|Year : 2021 | Volume
| Issue : 4 | Page : 144-152
Interpersonal psychotherapy knowledge dissemination in China
Wanhong Zheng1, Xuejun Liu2, Dilip N Chandran1, Joanna L Twist3, Aradhita Yadava4, Weihui Li5, Mark Miller1
1 Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, West Virginia, USA
2 The Brain Hospital of Hunan Province, Changsha, Hunan, China
3 School of Medicine, West Virginia University, Morgantown, West Virginia, USA
4 Eberly College of Arts and Sciences, West Virginia University, Morgantown, West Virginia, USA
5 Second Xiangya Hospital, Central South University, Changsha, Hunan, China
|Date of Submission||11-Aug-2021|
|Date of Acceptance||02-Sep-2021|
|Date of Web Publication||30-Nov-2021|
Dr. Wanhong Zheng
Department of Behavioral Medicine and Psychiatry, 930 Chestnut Ridge Road, West Virginia University School of Medicine, Morgantown, West Virginia 26505
Source of Support: None, Conflict of Interest: None
While many Chinese mental health professionals are familiar with modern psychotherapy, psychoanalysis, and cognitive behavioral therapy (CBT) are the mainstream therapy education and practice in today's China. Interpersonal psychotherapy (IPT) is a time-limited evidence-based psychotherapy that was originally developed for the treatment of depression. It has since been supported by over 250 randomized clinical trials in the treatment of various mental conditions including anxiety, and eating disorders. Despite good evidence for efficacy, IPT was not formally introduced to China until recently. This article describes a strategic plan for disseminating IPT knowledge in China and reports on current progress to date. We also summarize the discussion results from recent training lectures and workshops, and present suggestions for cultural adaptation per feedback from many enthusiastic trainees. Challenges and the future of promoting further integration of IPT as another effective psychotherapy option in China are discussed as well.
Keywords: Interpersonal Psychotherapy, IPT, therapy, China, knowledge dissemination, cultural adaptation, teaching
|How to cite this article:|
Zheng W, Liu X, Chandran DN, Twist JL, Yadava A, Li W, Miller M. Interpersonal psychotherapy knowledge dissemination in China. Heart Mind 2021;5:144-52
| Introduction|| |
Attitudes toward mental health treatment have changed drastically in China in the past few decades. Before psychotherapy was introduced in China, various traditional methods were used to treat mental health problems. These Traditional Chinese Medicine (TCM) therapies, including acupuncture, tai chi, qi gong, and herbal products, became popular and have been commonly practiced to relieve various psychiatric symptoms. The pervasive belief of the mechanism of action of TCM is in its holistic approach that links the spirit, body, and mind.
The initial introduction of psychotherapy in China began in 1949. At the time, psychotherapy was based on the Soviet Union's political interactions with China. Treatment methods revolved around Pavlov's theory of classical conditioning. From 1966 to 1977, work in the field of psychology came to an abrupt halt during the Cultural Revolution because of the science's Western roots. In the early 1980s, the concept of modern Western psychotherapy was introduced in China. Larger hospitals started using psychotherapy, and it was being taught in universities. As the awareness and interest in psychotherapy increased, scientific publications on the topic also started increasing.,
Psychoanalysis and cognitive behavioral therapy (CBT) were the first psychotherapies introduced in China. Consequently, these two therapies are also the most widely used. Psychoanalysis was formally introduced in China with international training programs in the 1990s. These were initially centered in big cities and then spread to smaller communities all over the country. The China-American Psychoanalytic Alliance became the first program to use distance technology to train psychotherapists by providing regular classes as well as case supervision., As time went on, psychoanalytic psychotherapy became popular in hospitals and other clinical settings. Lectures and workshops have made at least a rudimentary knowledge of psychoanalysis widely available. As a ripple effect, the candidates who graduated from early training programs have become a major influence in the evolution of the practice of psychoanalysis and psychodynamic psychotherapy in China.
