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Graduate Student Journal of Psychology                                                                             Copyright 2007 by the Department of Counseling & Clinical Psychology  
2007, Vol. 9                                                                                                                          Teachers College, Columbia University                          ISSN 1088-4661 
 
 
 

Interpersonal Psychotherapy for Adolescents with Depression: 
What Has the Research Taught Us So Far? 

 
Sadia R. Chaudhury and Karen A. Shoum 

Teachers College, Columbia University 
 

Given the high prevalence of depression among adolescents, there is a dire need for efficacious, 
cost-effective, and accessible treatments for adolescent depression. One type of psychosocial treat-
ment shown to be efficacious in the treatment of adolescents with depression is Interpersonal Psy-
chotherapy (IPT-A). Originally developed and tested for depressed adults and modified for work 
with adolescents, IPT-A is a time limited, brief psychotherapy based on the premise that depression 
occurs in the context of interpersonal relationships (Weisman, Markowitz, & Klerman, 2000).  
Both the time-limited nature and focus on the present, especially social relationships, seem particu-
larly relevant to adolescents and their specific developmental issues, including major life choices in 
education, work, and the establishment of intimate relationships. Efficacy and effectiveness trials of 
IPT-A have demonstrated its flexibility and applicability. Nevertheless, more efficacy data is war-
ranted, with larger sample sizes and more diverse populations. 

 
 

 Depression in adolescents is much more prevalent than 
was once believed, and is currently seen as comparable to 
adults. This has been demonstrated in epidemiological sur-
veys both nationally (i.e. The National Comorbidity Study 
[NCS], Kessler, 2006) and in smaller community surveys of 
adolescents (e.g., Cohen, et al., 1993). It is estimated that 
the one-year prevalence rate of depression in adolescents is 
between 1.6% and 8.9% (Angold & Costello, 2001). These 
rates of depression in youth may reflect an increased preva-
lence over previous decades. Recent survey results from the 
NCS also show evidence of increased prevalence of child-
hood or adolescent onset depression among those born in 
more recent decades (Kessler, Avenevoli, & Merikangas, 
2001). In fact, half of all individuals who have a mental 
illness during their lifetime report that the onset of disease 
occurred by age 14 and three fourths report onset by age 24 
(Keuhn, 2005). Retrospective assessment among commu-
nity adults typically indicates that middle to late adoles-
cence is the most common age at onset of first major de-
pression or significant symptoms (e.g., Burke, Burke, 
Regier, & Rae, 1990). This has also been demonstrated 
across diverse cultures (Cross-National Collaborative 
Group, 1992). 
 Young people who have an untreated mental illness 
may suffer debilitating symptoms during their most produc-
tive years, including problems with educational attainment 
and career and family building (Kessler, Avenevoli, & 
Merikangas, 2001). Despite these detrimental conse-
quences, depression in adolescence is largely untreated 
(Flaherty, Weist, & Warner, 1996). Depressed adolescents 
are a largely underserved population that faces multiple 
barriers to receiving treatment (Mufson, Dorta, Olfson, 
 
Correspondence concerning this article should be addressed to the 
authors; email: sadiac80@gmail.com or ks46@columbia.edu. 

Weissman, & Hoagwood, 2004). There is a pressing need 
for more efficacious, cost-effective, and accessible treat-
ments for adolescent depression. This paper will address an 
attempt to alleviate this problem through the development 
of a modified Interpersonal Psychotherapy for Depressed 
Adolescents (IPT-A). 
 

Description of Interpersonal Psychotherapy (IPT) 
 
Interpersonal psychotherapy is a time-limited therapy 

based on the idea that depression can be treated by focusing 
on the patient’s key interpersonal relationships (Weissman, 
Markowitz, & Klerman, 2000). Unlike other types of psy-
chotherapy, IPT does not delve into the patient’s past to try 
and determine the cause of the depression. Rather, by fo-
cusing on current interpersonal conflicts and improving 
relationships, IPT alleviates depressive symptoms by reduc-
ing current stressors. One of the most important steps in 
IPT is identifying a primary interpersonal problem area. 
The four main interpersonal problem areas are grief, inter-
personal disputes, role transitions, and interpersonal defi-
cits. During the 16 sessions of IPT, the therapist and patient 
focus on one, or at most two, of these problem areas as the 
primary focus of the therapy. In recent years, there has been 
strong empirical support for IPT’s effectiveness in the 
treatment of depressed adults (de Mello, de Jesus, Ba-
caltchuk, Verdeli, & Neugebauer, 2005; O’Hara, Stuart, 
Gorman, & Wenzel, 2000; Talbot, et al., 2005; Weissman, 
2007; Weissman, Klerman, Prusoff, Sholomskas, & Padian, 
1981). 

