Depression in Late Life: Interpersonal Psychotherapy

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Introduction

Psychotherapy can be defined as the process of interaction between a trained psychological professional and a client. The client may be a patient, a couple, a group or even a family. Psychotherapists, in most cases, address psychological issues that are aimed to increase an individual’s well- being. Psychologists often employ various techniques in obtaining useful information from the client. For example, they can use dialogue, direct behavior organization or even communication (Munsterberg, 2006).

There are various psychotherapists who are involved in various activities of offering psychotherapists services to clients. Psychotherapy and counseling have been used interchangeably in the past to refer to the process of giving guidance services to a client, in order to overcome the problem they are facing (Munsterberg, 2006).

This essay is going to critically evaluate the article titled “Interpersonal psychotherapy for late-Life depression” by Mark et al. The literature review part will critically analyze the article in terms of its strengths and weaknesses.

Background information

Interpersonal psychotherapy can be defined as limited treatment that is aimed at encouraging a patient to regain their functioning and moods (Weissman et al, 1999). Interpersonal psychotherapy normally lasts for almost 13 – 17 weeks. The psychotherapist will always help the client to understand themselves, and arouse some effects in them (Frank et al, 2011).

Depression can be defined as the state where an individual experiences low moods and a repugnance of activity. Depression, to some extent, might affect a person’s way of thinking, physical well-being and behavior (Markowitz, 1998).

Recent research has shown that the elderly people always suffer from late-life depression. In their article, Mark et al. sought to find out the effect and efficiency of applying interpersonal psychotherapy to people who were suffering from late-life depression. It is noted in the article that there has been an increased efficacy in the process of protecting recurrence of some major depressions in elderly people. The fact stated is that, efficacy is increased when such interpersonal psychotherapy methods are combined with antidepressant medication (Mark et al, 2001).

Discussion

Critical analysis

The authors of the article carried out an experiment in a bid to determine the effect of interpersonal psychotherapy on the elderly subjects. The research involved the study of older people who were over the ages of 70 years. The research involved observation of the effect of interpersonal psychotherapy on older people for a period of over 10 years. Such a sample is quite good because, most people who are over the ages of 70 years suffer from a moderate cognitive impairment (Mark et al, 2001).

Emphasis of the article

The article emphasizes on the role and importance of interpersonal psychotherapy in reducing the level of late-life depression among the elderly. The article points out, the elderly, and the young children are the most vulnerable populations because they do rely more on the support provided for by other family members. Also, the elderly are the elderly suffer from a moderate cognitive impairment, which makes the sample used in the research as an appropriate sample (Mark et al, 2001).

The article points out to the fact that there was no significant difference noted between the cognitively unpaired, and the cognitively paired groups of subjects in relation to the time of remission in acute phases or the achievement of remission (Mark et al, 2001). The research also found out that, the ability of a subject to willingly participate in the IPT program declined with increased cognitive impairment. This in essence created a sense of ambiguity because; it was not clear whether the achievement of remission in subjects was purely caused by interpersonal psychotherapy (IPT) or whether it was caused by the effect of drugs like paroxetine (Mark et al, 2001).

The article later concludes that, IPT alone is not sufficient to effectively treat late-life depression among the elderly. There must integration and considerations of other treatment in order to fully treat late- life depression among the elderly. For example, IPT could be combined with paroxetine in order to effectively treat late-life depression among the elderly (Mark et al, 2001).

The article coherence and logical structure

The authors’ of the article presents a coherent and logical argument that fascinates the user. The user is intrigued by the emphasis the article points out. Firstly, the article’s title is quite fascinating and interesting. The elderly are always ignored in the society, and are always known to be suffering from various types of diseases with depression being the most common old age problems. The treatments to such problems are not quite common and an individual is intrigued by the topic, and develops an anxiety to read the article more and more.

The authors of the article presents a well thought and logical arrangement of ideas. Firstly, they start by introducing the definition of interpersonal therapy, its history and the various scenarios where the concept could be applied. The article has a continuous prose and well supported evidence, which is mainly backed up by scientific presentations and analysis. For example, the authors used the Mattis Dimentia scale to measure the cognitive status of the subjects (Mark et al, 2001).