Following the steps of psychoanalysis, CBT has also become an increasingly popular therapy in China. Research has shown that CBT can be used to treat a variety of ethnically and culturally diverse patient populations after modification and adaptation., It is also considered compatible with Chinese culture because of its timed structure and task-focused nature. Since 2000, there has been an increasing number of systematic training courses, case supervisions, and clinical studies to meet the needs of Chinese clients.,
Although CBT and psychodynamic therapy are the most commonly used forms of psychotherapy, various other methods are additionally practiced. These include, but are not limited to, client-centered therapy, behavior therapy, eclecticism, Morita therapy, and Shudao therapy, etc. In addition, supportive therapy, family therapy, biofeedback, humanistic therapy, hypnotherapy, and music therapy have also been implemented. As the awareness and demand for psychotherapy increases in China, there is a clear need for additional evidence-based therapies such as interpersonal psychotherapy or IPT.
IPT is a form of psychotherapy that focuses on relieving symptoms by improving interpersonal functioning. It is a time-limited intervention, consisting of 12–16 1 h sessions, originally developed by the late Dr. Gerald Klerman and his wife Dr. Myrna Weissman in the late 1970s for the treatment of depression. The first IPT manual was published in 1984, after the demonstration of the therapy's efficacy in randomized controlled clinical trials. Unlike CBT which focuses on cognitions and behaviors, IPT is primarily concerned with how specific interpersonal events impact interpersonal relationships and ultimately mood. IPT conceptualizes depression as a medical illness that is treatable to reduce demoralization and feelings of guilt. It focuses on how social roles can change with life events causing stress and potential negative changes in mood. IPT techniques ask the patient to “brainstorm” with the therapist to search for more adaptive strategies to cope optimally and encourage them to try implementing these new strategies between weekly sessions such that they can be reviewed and modified further at subsequent sessions. IPT seeks to instill hope that depression is treatable within a short-term time interval (12–16 weeks). This new learning or psychoeducation is a key component of IPT that seeks to empower the consumer of IPT to practice searching for and recognizing their own triggers of low mood within an interpersonal context and then to apply more adaptive strategies to relieve depressive symptoms and prevent its recurrence. IPT therapists focus on four problem areas: grief, role transition, role dispute, and interpersonal deficit. Since the original development, there have been over 250 randomized control trials evaluating the outcome of IPT in the treatment of various mental conditions. Most of these randomized control trials have shown IPT to be effective for the treatment of depression, anxiety, and eating disorders. IPT trials for other mental health problems such as addiction, PTSD, and distress from medical disorders also showed promising effects.
Despite good evidence for efficacy, IPT was not formally introduced to China until recently. As many practitioners in China are focused on psychoanalysis and CBT as the mainstream psychotherapy options, a very limited number of IPT studies could be found in our literature review of both English and Chinese language publications. Recent introductory projects conducted in China suggest that IPT can also be applied to Chinese individuals with few modifications. Group IPT may be a practical and efficient method of depression treatment for China's rapidly aging population., Given the fact that there has been an increasing interest in evidence-based psychotherapy in China, we feel it is important to promote IPT dissemination in China. This article describes a strategic plan for disseminating IPT knowledge in China and reports on current progress to date. We also summarize feedback and discussion results from training lectures and workshops and discuss challenges for promoting further integration of IPT as another effective psychotherapy option in China.
| Completed Strategies for Disseminating Knowledge about Interpersonal Psychotherapy within China|| |
In 2014, Ravitz et al. proposed training recommendations for the broad dissemination of psychotherapies. This model consisted of pyramid training (training trainers) using multimodal methods, including printed materials, workshops, supervised simulations, and participation in reflective case-based discussions. The success of IPT dissemination in Europe serves as an excellent example of the outcome of this pyramid training model. Psychiatrists in Germany, initially trained by IPT experts in the United States, started teaching IPT by giving IPT courses for mental health providers throughout Europe. As the exposure started slowly increasing, more people wanted to use IPT. As the use of IPT increased in Europe, the creation of a European IPT association was called into action and subsequently fermented growth of IPT therapist population throughout the continent.
In order for IPT to be successfully adopted in China, we need to borrow from the experience of psychoanalysis and CBT development in China, as well as from IPT knowledge dissemination in Europe. We, therefore, propose a phased introduction strategy that includes four phases: preparation, training, adaptation to Chinese culture, and wider dissemination to smaller population centers, as shown in [Figure 1].