 
The Development of Interpersonal Psychotherapy 

for Depressed Adolescents (IPT-A) 
 

33 



CHAUDHURY AND SHOUM 
 

34 

Because IPT is based on the premise that the onset and 
perpetuation of depressive episodes occurs in an interper-
sonal context, its adaptation for adolescents is relevant. IPT 
addresses issues important to the developmental context of 
adolescents, such as major life choices in education, work, 
and establishment of intimate relationships. Furthermore, 
the time-limited nature of IPT may fit the adolescent’s re-
luctance to seek or stay in treatment. The rationale for an 
adolescent adaptation to IPT is that improving the adoles-
cent’s interpersonal context will help change the course of 
the depressive episode and result in recovery (Moreau, 
Mufson, Weissman, & Klerman, 1991).  

The initial phase of treatment in IPT-A is very similar 
to that of IPT; however, there are some key modifications. 
For example, drug abuse and suicidal behavior, both of 
which are serious problems with depressed adolescents, are 
thoroughly evaluated during the initial sessions. Further-
more, in IPT-A the responsible parent plays an integral role 
in the therapeutic process and is brought into the initial 
phase of treatment to participate in psychoeducation about 
depression along with the adolescent. The middle phase of 
IPT-A focuses on one of the four primary problem areas 
identified during the interpersonal inventory completed 
during the initial phase. The main purpose of this phase of 
therapy is to assist the patient in making the association 
between depressive symptoms and interpersonal difficul-
ties. Finally, throughout all of the sessions of IPT-A, the 
issue of termination is raised in order to ensure that the ado-
lescent is aware that the therapy is indeed time-limited. 
Patients are advised that it is not uncommon for a slight 
exacerbation of symptoms to occur as therapy comes to an 
end. The skills acquired during therapy are reviewed during 
the termination phase, and the availability of an external 
support system is reiterated. Early signs of depression and 
possibilities for future treatment, as needed, are discussed in 
order to ensure that the adolescent knows how to cope if 
there is a recurrence of depression (Moreau et al., 1991). 
  

Do the Modifications Work? 
Initial Trials of IPT in Depressed Adolescents 
 
In order to test the efficacy of IPT-A, phase I and phase 

II studies were conducted (Mufson et al., 1994). During 
phase I, modifications to IPT-A were made to the original 
IPT-A manual based on findings from therapeutic work 
with five depressed adolescents. In phase-II, 14 depressed 
adolescents were enrolled in a clinical trial of IPT-A. This 
study found that depressed adolescents who underwent IPT-
A experienced a significant decrease in depressive symp-
toms along with a significant improvement in overall func-
tioning. In fact, by the end of the study, not one of the ado-
lescents met criteria for a DSM-III-R depressive disorder. 
While the phase II study indicated the promise of IPT-A as 
an effective treatment for adolescent depression, a larger 
randomized controlled study, which would allow IPT-A to 
be compared to either a control condition or another treat-

ment condition, was needed in order to truly determine effi-
cacy of the therapy.  

Recognizing that relapse is common in adolescents 
with a history of depression (Kovacs et al., 1984, as cited in 
Mufson & Fairbanks, 1996), the authors set out to deter-
mine the clinical status of adolescents one year after the 
completion of therapy, and  attempted to recontact the 14 
adolescents who participated in the phase-II trial. Of these 
adolescents, 10 (7 Hispanic females and 3 African-
American females, mean age 17.5) agreed to participate in 
the follow-up evaluation. At follow-up, 9 of the adolescents 
met recovery criteria for depression based on both subjec-
tive (Beck Depression Inventory, BDI) and objective (Ham-
ilton Rating Scale of Depression, HRSD) measures of de-
pression. In the realm of social functioning, though a trend 
was found suggesting some difficulties in the “friends” and 
“dating” dimensions, the overall gains in social adjustment 
were maintained one year after termination. The results of 
this study demonstrated that the improvements made during 
the 12-week trial of IPT-A were maintained during the full 
year following completion of treatment, suggesting that 
IPT-A is an effective treatment option for adolescents suf-
fering from depressive disorders. However, there are limita-
tions that must be considered when interpreting these re-
sults: 1) by only enrolling Hispanic and African-American 
females, the sample is not representative of the general 
population; 2) with such a small sample, there was not 
enough statistical power to detect potentially significant 
benefits of IPT; and 3) this trial, as well as the initial open 
trial, lacked control groups for comparison. Despite these 
limitations, this study provides important information about 
IPT-A while stressing the importance of conducting larger 
clinical trials in depressed adolescents to confirm prelimi-
nary findings.  