Methodological issues presented in the research

There are some methodological issues that are associated with the research, firstly, the authors indicates that, in order to minimize and reduce transportation costs, some phone calls were used to gather information from the clients (Mark et al, 2001). This in its sense undermines the integrity and accuracy of the results collected. In order to make generalizations, research data needs to be accurate, and one such way of ensuring data accuracy is by using the correct data collection methods.

By using phone calls as a method of collecting data, the authors of the article made a serious flaw in their research because the data collected could not be verified. For example, a person might provide wrong information regarding their experience with IPT program which eventually an effect on the results has obtained.

Another methodological issue being presented in the article is the measure of cognitive impairment. Cognitive impairment can be defined as the inability of an individual to concentrate, think, reason and formulate ideas (Mark et al, 2001). Mild cognitive impairment, also known as incipient dementia is a syndrome associated with the brain which causes mental impairment. The mental impairment created by incipient dementia does not largely affect the manner in which the individual performs the day to day activities (Mark et al, 2001).

Mental and cognitive impairment are naturally determined and cannot be fully measured using scientific means. Although some scientific means are more reliable in measuring cognitive impairment, such methods should not be relied upon purely because they have some degree of errors. The authors’ of the article entirely depended on the Mattis dementia scale of measuring cognitive impairment. This scale has some degree of flaws which underpins to the fact that, the data collected had some degree of inaccuracy in it.

Also, another methodological issue that was experienced is the problem of free participation of subjects in the entire IPT program. The authors note that, there existed some limiting factors that affected the willingness of the subjects to fully participate in the IPT program. Such limiting cognitive deficits factors included but not limited to the following factors; memory loss, judgment, insight, and problem-solving capabilities (Mark et al, 2001).

Articles relevance to clinical practice

The article is quite relevant to the clinical practice because it provides blue print and fundamental ideas that could help in understanding interpersonal psychotherapy and its application. Through reading the article, a psychotherapist is able to understand some concepts and ideas in the interpersonal psychotherapy field (Mark et al, 2001).

Also, the article provides some useful and meaningful approaches towards treating of late- life depression among the old. The article provides an exhaustive late-life depression treatment solutions. This is important to the clinical practice field because a psychotherapist is able to understand the various treatments that are available in treating late-life depression (Mark et al, 2001).

Recommendations

As a major recommendation to the research carried out, the researchers should have considered the several causes of depression among the older generation. The article did not put into consideration the various causes of depression. There are various causes of depression among the older generation and such causes have a positive correlation to the willingness of subjects to participate in the Interpersonal psychotherapy.

Also, as another recommendation for future research, relevant measures should be put in place to ensure that there is a provision for error tolerance in the various scientific methods used. The authors of the articles did not provide any room for error tolerance in their scientific methods used in analyzing the data gathered. When there is no error tolerance in any data analysis method, the obtained results are prone to error, hence compromising the integrity of the data.

Other important areas

Other key important areas in the article include the aspect of ethical issues. Any research paper should have a consideration for the ethical issues. Ethical issues will involve telling the subjects about the purpose of the research, the duration of the research, and the voluntary participation of the subjects in the research. The authors of the article did not consider the ethical issues regarding research because they did not inform the subjects about the main purpose of the research. Also, the authors did not fully inform the subjects on how long the research was going to run. Also, the article does not tell us whether the participation of the various subjects was voluntary or they were forced to participate in the research.

Conclusion

In conclusion, the article represents an analytical approach towards understanding the interpersonal therapy towards treatment of late-life depression among the elderly. The article also presents a combination of various treatments approaches. From the data collected, it is evident that, in order to effectively treat late-life treatment, then, interpersonal psychotherapy should be combined with other treatment methods.

Reference List

Frank, E & Levenson, J. C & American Psychological Association. (2011). Interpersonal Psychotherapy. Washington, DC: American Psychological Association.

Mark, D. M. et al. (2001). Interpersonal Psychotherapy for Late-Life Depression. Journal of Psychology Practise and Research. 10:231-238

Markowitz, J. C. (1998). Interpersonal psychotherapy. Washington, DC: American Psychiatric Press.

Munsterberg, H. (2006). Psychotherapy. New York: Cosimo.

Weissman, M & Markowitz, J. C & Klerman, G. L. (1999). Comprehensive guide to Interpersonal psychotherapy. New York: Basic Books.

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