|Figure 1: Phased Introduction strategy for interpersonal psychotherapy knowledge dissemination in China|
Click here to view
| Preparation|| |
Lectures and workshops by interpersonal psychotherapy experts
The intent of this initial phase was to introduce IPT concepts to audiences of interest. Lectures or oral presentations with Chinese translation were determined to be the best way to teach people about IPT. Before this project started, we noticed that IPT remained virtually unknown in China. This completely changed in August 2017 when Dr. Holly Swartz, former president of the International Society of IPT (ISIPT), was invited as a keynote speaker of the First China-America Xiaoxiang Summit on Psychiatry and Clinical Psychology and Annual Meeting of Psychiatric Branch of Hunan Medical Association. She went to China and gave three 60-min introductory lectures on IPT in Changsha and Hangzhou. The first lecture took place in Changsha, where over 600 mental health clinicians attended, including psychiatrists, primary care physicians, nurses, and counselors. Many Chinese clinicians expressed interest in integrating IPT into their daily practice to help patients with depression, anxiety, and other mental problems.
One year later, in 2018, Dr. Mark Miller, a well-published geriatric IPT expert, attended the Second China-America Xiaoxiang Summit on Psychiatry and Clinical Psychology in Changsha and gave a 300-min course on IPT to over 800 mental health clinicians. He gave the same lecture at the Seventh People's Hospital on July 09, 2018, in Hangzhou. In October 2018, Dr. Paula Ravitz (president of ISIPT from 2017 to 2018) and Dr. Holly Swartz successfully ran two IPT Workshops at the Xiangya Mental Health Institute, Changsha, Hunan, and the Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China, with each workshop lasting 2½ days.
At almost the same time, Dr. Joseph Chung, a psychiatrist in Hong Kong, and Dr. Sarah Bledsoe, an associate professor at the University of North Carolina, worked together to lead a 2-day IPT workshop in Hong Kong where 183 mental health practitioners learned IPT and received level A certification. In the same year, Dr. Diana Koszycki, a professor at the University of Ottawa, initiated a cross-national collaboration between the University of Ottawa and Jiao Tong University. Since then, Dr. Koszynski has provided continuous follow-up teaching and supervision for IPT learners in China.
With this initiation, many other IPT experts were later contacted and agreed to provide IPT training lectures or workshops in China.
Language can be an obstacle to sharing detailed information and research between cultures, and this was the case faced by IPT instructors in China, where no teaching manuals were available in the Chinese language. Without translation into Chinese, the process of teaching about IPT is more difficult as those interested in learning about IPT might forgo additional training steps required to successfully comprehend the books and written training materials.
To ensure that the concepts of IPT are accurately and effectively explained, translating books and articles is an essential part of increasing awareness about IPT in China. By providing the text in different languages, translation allows us to overcome the language barrier and reach a much larger audience.
Working with three Chinese colleagues, Dr. Wanhong Zheng, a psychiatrist working at West Virginia University, translated the WHO IPT Group Manual for Depression. It was published online on the WHO website (https://www.who.int/zh/publications/i/item/WHO-MSD-MER-16.4), where it can now be accessed by anyone interested in learning about IPT. In addition, the book “The Guide to Interpersonal Psychotherapy,” by Weissman and Markowitz (Oxford University Press 2017, ISBN-13: 9780190662592) was also translated by Dr. Zheng and his colleagues and published in September 2018. To the knowledge of the authors, by the time of this manuscript, a group of Chinese mental health professionals is in communication with different publishers on signing contracts to translate more IPT-related books into Chinese.
The next step in disseminating IPT in China required reaching out to local Chinese health organizations to spread awareness of IPT and increase the number of potential IPT trainers. The ultimate goal of outreach efforts is to ensure that as many people as possible can benefit from this therapy. Several local Health Committees in China were contacted for collaboration. By the time of this article's publication, 91 such community centers and over a thousand individual psychiatrists or counselors have shown great interest in not only learning IPT but in becoming trainers to further disseminate to other practitioners in China. In addition, ISIPT has demonstrated their willingness to further support IPT training and dissemination in China by facilitating communication between ISIPT and Chinese IPT therapists by creating a symposium entitled “IPT Knowledge Dissemination in China” within their 2019 Biennial Conference on ISIPT. This symposium was well attended as speakers and audiences exchanged ideas and experiences about IPT knowledge dissemination in China.
Train the trainers
In addition to translating IPT training manuals into the native language, “hands-on” training sessions and ongoing supervision of cases are essential to help professionals practice incorporating IPT into their daily practice. These teaching elements are essential to convert those merely interested in learning about IPT to experts in IPT who can become local teachers of IPT to new practitioners. Without proper training in IPT, practitioners and patients might not gain as much confidence in the psychotherapy, which could decrease its usage and wider dissemination. Well-trained Chinese professionals are thus an integral part of increasing the recognition and integration of IPT in treatment plans across China.
