Conducting IPT-AST in Schools

This chapter discusses the delivery of Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST) in school settings. The literature on school-based mental health programs is reviewed. Advantages of delivering preventive interventions in schools and challenges to implementation are outlined. These challenges include obtaining agreement from school personnel and boards of education; identifying personnel who will take the lead in implementing IPT-AST; identifying adolescents who will be appropriate for these services; explaining IPT-AST to adolescents and parents to engage them in the program; and managing logistical and scheduling issues within the schools. The authors discuss strategies to address the challenges of implementing this depression prevention program in a school setting.

IPT-AST Mid-Group Session

This chapter describes the structure and content of the mid-group session in IPT-AST, which is scheduled with each adolescent individually between group sessions 4 and 6. The purpose of the mid-group session is to review how the teen is doing, discuss areas that still need to be addressed, and allow the teen to practice new communication strategies related to one of her interpersonal goals for group. For teens whose identified goals involve parents, this session is a particularly useful opportunity to practice new communication strategies with the parents in a safe environment. When a parent cannot attend the mid-group session, the mid-group session allows the teen to do targeted work toward her interpersonal goals in a one-on-one session.

IPT-AST Pre-Group Sessions

Adolescents in Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST) participate in two individual pre-group sessions before the group begins. If two sessions are not feasible, a single 90-minute session can be offered. The goals of these sessions are to get to know the adolescent and build rapport; assess for depression symptoms over the past week; provide psychoeducation about depression; explain the structure of IPT-AST; conduct an interpersonal inventory of important relationships; and help the teen to set interpersonal goals for group. When possible, it is helpful for parents to attend the first pre-group session to learn about the program’s focus and structure. This chapter describes the structure and content of these pre-group sessions.

IPT-AST With Different Populations and in Diverse Settings

This chapter discusses modifications that can be made when offering IPT-AST to adolescents at varying levels of risk, in particular universal and selective populations. The chapter also describes a number of settings where IPT-AST can be implemented, including medical, mental health, and community settings, and discusses associated benefits as well as challenges. Finally, logistical considerations when IPT-AST is offered in these diverse settings are discussed.

Review of Empirical Evidence for IPT-AST

This chapter provides an overview of the past decade of research on Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST). Studies on the efficacy of IPT-AST for the prevention of depression in adolescents are discussed to provide a summary of the empirical evidence for IPT-AST available to date. Current and future directions for research on IPT-AST are outlined. Adaptations of IPT-AST for other populations are briefly described. Research to date suggests that IPT-AST may be effective for these populations.

Common Clinical Issues

This chapter addresses common clinical issues that Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST) group leaders have encountered. These issues include absences, engaging reluctant adolescents in group activities, difficult or defiant adolescents, breaches to confidentiality, challenging family situations, sensitive topics, and crises, including disclosures of suicidal thoughts and suspected abuse. The chapter discusses ways that the authors have addressed these common clinical situations in IPT-AST groups. Examples for addressing these situations are provided.

IPT-AST Middle Phase

In the middle phase of Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST) (sessions 4–6), adolescents practice applying communication strategies to specific situations that are important to them. Sessions focus on helping adolescents work on their interpersonal goals by planning and practicing conversations using the interpersonal skills they learned during the initial phase. Communication analysis, decision analysis, application of the communication strategies, scripting, and role-playing are used to facilitate the work in middle phase. The situations of each adolescent are connected to those of others in the group, pointing out when particular strategies may be applicable in different situations and for different interpersonal goals. This chapter describes how to implement the middle phase of this depression prevention program.

IPT-AST Overview

Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST) is an adolescent depression prevention program that teaches communication and interpersonal problem-solving skills to improve relationships. IPT-AST is rooted in the theory that depression occurs in an interpersonal context. This primarily group-based intervention helps adolescents learn ways to resolve conflicts, negotiate with others, and strengthen important relationships. This chapter describes the theoretical basis, key components, and structure of this intervention. In addition, there is a discussion of the leader’s role in implementing the program.

IPT-AST Initial Phase

The initial phase (sessions 1–3) of Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST) provides an opportunity for group members to get to know each other and feel comfortable in the group setting. These sessions are educational in tone. In session 1, group members introduce themselves, establish group rules, learn about the purpose of the group, and talk about symptoms of depression and interpersonal issues that are common in adolescence. In session 2, the leader uses activities to illustrate issues in communication, and group members role-play hypothetical interpersonal situations to illustrate the technique of communication analysis. In session 3, the group leader teaches adolescents six communication strategies and continues to use hypothetical interpersonal situations to illustrate how these strategies can be used. This chapter describes how to implement the first three group sessions of this depression prevention program.

Selecting Adolescents to Participate in IPT-AST

This chapter describes the process of selecting adolescents to participate in Interpersonal Psychotherapy–Adolescent Skills Training (IPT-AST), including considerations regarding target population and level of prevention. This chapter includes a detailed discussion of how to conduct a clinical interview to determine appropriateness for this depression prevention program. The importance of thoroughly assessing symptoms of depression as well as other mental health problems is discussed. The authors describe considerations that can help to determine whether or not a particular adolescent is an appropriate candidate for IPT-AST, including mental health diagnoses, interpersonal functioning, and the adolescent’s ability to behave appropriately in a group setting. Finally, the authors discuss considerations for group composition.