 
Efficacy of IPT-A 

 
Based on the result of the open clinical trial (Mufson et 

al., 1994) and the one-year follow-up study (Mufson & 
Fairbanks, 1996), a randomized clinical trial to test the effi-
cacy of IPT-A was conducted (Mufson, Weissman, Moreau, 
& Garfinkel, 1999) with 48 clinic-referred adolescents 
(ages 12-18 years) randomly assigned to either weekly one-
hour IPT-A sessions (n=24) or biweekly clinical monitoring 
(CM) with a therapist (control group, n=24) for 12 weeks. 
Participants were administered an assessment battery bi-
weekly by a blind independent evaluator to monitor their 
progress throughout the study. Eligibility criteria for the 
study included meeting DSM-III-R criteria for a current 
major depressive episode and having a score of 15 or more 
on the HRSD. There were no significant baseline differ-
ences demographically or on any outcome measures. Al-
though the IPT-A group (in comparison to the control 
group) reported significantly fewer depressive symptoms at 
Week 12 on the HRSD (clinician-report), BDI (self-report) 
results showed no significant differences at the end of the 
treatment. The investigators of this study defined rates of 



INTERPERSONAL PSYCHOTHERAPY FOR ADOLESCENTS 
 

35 

recovery as less than or equal to 6 on the HRSD, and less 
than or equal to 9 on the BDI. With these criteria, signifi-
cantly more IPT-A patients (75%) than control patients 
(46%) met recovery criteria on the HRSD, a result that was 
significant at the p=.04 level.  

The results of the randomized controlled trial con-
ducted by Mufson et al. (1999) support the findings of the 
previous studies of IPT-A (Mufson et al., 1994; Mufson & 
Fairbanks, 1996), providing further evidence that IPT-A is 
an efficacious tool in the treatment of depression in adoles-
cents. However, the relatively small sample (24 subjects in 
each condition) implies the need for replication studies with 
larger sample sizes in order to confirm these findings. There 
was also a large drop-out rate in the clinical monitoring 
group which may have led to skewed results. Furthermore, 
the sample in this study was predominantly Hispanic fe-
males, which is not representative of the general population 
of depressed adolescents as a whole. Finally, a key limita-
tion with this efficacy trial, as with all efficacy trials, is the 
fact that given the stringent inclusion and exclusion criteria 
for this study, the results are not necessarily generalizable. 
In order to remedy this problem, effectiveness trials of IPT-
A were conducted.  

 
Effectiveness Trials of IPT-A 

 
Mufson, Dorta, Wickramaratne, Nomura, Olfson, and 

Weissman (2004) examined the effectiveness of IPT-A 
compared with treatment as usual (TAU) in school-based 
mental health clinics in the New York City area. Details of 
how IPT-A was adapted for the school-based mental health 
clinics have been published (Mufson, Dorta, Olfson, 
Weissman, & Hoagwood, 2004). Participants in this 16-
week randomized clinical trial were 63 adolescents ages 12-
18 (mean age 15) who were referred for mental health in-
take visits and met DSM-IV criteria for major depressive 
disorder, dysthymia, depressive disorder not otherwise 
specified, or adjustment disorder with depressed mood. 
Patients were randomized to either IPT-A (n=34), consist-
ing of 12 sessions during 12-16 weeks, or TAU (n=29), 
defined as whatever psychological treatment the adoles-
cents would have received in their school clinics if the 
study had not been in place. Though TAU may have varied 
between schools, it was comparable to supportive individ-
ual counseling. Results showed that adolescents who re-
ceived IPT-A compared with those who received TAU had 
significantly greater decreases in depressive symptoms both 
on both the clinician-report (HRSD) and self-report (BDI) 
at week 12. Overall functioning and social functioning also 
significantly improved in the IPT-A group at week 12 as 
compared with the TAU group.  