In 2019, a 16-week online case supervision course was delivered through ZOOM. A total of 24 therapists were divided into six groups and received weekly 75-min virtual case supervision sessions. Each group had one interpreter and a designated group leader who coordinated the schedule and communications between the sessions. Two supervisees presented at each supervision session, and all supervisees were expected to “attend” all sessions, even if they were not scheduled to present. Supervisors might choose to spend more or less time on a specific case, depending on its complexity and potential for using the case to teach important IPT-related themes. Supervisees learned from presenting their own cases as well as learning from the case presentations of other students. Questions about cases that arose in between sessions were addressed by E-mails between the supervisees and the supervisor. Throughout the supervision, the supervisees were encouraged to consider the specific cultural context of the patients receiving IPT. Examples of questions to think about and discuss during the sessions included:
- What are local Chinese traditions or practices surrounding each of the four core IPT interpersonal problem areas of Grief, social role transitions, role disputes, and interpersonal deficits?
- How is psychotherapy in general and having regular meetings to talk with a health professional viewed by the local populace?
- How do the proposed IPT approaches that seek improved resolution of each of the four interpersonal problem areas differ from traditional Chinese practices of managing stressful life events?
- How is a medical model of explaining depression symptoms and treatment viewed?
- What is the traditional understanding of triggers or causal factors that Chinese people attribute to causing symptoms of depression?
- What are the traditional pathways to care? Where have patients gone prior to (or simultaneous to) seeing mental health professionals, for example, spiritual or religious healers, TCM?
- How might stigma be affecting the patient and their family?
- How might stigma dissuade participation in IPT?
The goal of IPT supervision was to translate specific IPT skills into practice but not to oversee the actual clinical care of patients being discussed. In other words, it was made clear that the supervisory sessions would not take the place of clinical care supervision. This was clearly explained before the course was started and its acceptance was required by all trainees.
The communication gap between various parts of the world is not only due to language barriers but also cultural differences. While it is important to continue to train mental health clinicians, we have arrived at an adaptation phase of IPT Dissemination in China. The main goal of this phase is to identify cultural differences and collaborate with international IPT experts to make proper adjustments in the delivery of IPT that will make it suitable for the Chinese population. It is now imperative to conduct clinical trials to prove the effectiveness of adapted IPT in Chinese subjects. As research on the validity and reliability of IPT in Chinese subjects increases, so will the confidence in the usage of IPT throughout China. In addition, the data obtained from clinical trials will allow researchers to make further modifications to IPT to ensure that cultural requirements are met.
Further dissemination of interpersonal psychotherapy
Several strategies for the broad dissemination of IPT have been considered by these writers. First, we need to encourage newly trained IPT trainers to provide more IPT lectures, workshops, and beginning level training classes. Since these trainers are Chinese speakers, they will be able to train other local Chinese mental health care providers interested in IPT in a culturally sensitive way. Many years ago, Stuart proposed stepwise IPT training pathways for trainees with different backgrounds and preparations. Depending on what route one selects, an A (Introductory Course), B (Clinical Training), C (Clinical Certification), D (Certified Supervisor), and/or E (Certified Trainer) level certification could be received. Recently, ISIPT has started a formal certification process to provide certification for Supervisors, Trainers, and Therapists to maintain the highest standards and consistency in IPT. This will allow Chinese IPT pioneers to learn from ISIPT certified clinicians to promote IPT in China. It is our hope that some trainer therapists who completed our 2019 case supervision course can also apply and be awarded ISIPT certification. In addition, we need to continue to collaborate with ISIPT certified IPT experts who have an interest in teaching IPT in China to give more lectures and workshops. And finally, to sustain IPT learning, psychotherapeutic training in psychiatry residency programs and clinical counseling training curriculums need to incorporate the IPT approach as well as that of other modalities such that exposure to the basic tenets of IPT are introduced to students early on in their training and repeatedly throughout various courses in their training.
| Lecture and Workshop Feedback, Discussion Results, and Suggestions for Cultural Adaptation|| |
In this section, we summarize the important feedback and discussions from Chinese participants who completed the aforementioned lectures and workshops to better understand their experience learning IPT and elicit their opinions on how it could be best adapted to the Chinese culture. The results showed that Chinese therapists believed IPT can be used to help Chinese patients, but they also expressed concerns about how IPT should be adapted to unique Chinese traditions and cultural aspects. We also present participant opinions on how traditional Chinese practices impact on each of the IPT interpersonal problem areas (grief, role transition, role dispute, and interpersonal deficit). Collectively, these open-ended feedback and discussions open an opportunity to assess the applicability and challenges of successfully implementing IPT in China.
