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It is important that you are given enough

information and help to make a choice youare happy with and that your therapist issomeone you have confidence in workingwith. Above all, you should feel listenedto, treated with respect and that yourconcerns and need for help are takenseriously.

Your therapist will check this by askingfor your feedback about whether you are

satisfied with the therapy you are beingoffered and confident you will get the careyou need before you start therapy as wellas after you finish to check if it really hashelped you.

If you are not satisfied at any point, youshould say so and your therapist shouldthen help you review your options. If youdon’t feel comfortable giving this feedback

to your therapist, you can ask to speakwith the service manager or clinical lead.The more information youhave about what to expect, and themore confidence you have in the agreedapproach, the less likely you are to bedisappointed.

You should be given a choice of time, date,the place where you have your therapyand how you wish to be contacted..

Questions you may also like to ask include:

they held?

how does it end?

some benefit from therapy?

between sessions who can I call?

with people with similar problems tomine?

confidentiality be broken?

particular trype of treatment?

disadvantages of this treatment?

expect?

treatment or with any medication I (may)also have been prescribed?

recover by the time we finish?

Monitoring your

progress in therapy…Your therapist will ask you to completesome questionnaires during therapy, oftenon a weekly basis. This is to help you andyour therapist to see what progress youare making and so you can give feedbackabout whether you are finding the therapyhelpful.

This is very useful because not everyonemakes progress at the same rate. If thequestionnaires show that you are notbenefitting sufficiently from therapy, itgives you and your therapist a chanceto think about why this might be and, ifnecessary, to review your therapy plan andmake changes.



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Interpersonal Psychotherapy (IPT)

IPT is a time-limited and structuredpsychotherapy. A central idea in IPT is thatpsychological symptoms, such as depressedmood, can be understood as a response tocurrent difficulties in relationships. In turn,the depressed mood can also affect thequality of our relationships.

An example may help. If someone isdepressed they may withdraw from thoseclose to them, apparently refusing theirhelp (perhaps because they feel like afailure and are ashamed of this). Familyand friends may feel rejected and hurt,unable to understand why their offers ofhelp are not taken up, and they may, inturn, pull away. The depressed personmay take this as confirmation of their viewof themselves as a failure, and this couldmake them feel even more depressed andwithdrawn, setting up a vicious circle.

How does it work?The main focus of IPT is on relationshipproblems and on helping the person toidentify how they are feeling and behavingin their relationships. When a person is ableto deal with a relationship problem moreeffectively, their psychological symptoms

often improve. IPT typically focuses on thefollowing relationship difficulties:

about yourself and others:

relationships going



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Brief Dynamic Interpersonal Therapy(DIT)

DIT is a form of brief psychodynamicpsychotherapy developed for treatingdepression. It is particularly helpful forpeople with emotional and relationshipproblems, especially if these are linked toprevious relationship difficulties.

We have known for some time that

difficult experiences in the past cancontinue to affect the way people feel andbehave in the present and that this cancause problems in relationships which inturn can be linked to depression.

How does it work?Psychodynamic therapy is based on the

idea that when something is very painfulwe can find ourselves trying to ignore it.Most of the time we know when we’redoing this but sometimes we can burysomething so successfully that we losesight of it completely.

DIT aims to help people by focussing oncertain key aspects of someone’s currentrelationship patterns. If we can help them

change these they feel more able to sustain

intimacy and closeness with others andtheir depression lifts.

In practice, DIT tries to help someone talkmore freely about themselves. In doing so,it might become clear, for example, thatwhenever someone tries to get to knowthem, they fear the worst and push them

away to make sure no-one gets closeenough to hurt or disappoint them again.This would be one kind of self-defeatingpattern.

If a person’s difficulties go back to earlierin life they may not notice for themselvesthe impact this can have on how they arebehaving or responding to others becauseit becomes second nature – ‘the way

things are’. By drawing attention to somekey aspects, picking up on an immediatedetail in the moment, for example, the DITtherapist tries to help them make sense ofhow they are in their present relationshipsmore clearly. In this focussed way, usinga combination of feelings and reflection,they can then change how they respondand move on, more secure in their abilityto relate to others.



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Couple Therapy for Depression

Couple Therapy is an approach that canhelp both people in a relationship withthe emotional difficulties that sometimesflow from problems between partners,especially when one or both people aredepressed. There are many different typesof couple therapy but what is describedhere is a particular type of couple therapy

that has been developed to help peoplewho are suffering from depression.

People might benefit from couple therapyfor many different reasons. It may be thatthe relationship has broken down or thatthere is anxiety that it might. Sustaininga fulfilling and stable relationship isnever easy. Pressures from work, money,children, family tensions and ill health can

all contribute to creating problems andthese problems can lead to depression andother difficulties for one or both partners.Sometimes couples can’t talk to each otherand meeting with a couple therapist canopen the way to better communicationwhich seems to be a key part of improvingrelationships.

How does it work?Research has shown that couple therapyhelps people with depression when theyare in relationships that are experiencingdifficulties. Improving your relationshipthrough working together on the thingsthat create unhappiness, helps both youand your partner move on from stuck andoften hostile patterns of interaction.

This in turn can lead to a happier and morefulfilling relationship. Having a happier andmore fulfilling relationship often relievesdepression which in turn improves yourrelationship. This positive cycle tends toimprove mood and emotional well being.



Produced by the National IAPT Programme, with thanksto those who have contributed to this document.

[email protected]

www.iapt.nhs.uk

Refs:Understanding NICE guidance,Information for people who use NHSservices. (NICE, October 2009)

Speak to the person who gave you thisbooklet about obtaining it in an audioformat or in other languages.

This booklet is also available on theImproving Access to PsychologicalTherapies website at:

www.iapt.nhs.uk

which therapy

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