In examining whether research therapy can be applied 
to community settings, the present study (Mufson, et al., 
2004) concluded that interpersonal psychotherapy delivered 
in school-based health clinics was an effective therapy for 
adolescent depression. It was also notable that depressed 
adolescents in the IPT-A group, when compared to the 

TAU group, showed significantly more improvement at a 
faster rate after eight consecutive weekly sessions of IPT-A. 
Because larger treatment effects occurred in older and more 
severely depressed adolescents, the authors suggest that this 
group may benefit more from structured, targeted treat-
ments such as IPT-A. Despite its application to a “real 
world” setting, this study was limited again by its largely 
Hispanic female sample from low socioeconomic back-
grounds. Other groups must be studied in order to establish 
the generalizability of these benefits. 
 Many of the participants in the aforementioned trial 
had comorbid disorders, in particular, comorbid anxiety 
disorders. Young, Mufson, and Davies (2006) examined 
how comorbid anxiety affected the effectiveness of IPT in 
depressed adolescents within this sample. They found that 
comorbid anxiety was often indicative of a more severe 
depression, as evidenced by higher depression scores at 
baseline. Furthermore, the depressed adolescents with co-
morbid anxiety had higher depression scores at the end of 
the study, regardless of treatment group, implying that this 
combination of depression and anxiety is more difficult to 
treat. At the same time, a non-significant trend was found 
suggesting that IPT-A was more effective in treating de-
pression in adolescents with comorbid anxiety compared to 
TAU. These results suggest that though depressed adoles-
cents with comorbid anxiety tend to have a more severe 
course of illness than those without comorbid anxiety, IPT-
A shows promise as an effective treatment for this difficult-
to-treat combination of disorders. 
 In another study of effectiveness, Rosselló and Bernal 
(1999) evaluated two treatments—Cognitive Behavior 
Therapy (CBT) and IPT-A, comparing them with each 
other and with a wait-list control (WC). This trial consisted 
of 71 adolescents, ages 13-17, in school grades 5 through 
12 who met DSM-III-R criteria for major depressive disor-
der, dysthymia, or both and who were randomly assigned to 
either CBT, IPT-A, or WC conditions. CBT and IPT-A 
treatment conditions consisted of 12 one-hour weekly indi-
vidual therapy sessions over 12 weeks. The investigators 
found that both IPT-A and CBT were more effective than 
the control condition in reducing adolescents’ reports of 
depressive symptoms. They also found that IPT-A, when 
compared to CBT, increased self-esteem and social adapta-
tion. Although both IPT-A and CBT were superior to the 
wait-list control group, participants in the IPT group only 
benefited in their self-concept and social adaptation signifi-
cantly more than participants in the wait-list control condi-
tion. Limitations again included a small, mostly Hispanic 
female sample and the use of only self-report measures. 

 
Novice Therapists 

 
Given the fact that most adolescents receive care in 

community settings such as schools (Mufson et al, 2004) it 
is important to design a brief yet effective training protocol 
that is feasible within existing constraints (i.e. training less 
experienced therapists). Santor and Kusumakar (2001) con-



CHAUDHURY AND SHOUM 
 

36 

ducted a trial of IPT-A using “novice” therapists. These 
therapists were considered novice because they lacked prior 
experience with IPT, learning about its principles during a 
3-day intensive training workshop, followed by weekly 
supervision sessions during the following year. In this trial, 
25 adolescents (ages 12-19 years; 23 females, 2 males) with 
DSM-IV diagnoses of major depression were recruited via 
consecutive referrals from outside clinicians. Unlike the 
samples in other studies (Mufson et al., 1994; Mufson & 
Fairbanks, 1996; Mufson et al., 1999), all of the participants 
in this study came from two-parent homes of middle socio-
economic status. Sixty percent of patients also met criteria 
for a comorbid diagnosis (dysthymia, posttraumatic stress 
disorder, anorexia nervosa, generalized anxiety disorder, 
conduct disorder, and/or social phobia). Depression severity 
was assessed via the BDI (recovery defined as 13 or less) 
and HRSD (recovery defined as 5 or less), and global func-
tioning was assessed through the Children’s Assessment of 
Global Functioning (C-GAS).  

