 7.7%). The number of subjects included in the studies ranged between 14 and 442 (mean: 140.0 ± 124.9), for a total of 1850 patients. The mean age of the enrolled subjects was 47.8 ± 9.3 years (range: 27.4-70.4). Thirty-four different instruments were utilized. Qualitative synthesis was conducted only on randomized controlled trials (RCTs), namely on six studies. RCTs were almost all of good quality (mean score/standard deviation of the RCT-Psychotherapy Quality Rating Scale omnibus rating: 5.6 ± 1.2 points; range: 3-7). CONCLUSIONS: IPT-T showed response rates similar to IPT administered in the usual way. Results are limited by small samples sizes, selection bias of the less severe depressed patients, and the heterogeneity of rating scales.

Interpersonal Psychotherapy for Depression in Parkinson's Disease: A Feasibility Study.

Individuals living with Parkinson's disease (PD) experience interpersonal stressors that contribute to depressive risk. Interpersonal psychotherapy (IPT) emphasizes the bidirectional relationship between interpersonal stressors and mood may therefore be a suitable treatment for PD-depression. The primary aim of this study was to evaluate the feasibility of delivering 12 sessions of IPT to depressed PD patients and explore the need for modifications. A secondary aim was to obtain descriptive information about efficacy outcomes. The study used a pre-post design without a comparison group. Participants were 12 PD patients with a major depressive disorder. IPT was well accepted and tolerated by patients and required minimal modifications. Compliance with session attendance and completion of study questionnaires were excellent and treatment satisfaction was high. Depression scores declined from baseline to endpoint, with 7 patients meeting criteria for remission at endpoint. Findings are encouraging and a larger randomized controlled trial is currently underway to ascertain if IPT is an efficacious treatment for PD-depression.

Depression Prevention in Pediatric Primary Care: Implementation and Outcomes of Interpersonal Psychotherapy-Adolescent Skills Training.

This study evaluated the fidelity, feasibility, acceptability, and preliminary outcomes of a depression prevention program, interpersonal psychotherapy-adolescent skills training (IPT-AST), in urban pediatric primary care (PC) with a sample of primarily Black youth. Twenty-two adolescents with elevated depressive symptoms participated in this open clinical trial. Adolescents were identified through a screening questionnaire completed at well visits. Ratings of IPT-AST fidelity and session attendance were recorded. Youth and caregivers reported on their attitudes toward the intervention and completed measures of adolescents' symptoms and functioning pre- and post-intervention. Results demonstrated high levels of fidelity, attendance, and acceptability, despite some difficulties with recruitment. Adolescents and caregivers reported significant improvements in functioning. There were marginally significant reductions in self-reported depression, anxiety, and total mental health symptoms. Caregivers reported a significant decrease in total mental health symptoms. Findings provide preliminary information regarding the implementation and effects of IPT-AST when delivered in PC.

Change in reflective functioning in interpersonal psychotherapy and cognitive behavioral therapy for major depressive disorder.

BACKGROUND: Patients with Major Depressive Disorder (MDD) have been found to have restricted capacity for mentalization, and it is possible that this constitutes a vulnerability factor for developing depression. Due to its focus on linking depressive symptomatology to emotions and interpersonal relations, it was hypothesized that Interpersonal Psychotherapy (IPT) would improve mentalization more than Cognitive Behavioral Therapy (CBT). METHODS: In a randomized controlled trial of 90 patients undergoing IPT and CBT for MDD, Reflective Functioning (RF) was rated from Adult Attachment and from Depression-Specific Reflective Functioning (DSRF) Interviews before and after therapy. Treatment outcome was assessed using the Beck Depression Inventory-II. RESULTS: The interaction between time and treatment approach was statistically significant, with RF improving significantly more in IPT than in CBT. Change in RF was not correlated with change in depression. The difference in DSRF ratings before and after therapy was not statistically significant for any of the treatments. CONCLUSIONS: IPT may improve mentalization more than CBT. However, although RF increased significantly in IPT, the mean level was still low after therapy. A limitation of the study is the large amount of post-treatment missing data. More research is needed to understand the potential role of mentalization in symptom reduction.

Interpersonal psychotherapy for treatment of obesity: A systematic review and meta-analysis.

