Grief, interpersonal disputes, and role transitions: the breadth of interpersonal telepsychotherapy as a strategy to reduce mental health suffering due to the COVID-19 pandemic among health professionals

The COVID-19 pandemic necessitated the rapid development of strategies to treat mental suffering among health professionals. Our letter reports the prevalence of problem areas used in interpersonal psychotherapy (IPT)¹ and the fitness of the IPT model as applied to health professionals seeking emotional support during the COVID-19 pandemic.

We investigated the appropriateness of IPT problem areas in a sample of participants in the TelePSI project.² TelePSI is a 3-arm randomized clinical trial started in May 2020 designed to evaluate the effects of ultra-brief IPT, cognitive behavioral therapy (4 sessions), and psychoeducation (1 session with reinforcing videos) to reduce symptoms of anxiety, depression, and irritability among health workers in Brazil.² TelePSI chose IPT due to its versatility and evidence of efficacy in psychiatric conditions with anxiety and depressive symptoms.³ It is level-1 evidence in guidelines for treating depression, eating disorders, and bipolar disorders. IPT originally includes four problem areas, but three of them (grief, interpersonal disputes, and role transitions) are more suitable for brief treatment.¹

We analyzed data from the first 300 participants in the TelePSI interpersonal arm. The participants were 83.6% female, with a mean age of 37.8 (SD = 9.7) years. Nine therapists provided online IPT for health professionals during the pandemic, with weekly supervision. The average score for the Clinical Global Impression - Severity scale, which ranges from 1 (asymptomatic) to 7 (among the most symptomatic patients), was 3.58 (SD = 1.29), and the functionality score, which ranges from 1 (no impairment) to 4 (severe impairment), was 1.96 (SD = 0.81).

A total of 69.4% participants only had one problem area, and 27.4% had two problem areas. A total of 5% had all three problem areas. Regardless of the combinations, a total of 12% (n=36) selected grief as the primary IPT problem area, 45.7% (n=137) selected interpersonal dispute as the primary IPT problem area, and 71.3% (n=214) selected role transition as the primary IPT problem area.

In a multiple regression model including all three problem areas and adjusting for the effects of co-occurrence, role transition as the IPT area was independently associated with higher severity in crude severity scores (b = 0.51, p < 0.001) and crude functionality scores (b = 0.26, p = 0.025). The role transitions group seems to have more diffuse difficulties in dealing with the pandemic as a whole than the other two groups.

The TelePSI project observed that the IPT model adequately fits most pandemic-associated clinical situations presented by health workers. The IPT problem area model was an excellent way to focus ultra-brief psychotherapy during the COVID-19 pandemic. In 95% of our sample, the therapist detected a primary IPT area problem, confirming the fitness of the IPT model for the COVID-19 pandemic. Role transition was the most prevalent IPT problem area, as expected, and was associated with greater symptom severity. IPT is a life-event psychotherapy,⁴ and its model appears to be a promising approach for mental suffering during the COVID-19 pandemic.

References

• ¹
  Klerman G, Weissman M, Rousaville B, Chevron E. Interpersonal psychotherapy of depression: a brief, focused specific strategy. Oxford: Rowman & Littlefield; 1984.
• ²
  Salum GA, Spanemberg L, Hartmann de Souza L, Teodoro MD, Marques MC, Harzheim E, et al. Letter to the editor: Training mental health professionals to provide support in brief telepsychotherapy and telepsychiatry for health workers in the SARS-CoV-2 pandemic. J Psychiatr Res. 2020;131:269-70.
• ³
  Cuijpers P, Donker T, Weissman MM, Ravitz P, Cristea IA. Interpersonal psychotherapy for mental health problems: a comprehensive meta-analysis. Am J Psychiatry. 2016;173:680-7.
• ⁴
  Markowitz J. In the aftermath of the pandemic: Interpersonal psychotherapy for anxiety, depression, and PTSD. Oxford: Oxford University Press; 2021.

Publication Dates

• Publication in this collection
  19 Apr 2023
• Date of issue
  Mar-Apr 2023

History

• Received
  22 Oct 2022
• Accepted
  18 Dec 2022