MEQ: IPT formulation and treatment plan after partner role dispute

(i) Definition, four foci, primary focus (5). IPT is a time-limited, diagnosis-focused psychotherapy linking a medical-model view of depression to current interpersonal context; mood and relationships are reciprocal.[1] Four classic problem areas: complicated grief, interpersonal role dispute, role transition, interpersonal deficits.[1] Primary focus here: role dispute (nonreciprocal expectations about finances/intimacy with partner under long-distance strain). Secondary notes: possible role transition elements (long-distance relationship structure) and withdrawal from friends (deficits secondary to depression). Name one primary focus for fidelity.[1]

(ii) Initial phase (5). Confirm MDD diagnosis and risk; explain depression as treatable illness (reduce self-blame); grant temporary sick role (relief of some expectations while mobilising help-seeking and recovery tasks — not permanent invalidism); complete interpersonal inventory of key relationships and recent events; collaboratively select focus and set a time limit (typically about 12–16 sessions); agree goals and review medication plan.[1][3]

(iii) Middle phase and safety (5). Stay on dispute: clarify stages (renegotiation vs impasse vs dissolution), reconstruct recent arguments with communication analysis (what was said/felt/wanted; how it landed; alternative clearer needs expression), limited role play, rebuild supports beyond the partner so isolation does not maintain depression.[1] Safety caveat: screen for intimate partner violence/coercive control before homework that escalates confrontation; alcohol use needs parallel brief intervention so sessions are not undermined.[1]

(iv) Combined care and priorities (5). IPT is efficacious for depression in meta-analysis and sits among major brief psychotherapies evaluated with medication in comparative research traditions.[2][5][3] Sertraline 50 mg for only 3 weeks is early; plan dose optimisation per usual antidepressant practice plus IPT rather than either/or ideology; historical work supports combined drug and psychological strategies in depression care pathways.[4] IPT is not priority today if high acute suicide risk needing containment, emerging mania, psychosis, delirium, severe intoxication, or unsafe domestic situation requiring immediate protection pathways.[1]