Considerations When Choosing Treatment Modality
When determining the treatment approach for clients with EDs, the counselor and client should together review the various advantages and disadvantages of using IPT, CBT, or another therapeutic modality. It is crucial for counselors to also explore their own comfort level in terms of their expertise, theoretical knowledge, and propensity to use an interpersonally focused treatment as part of this decision. IPT is a specialty treatment, as is CBT, and should be administered only by trained practitioners. However, it has been argued that experienced counselors who have been trained in other treatment modalities tend to learn IPT quickly and are often able to implement IPT with a high degree of integrity even with minimal training (Birchall, 1999).
To date, although more data exist in support of CBT's efficacy, evolving literature has indicated that IPT may be well suited to clients presenting with or without exacerbated difficulties in social functioning. Although greater problems were associated with poorer outcomes for both CBT and IPT in the Hilbert et al. (2007) study, the moderator effect found in the more recent multisite study (Wilfley et al., 2008) – that clients presenting with greater psychopathology seem to respond well to IPT – suggests that IPT may be well suited to individuals with a broad range of disordered eating and general psychopathology. Moreover, IPT may be enhanced for individuals with exacerbated psychological problems (Markowitz et al., 2006). IPT may also possibly be especially fitting for some minority groups (e.g., African Americans) or specific age cohorts (e.g., adolescents). Last, some clients may express discomfort or difficulties with elements of CBT (e.g., self-monitoring), and IPT should be considered for these individuals.