BACKGROUND: Social and interpersonal context are associated with the onset and persistence of psychiatric disorders. We compared the effects of short-term interpersonal psychotherapy (IPT) on weight loss, binge eating behaviors, and depressive symptoms against cognitive-behavioral therapy (CBT), health education (HE), and behavioral weight loss (BWL). METHODS: We searched until May 28th, 2022 following databases: PubMed, CINAHL, Science Direct, Web of Science, EMBASE, and Scopus. Articles on parallel randomized clinical trials were included. Outcomes were body mass index (BMI), binge days (bulimic episode), and depressive symptoms. These outcomes were self-reported or measured with specific scales (BMI) or instrument (depressive symptoms). RESULTS: The initial search retrieved 820 articles, a total of 10 studies met the eligibility criteria, and seven were included in the meta-analysis. Participants with overweight/obesity were women (62-100 %), aged between 11 and 50 years. There was a trivial to small effect on BMI favoring IPT over other interventions (standardized mean difference [SMD] = -0.10; 95%CI: -0.27 to 0.07, I2 = 0 %), especially when compared to health education (SMD = -0.21; 95%CI: -0.54 to 0.12, I2 = 0 %); no effect on number of binge days (SMD = -0.09; 95%CI: -0.30 to 0.11, I2 = 0 %); and a small effect on depressive symptoms (SMD = -0.25, 95%CI = -0.50 to 0.00, I2 = 0 %). LIMITATIONS: Small number of studies, the discrepancy in age cohorts, and racial diversity. Psychotherapeutic protocols and assessment tools had to be adapted across studies. CONCLUSIONS: Patients with overweight/obesity and depression had some benefit from IPT when compared with other interventions. In view of existing evidence, an IPT program adapted to obesity could help to achieve reliable and long-term effects.

Effect of interpersonal psychotherapy on social functioning, overall functioning and negative emotions for depression: A meta-analysis.

BACKGROUND: Interpersonal psychotherapy (IPT) has been widely used for depression. However, current studies of IPT have been restricted to depressive symptoms, and the results for improving social functioning were controversial. METHODS: A comprehensive literature search of randomized controlled trials (RCTs) was conducted through eleven databases. Data analysis was performed by RevMan5.3, and effects were summarized by using a random effects model of mean differences with 95 % confidence intervals. RESULTS: From 2443 records, eleven studies met inclusion and exclusion criteria were used for meta-analysis. The results showed that IPT had significant effects on improving social functioning (SMD: -0.53, 95 % CI: -0.80 to -0.26), reducing depression (SMD: -0.49, 95 % CI: -0.80 to -0.19) and anxiety (SMD: -0.90, 95 % CI: -1.28 to -0.52), but the effect on the overall functioning (SMD: -0.37, 95 % CI: -0.73 to -0.01) is not obvious. Moreover, subgroup analysis showed that IPT was effective in improving social functioning in adolescent depression (SMD: -0.35, 95 % CI: -0.58 to -0.13) and perinatal depression (SMD: -1.01, 95 % CI: -1.35 to -0.67), while there was no significant difference in the adult depression group (SMD: -0.39, 95 % CI: -1.05 to 0.27). LIMITATION: The blind method cannot be carried out in most studies due to the particularity of psychotherapy, heterogeneity in some results. CONCLUSION: IPT has a significant effect on improving social functioning and reducing depression and anxiety, while the effect on overall functioning requires further research. Overall, IPT is one of the effective nonpharmacological treatments for depression.

Pilot Study of Blended-Format Interpersonal Psychotherapy for Major Depressive Disorder.

OBJECTIVE: Blended-format interpersonal psychotherapy (IPT) is an integrated approach consisting of alternating face-to-face (in person or videoconferencing) and online sessions, and this format may increase access to care, empower patients, and improve quality and cost-effectiveness of care. This study, conducted in the Netherlands, was one of the first to investigate the feasibility of blended-format IPT in specialized mental health care. METHODS: Participants (ages 18-64, N=21) with a unipolar depressive episode were recruited at an outpatient mood disorder clinic. In this pre-post nonrandomized pilot study, the blended IPT consisted of six online sessions alternated with six to 10 in-person or videoconferencing sessions. Feasibility (defined as >60% of the participants having completed >50% of the online sessions), usability (via the System Usability Scale [SUS]), satisfaction (via the Client Satisfaction Questionnaire-8 [CSQ-8] and qualitative interviewing), and symptom reduction (via the nine-item Patient Health Questionnaire [PHQ-9]) were assessed. RESULTS: Of the participants, 90% (95% CI=70%-99%) completed all online sessions. Mean±SD scores were 25.12±3.55 (of 32) on the CSQ-8 and 66.0±12.4 (of 100) on the SUS. PHQ-9 scores (N=21) decreased significantly, from 17.48±5.41 at baseline to 11.90±6.45 postintervention, indicating improvement (t=4.86, df=20, p=0.001). Hedges' g was 0.90 (95% CI=0.44-1.41), indicating a large effect size. The treatment response rate was 33% (95% CI=15%-57%); the remission rate was 19% (95% CI=6%-42%). CONCLUSIONS: Blended-format IPT was feasible, and patients were satisfied with the intervention. The therapy described here may serve as a starting point for cost-effectiveness research on this promising format.

Examining changes in binge-eating disorder network centrality and structure in patients treated with cognitive-behavioral therapy versus interpersonal psychotherapy.

