Interpersonal psychotherapy as a treatment for depression in later life.

You are a psychologist in independent practice who begins to see an increasing number of depressed older adults. Without formal training in clinical geropsychology, you wonder which psychotherapies might be best to treat this clinical population. In this article, the author discusses a time-limited, empirically supported treatment, interpersonal psychotherapy (IPT), that seems well-suited to the kind of clinical problems often evident in depressed older people. The general structure of IPT, its suitability for older adults, relevant research, and a clinical case are briefly reviewed. In addition, our clinical experience with conducting IPT with older adults, a description of a program for teaching IPT to psychology trainees, and suggestions on how to acquire IPT skills are discussed. Is there a baby boomer in your future? In only 4 years, the first members of the 75 million baby-boomer generation—those born between 1946 and 1964—will reach age 65 years. By the year 2030, fully 20% of the United States population will be 65 years of age or older. Ready or not, here they come—and most psychol- ogists in practice in the next 20 years will be seeing older adults in clinical practice. The fact is that almost 70% of practicing psy- chologists currently see at least a few older adults in clinical practice, although only a tiny 3% view older adults as their primary professional practice group (Qualls, Segal, Norman, Niederehe, & Gallagher-Thompson, 2002). There will not be enough trained geriatric mental health care providers to serve the needs of the soon-to-balloon population of older adults, and generalist practi- tioners will almost certainly be responsible for most care of older people (Jeste, Alexopoulos, Bartels, Cummings, Gallo, et al., 1999). Psychologists who provide services to older adults are urged to become familiar with gerontology and geropsychology in a manner that maximizes their effectiveness in assessing and treating late-life psychological difficulties (American Psychologi- cal Association, 2004). For those who conduct or will conduct psychotherapy with older adults, what therapeutic options are available? The good news is that most psychotherapies developed for younger adults appear useful for older adults when applied in an age-informed, age- sensitive manner (Knight, 2004; Scogin, Welsh, Hanson, Stump, & Coates, 2005). In the early 1990s, after 10 years of clinical practice with older adults, I was interested in finding a psychotherapeutic modality that seemed well-suited to the clinical problems of de- pressed older adults, that was consistent with general recommen- dations for doing psychotherapy with older people, for which there was some evidence for its efficacy, and that was consonant with my own collaborative style of doing psychotherapy. I found that interpersonal psychotherapy (IPT) fit the bill and subsequently obtained formal training. For almost 15 years, I have conducted IPT and trained students in how to conduct IPT with older adults. I have found IPT an especially useful modality in the treatment of late-life depression and believe that many practitioners will simi- larly find IPT professionally appealing, consistent with their own clinical style, and effective.