Client Presentation and Current Symptoms
- Summary of presenting concerns and current mood symptoms
- Changes in symptoms or functioning since the previous session
- Results of any in-session assessments (e.g. depression rating scales)
- Significant life events or circumstances since last session
Treatment Phase
- Identification of current IPT phase: Initial (sessions 1–3), Middle (sessions 4–12), or Termination (final 2–3 sessions)
- Session number if documented
Interpersonal Context and Formulation
- Link between symptoms and current interpersonal situation
- How interpersonal context relates to onset or maintenance of symptoms
- Sick role assignment or discussion, including psychoeducation if provided
Interpersonal Inventory
- Key relationships discussed, including quality and nature
- Sources of social support and confiding relationships
- Communication patterns and interpersonal functioning
IPT Problem Area Focus
- Grief: Complicated bereavement, capacity to mourn, relationship with deceased, link to current symptoms
- Role Dispute: Conflict with significant other, stage of dispute, communication patterns, non-reciprocal expectations
- Role Transition: Old vs. new role, losses and gains, emotional response, skill development for new role
- Interpersonal Deficits: Social isolation, chronic relationship difficulties, past and current interpersonal patterns
IPT Techniques and Interventions Used
- Communication Analysis: Examination of specific interpersonal exchanges, intended vs. communicated meaning, patterns identified
- Role Play: Scenarios practised in session and communication skills rehearsed
- Decision Analysis: Exploration of needs, options, and realistic courses of action
- Encouragement of Affect: Emotion identification, validation, and linking to interpersonal events
- Clarification: Helping client understand interpersonal patterns and relationship dynamics
- Exploration of Options: Brainstorming alternative interpersonal strategies
- Other IPT Techniques: Psychoeducation, normalisation, symptom-to-relationship linking
Client Response
- Engagement with interventions and observable responses
- Evidence of improved communication, assertiveness, or capacity to express needs
- Insights about relationship patterns or interpersonal functioning
- Barriers to implementing new strategies
- Observable changes in symptoms or interpersonal functioning
Therapeutic Alliance
- Quality of rapport and collaboration
- Use of therapeutic relationship as transitional support
- Any challenges in alliance and adjustments made
Risk Assessment
- Risk factors discussed (e.g. suicidal ideation, self-harm)
- Protective factors including social support
- Safety planning or actions taken
Termination Planning
- Review of treatment gains and progress on problem area
- Termination framed as a role transition
- Client’s reaction to ending therapy
- Plans for maintaining gains; referrals or maintenance sessions if needed
Plan and Next Steps
- Interpersonal actions or goals for before next session
- Anticipated focus or goals for next session
- Date, time, and location of next appointment if scheduled
Session Summary
- Brief recap covering: interpersonal focus, key interventions, client response and progress
Client Presentation and Current Symptoms
- Emma presented as mildly distressed, reporting persistent low mood, fatigue, and poor concentration over the past week.
- She noted slight improvement in sleep since the previous session, though mood remained flat for much of the week.
- PHQ-9 score of 14 (moderate depression), down from 17 at initial assessment.
- Emma reported a difficult conversation with her sister that left her feeling dismissed and alone.
Treatment Phase
- Middle Phase — Session 5 of 12.
Interpersonal Context and Formulation
- Emma’s depressive symptoms appear closely tied to ongoing conflict with her sister, characterised by repeated experiences of feeling unheard and undervalued.
- Therapist reinforced the link between these relational difficulties and the maintenance of Emma’s mood symptoms, building on psychoeducation from the initial phase.
IPT Problem Area Focus
Role Dispute
- Primary focus remains a role dispute with Emma’s sister around expectations of emotional support and reciprocity, currently at an impasse stage.
- Emma expects her sister to initiate contact during difficult periods; her sister appears to expect Emma to manage independently.
- Session explored how unspoken, non-reciprocal expectations have maintained the conflict.
IPT Techniques and Interventions Used
Communication Analysis
- A play-by-play analysis of the recent conversation with Emma’s sister was conducted.
- Emma’s indirect opening — asking whether things were okay between them — did not convey the full weight of her need for connection, contributing to her sister’s dismissive response.
Encouragement of Affect
- Emma identified feelings of hurt, loneliness, and resignation arising from the exchange, and linked these directly to her unmet relational needs.
- The therapist validated these emotions and normalised their connection to her depressive symptoms.
Role Play
- Emma practised more direct communication of her needs in a role-played version of the conversation. She found this difficult initially but reported feeling more confident by the end.
Exploration of Options
- Options discussed included a direct conversation, a written message, or temporarily drawing on other supports while reducing expectations of her sister.
- Emma identified a direct conversation as her preferred approach.
Client Response
- Emma was engaged and reflective, demonstrating increased willingness to examine her communication patterns and insight into how indirect communication may be maintaining the impasse.
- She left feeling more prepared to initiate the conversation with her sister, with no significant barriers identified beyond some anxiety about her sister’s reaction.
Therapeutic Alliance
- Rapport was strong. Emma was open and collaborative, and the therapeutic relationship continues to provide a supportive context for practising more direct communication.
Plan and Next Steps
- Emma agreed to initiate a direct conversation with her sister before the next session, using the communication approach practised in role play, and to note her emotional responses throughout.
- Next session will focus on reviewing the outcome of that conversation and further developing assertive communication strategies.
- Next appointment: Wednesday, 26 February 2026, 10:00 AM.
Session Summary
Session 5 addressed Emma’s role dispute with her sister, focusing on non-reciprocal expectations and indirect communication patterns maintaining an interpersonal impasse. Communication analysis, encouragement of affect, role play, and exploration of options were used to help Emma identify the gap between her intended and expressed needs and rehearse more direct communication. Emma engaged well, demonstrated meaningful insight, and left with a clear interpersonal goal for the coming week.