OBJECTIVE: A sizeable minority of patients with binge-eating disorder (BED) do not fully respond to evidence-based treatments. Evidence to guide refinements of treatments is needed. Conceptualizing BED as arising from a network of symptom-to-symptom interactions allows for identification of the most strongly connected symptoms, which could inform intervention targets. This study estimated networks of BED features at pretreatment and posttreatment to assess whether cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) differentially impacted the interrelationships of BED symptoms/features. METHODS: Participants were 392 adults (83% women, 88% white) with BED who received CBT (n = 236) or IPT (n = 156) and assessed at pretreatment and posttreatment. Networks were estimated across timepoints and treatments. Expected influence (EI) was calculated; symptoms with the highest EI have the most strong and frequent associations with other symptoms. We also assessed whether the symptoms with the highest and lowest EI predicted posttreatment remission indicators. RESULTS: In the CBT and IPT networks, shape concern, weight concern, and eating concern had the highest EI at pretreatment and posttreatment. EI significantly increased from pretreatment to posttreatment for some symptoms in CBT but did not change for any symptoms in IPT. Shape concern significantly and positively predicted BED remission indicators in CBT and IPT. CONCLUSIONS: CBT and IPT similarly impacted interrelations among BED features. Pretreatment EI predicted posttreatment remission indicators, indicating that pretreatment centrality could signal meaningful intervention targets. Clinical implications and avenues for future research are discussed including how personalized network analysis may advance the understanding of the clinical utility of centrality. PUBLIC SIGNIFICANCE: Cognitive behavioral therapy and interpersonal therapy for binge-eating disorder, which are two leading evidence-based treatments for binge-eating disorder that are quite different in their models and approaches, similarly impacted interrelations among binge-eating disorder symptoms. In addition, the most strongly interconnected symptom predicted indicators of remission. Studying the interrelations among symptoms may provide new insight on how treatments impact symptom relationships and inform intervention targets.

When Chinese Culture Encounters Western Interpersonal Group Psychotherapy.

This paper describes the decade-long, successful experience of developing a group therapy training program for mental health professionals in China. The perspectives of two Western group therapy instructors/supervisors and of a Chinese colleague who participated broadly in the program are described. We explore our understanding of Western ideas about group therapy and how these were experienced in the Chinese context. We address the opportunities that emerged at the interface of two very different cultures, and the challenges of translating and integrating Western group therapy principles and practices within a culture with a very different history and worldview.

Abordagem de narrativas como método de pesquisa em saúde pública: aproximações conceituais e contribuições da psicanálise / Narrative research in public health: conceptual approximations and contributions from psychoanalysis / Enfoque en narrativas como método de investigación en salud pública: aproximaciones conceptuales y aportaciones del psicoanálisis

Este artigo refere-se à parte de uma pesquisa de doutorado, realizada em hospital de alta complexidade do Sistema Único de Saúde, cujos participantes são os profissionais de saúde. O objetivo deste artigo é analisar o potencial da abordagem das narrativas como método de pesquisa e intervenção nos serviços de saúde, traçando aproximações com a teoria psicanalítica. Sua relevância no campo da Saúde Pública está calcada no reconhecimento do papel do sujeito como agente de mudanças. O texto divide-se em duas partes: na primeira, explora as especificidades do trabalho na área da saúde, o paradigma da saúde pública no que concerne à gestão e possíveis contribuições da clínica ampliada para esse modelo. Na segunda parte, analisa o uso das narrativas como método de pesquisa nesse campo e as aproximações conceituais entre a narrativa em Walter Benjamin e a psicanálise em Freud. Busca na literatura referências sobre experiências análogas que fundamentem a proposta ora realizada e conclui pela importância de, no momento atual, apostar na força germinativa das narrativas como fonte criativa de novas formas de cuidar.(AU)

This article derives from a PhD research conducted with health professionals at a high-complexity public hospital from the Brazilian Unified Health System (SUS). It analyzes the potential of the narrative as a research and intervention method in health services, outlining approximations with psychoanalysis. In the field of Public Health, the narrative approach acknowledges the individual as an agent of change. The text is divided into two parts. The first presents an overview of the peculiarities involved in healthcare, the Public Health paradigm regarding service management and possible contributions from the expanded clinic to this model. The second analyzes the use of narratives as a research method in this field and the conceptual approximations between Benjamin's narrative and Freud's psychoanalysis. It searches the literature for references on similar experiences to support the present proposal and concludes by highlighting the importance of betting on the creative power of narratives as a source for new ways to care.(AU)

Este artículo es parte de una investigación doctoral, realizada con los profesionales de la salud de un hospital de alta complejidad del Sistema Único de Salud de Brasil. Su propósito es analizar el potencial del enfoque en narrativas como método de investigación e intervención en los servicios de salud, esbozando aproximaciones entre las narrativas y la teoría del psicoanálisis. Su relevancia en el campo de la salud pública se basa en el reconocimiento del rol del sujeto como agente de cambio. El texto se divide en dos partes: La primera investiga las especificidades del trabajo en el área de la salud, el paradigma de la salud pública en la gestión de los servicios y las posibles contribuciones de la clínica ampliada a este modelo. En la segunda parte, analiza el uso de narrativas como método de investigación en este campo y las aproximaciones conceptuales entre la narrativa de Walter Benjamin y el psicoanálisis de Freud. Este estudio busca en la literatura referencias sobre experiencias similares que apoyen la propuesta ahora realizada y concluye con la importancia de, en el momento actual, apostar por el poder de las narrativas como fuente creadora de nuevas formas de cuidar.(AU)