Enhancing Interpersonal Psychotherapy for Bulimia Nervosa and Binge Eating Disorder

As efforts to more frequently and consistently link ED symptoms to interpersonal functioning have evolved in the use of IPT for BED, clinical researchers involved in developing IPT for BN should also consider stressing this link during the delivery of IPT so that it offers the utmost potency. IPT in its current form already seamlessly incorporates aspects of other therapeutic modalities. For example, the collaborative, behavioral formulation during the interpersonal inventory is one of the ways in which IPT more closely resembles the behavioral therapies than it does the supportive or psychodynamic therapies. Therefore, some aspects of CBT may support IPT's efficacy. For example, IPT counselors might wish to use self-monitoring as a method for clients to become more aware of the negative affect surrounding their ED symptoms. Such an approach is already being tested in other treatment modalities. Indeed, Fairburn (2008) and colleagues have found the inclusion of an interpersonal module effective when administering a recently modified version of CBT for EDs, enhanced CBT for EDs.

Testing Efficacy of Interpersonal Psychotherapy for Anorexia Nervosa

Research examining the utility of IPT for anorexia nervosa is relatively lacking. Indeed, no controlled studies have demonstrated the efficacy of IPT for anorexia nervosa. The IPT model could possibly be applicable to clients with anorexia because they tend to have deficits in social-cognitive skills that impede their capacity to create and experience validating social interactions (Rieger et al., 2010). Research into a possible adaptation of IPT for this population would be extremely useful, given the lack of efficacious evidence-based treatments for this disorder (Bulik, Berkman, Brownley, Sedway, & Lohr, 2007).

Adapting Interpersonal Psychotherapy Into Adolescent and Child-Parent Formats

Given the robust efficacy of IPT for adolescents with depressive disorders, and the initial promise of IPT WG (Tanofsky-Kraff et al., 2010), future research should involve additional adolescent adaptations. Adolescence is a key developmental period for cultivating social and interpersonal patterns, which may explain why adolescents appear to relate well to IPT. From its inception, Mufson, Dorta, Moreau, and Weissman (2004) made important adolescent-relevant adaptations to the treatment (e.g., the inclusion of a parent component and the assignment of a limited sick role, because youths are required to attend school and reducing their activities is likely to exacerbate their interpersonal difficulties). Given that this foundation has been established, the use of IPT for adolescents with BN and BED warrants investigation.

Using IPT with younger children may also be effective. A pilot study of family-based IPT for the treatment of depressive symptoms in 9- to 12-year-old children was found to be feasible and acceptable to families (Dietz, Mufson, Irvine, & Brent, 2008). Currently, an effectiveness trial is underway. The moderating influence of social problems on weight loss outcome in a family-based program (Wilfley et al., 2007) has suggested that targeting interpersonal functioning in the nuclear family milieu may serve as a point of intervention for the treatment of eating- and weight- related problems during middle childhood.

 
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