Interpersonal Psychotherapy for Bulimia Nervosa

Status: Strong Research Support


Interpersonal Psychotherapy (IPT) for bulimia nervosa is based on an intervention originally developed for the treatment of depression. In IPT, the focus is on interpersonal difficulties in the patientís life. The connection between these problems and the development and maintenance of the eating disorder is identified at the beginning of treatment, but only implied thereafter; for the majority of the therapy, the symptoms of bulimia nervosa are never explicitly addressed. IPT for bulimia nervosa is conducted in approximately twenty weekly sessions, which encompass three phases. The first phase of IPT is devoted to identifying specific interpersonal problems areas currently affecting the patient, and choosing which of these areas to focus on for the remainder of treatment. The four typical interpersonal problem domains are role disputes, role transitions, interpersonal deficits, and unresolved grief. Interpersonal precipitants of current binge eating episodes are highlighted during this phase. In the second phase of IPT for bulimia nervosa, the therapist encourages the patient to take the lead in facilitating change in the interpersonal realm. The therapistís role involves keeping the patient aware of the time frame of treatment and focused on the problem areas, clarifying issues raised by the patient, and encouraging change. The third phase covers maintenance of interpersonal gains and relapse prevention. This treatment is typically administered individually, but it can be delivered in group format. In clinical trials, IPT for bulimia nervosa has been shown to have a slower effect than CBT in achieving symptom improvement and resolution.

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