Results indicated no significant differences in outcome 
measures as a function of the therapist’s professional back-
ground. Santor and Kusumakar (2001) found that 84% of 
participants displayed a significant decrease in depression 
as measured by the BDI and HRSD. In fact, at termination, 
only one of the 25 participants met DSM-IV criteria for 
depression. Furthermore, based on C-GAS results at termi-
nation, over half of the participants displayed a significant 
improvement in overall functioning. The results of this 
study provide further evidence that IPT-A is a highly effec-
tive mode of treatment for depressed adolescents, while 
also demonstrating that IPT can easily be implemented in 
community settings with therapists who have little or no 
experience with this form of therapy, provided that they 
receive adequate training and supervision. However, there 
was no control group in this study and thus no way to tell 
whether the results could actually be attributed to therapist 
training and background. Generalizability was again limited 
by patient demographics, as all patients were mostly fe-
males from two-parent, middle-income families.  

 
Group Adaptation 

 
Group therapy is also believed to be an effective treat-

ment for adolescents with depression (Mufson, Gallagher, 
Dorta, & Young, 2004). It provides immediate opportuni-
ties to practice new skills, and it offers adolescents a con-
text to decrease their feelings of isolation. In a group set-
ting, collaboration can also provide adolescents with feel-
ings of empowerment. There are opportunities for role play 
of communication skills, and room for advice and valida-
tion from peers. Thus, the adaptation of IPT-A to a group 
setting (IPT-AG) seems particularly promising. Further-
more, IPT-AG appears cost-effective (requires less staff for 
the treatment of more patients) and feasible in various set-
tings including school, community, and primary care clinics 
(Mufson, Dorta, Wickramaratne, et al., 2004).  However, 
these benefits are also potential limitations in that the indi-

vidual member’s problems may be eclipsed by those of 
other group members. Mufson, Dorta, Olfson, Weissman & 
Hoagwood (2004) addressed this potential risk by incorpo-
rating individual initial sessions prior to group meetings, at 
midpoint, and at completion of the group. During these in-
dividual sessions, therapists conducted interpersonal inven-
tories and described to the adolescent how his or her issues 
would be addressed within the group. Nevertheless, in the 
group setting, attention to each individual’s specific prob-
lem(s) is more limited than in individual treatment, as the 
focus becomes common interpersonal elements among 
them.  

Three pilot groups of four to six adolescents each were 
conducted to aid in the development of IPT-AG. Of these 
three groups, one involved a chart review of mostly Latino 
female patients ages 13-17 of low socioeconomic status. 
Though measures could not be collected during group meet-
ings, chart reviews were conducted by an independent 
evaluator. Investigators found that the average attendance 
for group therapy was 90% (comparable to individual IPT-
A studies) and that C-GAS scores increased from baseline 
to termination (Mufson, Dorta, Olfson, Weissman & 
Hoagwood, 2004).  Future work is necessary to assess the 
efficacy of the group modality for IPT-A. 

 
Conclusion 

 
The literature review presented in this paper provides 

evidence for the efficacy, feasibility, and applicability of 
the adolescent adaptation of IPT (IPT-A). Both IPT-A’s 
time-limited nature and focus on the present, especially 
social relationships, seem particularly relevant to adoles-
cents and their specific developmental issues. Additional 
work has studied IPT-A adaptations in a group modality 
and with novice therapists, demonstrating the flexibility of 
IPT-A therapy and its applicability to “real-world” settings. 
Nevertheless, more efficacy data is warranted, with larger 
sample sizes and more diverse populations. For example, 
given that most of the trials of IPT-A were conducted with 
predominantly Hispanic females of low socioeconomic 
status, additional studies are required in order to ensure that 
the original findings can be generalized to the larger overall 
population of depressed adolescents. Additionally, it would 
be interesting to see how IPT-A compares to other evi-
dence-based psychotherapies, such as CBT, as well as 
medications such as selective serotonin reuptake inhibitors 
(SSRIs) in treating depression. Studies of this nature have 
been conducted with depressed adults, and it seems appro-
priate to conduct similar trials with depressed adolescents. 
The research to date on interpersonal psychotherapy in de-
pressed adolescents has led to many important findings; 
with further research, more questions regarding the treat-
ment of adolescents with depression will undoubtedly be 
answered. 

 
 



INTERPERSONAL PSYCHOTHERAPY FOR ADOLESCENTS 
 

37 

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