Fizza Hasan

998797431

Anna has previously gone through several episodes of depression, which brought her to
therapy. Keeping this into consideration, I highly think an Interpersonal Therapy (IPT) will best
serve in curing Annas depression and prevent future relapse. IPT has evidence through
randomized clinical trials of being highly effective with depressed patients, especially a
combined treatment of IPT with medication. The phenomena of expressed emotion comprises
of emotional over-involvement and chronic criticism of the distressed individual by spouse or
family member, where living in such households holds high risk of relapse. Annas parents
dragged her into their fights and got divorced when she was a child and constantly criticize her
on her weight, love life, and her career goals. She also went through an emotional override with
her personal divorce from her emotionally abusive husband about a year ago. These interpersonal
patterns that developed early in her life and recent environmental stressors make her more prone
to relapse. Since IPT is present-focused, by focusing on the context associated with the onset of
depression I hope to cure her depression once and for all.
Annas parents constant fights, eventual divorce, and endless remarks deprived her of
emotional nurturance, cognitive operations, and behavioral skills in childhood; which are
essential to develop satisfying relationships. This perhaps caused Anna to suffer from isolation
and resultant depression, leading her to develop poor social skills and impaired communication.
This lurked her into a vicious cycle of further isolation and rejection from others; where
environmental stressors such as her ungrateful friends and criticizing husband made it worse.
This pattern of isolation suggests that the source of Annas depression may be interpersonal
deficits that have prevented her from forming and maintaining relationships in her life. This
confirms why she gets anxious around men she goes on dates with, why she does not have
meaningful relationships with her friends in spite of her being generous and forgiving, and why

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her husband left her. It all points to the void her parents left within her, early in her life. This
interpersonal pattern of isolation and deficit that developed early in her life needs to be altered
for her pathological depression to curtail.
My goal in working with Anna is simple: I want to reduce her symptoms of depression as
fast as possible and help her identify her assets and develop skills, in order for her to improve her
relationships and therefore live a fully functioning life. I want to diagnose her right away, explain
Annas depression to her, identify the contextual factors underlying her symptoms, and focus on
her current interpersonal relationships to resolve her depression.
I will begin by predetermining when her therapy will terminate within the usual 12-16
weeks. I will adhere to the treatment manual in IPT, while working with the client to see what
assets can be used. As a therapist I will be Annas advocate, show warmth and empathy towards
her, but not provide her with unconditional acceptance. I will instruct Anna that her depression is
a problem that is temporary and needs to be resolved. The therapy will be divided into three
stages. In the first stage of IPT, I will review her symptoms, diagnose her with the sick role of
depression and educate her on it. I will prescribe her doses of medication, in this case Prozac
(proven to be highly effective for depressed patients). I will then identify the major problem
areas related to her depression, by exploring patterns in her relationships. Basically, I will make
Anna aware of how her past relationship with her parents has come to compromise her present
relationships and that she needs to develop better social and communication skills to enhance her
interpersonal life. In the second stage, I will focus on the primary problem area i.e. interpersonal
deficit. I will explain to Anna how she has formed a pattern of self-destruction of her own
relationships, which is why in spite of her earnest desire to have a family she cannot seem to find
a long-term partner because she will eventually push him away too. By employing a cathartic

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process to the problem of interpersonal deficits, I will allow Anna to explore the associated
positive and negative feelings e.g. dramatic relief and then, consider possible ways of getting
involved with others e.g. going on a new date. Catharsis will help her begin anew. After
accomplishing catharsis, my goal is to change the conditional stimuli causing depression, which
in Annas case would be criticism and being alone. I will change the stimuli by modifying Annas
environment as well as her behaviour, in resolving her interpersonal deficit problem. This means
building social support for Anna, working on her interpersonal skills and identifying her assets
e.g. building better and more caring relationships. This would help remedy her depression and
prevent future relapses. She might finally get the family and self-esteem that she has been eyeing
for a while. In the third stage, I will terminate the IPT where I will review Annas progress,
discuss her feelings about ending her treatment, and outline the remaining work.
Every therapy is not a perfect fit for all members of society and therefore has certain
limitations when specifically applied to them. In Annas case, the brief duration of IPT may not
be enough since Anna has a long way to go due to her recurring depression; in order to fully
eliminate it from the picture. Also, Anna may not respond well to Prozac, which might hinder her
progress. However, research has shown that the combined effect of IPT and tri-cyclic
antidepressant medication is more effective than either treatment alone. A one year follow-up
also revealed that IPTs positive benefits were sustained for most patients. Therefore, this
combined treatment of IPT with Prozac will definitely be effective in curing Annas depression
and allowing her to build more stable and healthy relationships in the long-term.