[Table 1] summarizes the work information of audiences who attended the 2.5 h lectures or the 2.5-day workshops. A total of 282 people participated and provided feedback. About 30% reported workplaces other than teaching or community hospitals. These included schools or college counseling centers, private counseling companies, and government agencies such as the Chinese Disease Control Center. Some individuals were from financial companies/banks or social organizations. In terms of professional background, over 40% were psychiatrists and about 9% were nurses. None of the audiences had social work background.
[Table 2] is a summary of 10-point Likert Scale feedback to the lecture or workshop. The answer to each question was a point value from 1 to 10, with 1 being “the least” and 10 being “the most.” Overall we found a high level of satisfaction with the training. Most people feel IPT is relevant to Chinese culture and will be accepted by Chinese patients. Many were interested in receiving further training or case supervision.
[Figure 2] summarizes the distribution of foreseen payment types relevant to IPT if delivered at the trainee's workplace. Many people (77%) believed it would be the patient's responsibility to pay out of pocket for the IPT service in their workplace, although some felt private insurance and government would provide coverage.
[Table 3] lists some of the reported traditions or rituals in Chinese culture that might be relevant in each of the IPT problem areas.
|Table 3: Chinese traditions or practices surrounding each of the interpersonal psychotherapy interpersonal problem areas|
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While all these IPT focuses could be generally applicable for Chinese patients, unique cultural beliefs could have a huge impact on how IPT can be implemented in China. One example is ShiDu – loss of the only child of the family. In IPT teaching, the strategy for coping with grief is to acknowledge and face the pain of loss and eventually to seek emotional investment in new places; however, given the devastatingly painful effect of losing one's only child, emotional re-investment options might be very limited. For many cases, there may not be an option to conceive any additional children in an attempt to replace what has been lost. Another example is ShiZheWeiDa . Chinese culture gives the highest respect to the deceased. Anything negative about the one who has passed away should be forgotten and never be mentioned. This is not the way IPT teaches to grieve. In IPT, all feelings the griever has toward the deceased are encouraged to be expressed to build an accurate composite picture of what the deceased person meant to the griever. Doing so, however, might also encounter negative or angry emotions toward the transgressions or attitudes the deceased demonstrated toward the griever that are considered inappropriate to express. While Chinese tradition avoids talking about what happened around the expiration time [Table 3], IPT encourages the recounting of feeling states around the time of the death in the griever. Furthermore, IPT recognized that grief can be complicated and that emotions about grief can be temporarily blocked by fears of becoming overwhelmed with emotion, but this does not necessarily indicate any disrespect. Similarly, well-meant prescriptions of medication to dampen strong emotion during the grieving process can also stifle the expression of emotion.
For role transition and role dispute in IPT, it is not hard to see that the listed Chinese traditions may lead to a culturally unique resolution. The IPT suggested ones might be seen as nontraditional or “out-of-line” in Chinese culture. For instance, while in IPT, the reasons why someone would not act to confront an identified problem are often explored, in Chinese culture, people may choose to subordinate and be silent to avoid any conflict with the superiors, as per Confucian philosophy, one's personal loyalty to superiors are of utmost importance.
MianZi means “face.” It is another important social concept in Chinese culture. Chinese people may choose not to interact with others to avoid embarrassment or “save face.” While it may seem to be a type of interpersonal deficit, it could be a cultural way to deal with disgrace or criticism. For example, parents may become totally isolated from the outside world because their only child did not get into the key university like they had hoped. Questions about MianZi were asked many times during the training workshops.
| Challenges for Interpersonal Psychotherapy Integration in China|| |
To successfully integrate IPT as a new mental health care option, it is essential that we recognize and address the challenges and barriers of knowledge dissemination. First, adaptation of IPT for the treatment of common mental disorders in non-Western countries must attend to contextual and cultural factors. As can be seen from the previous section, cultural differences require adaptation. Problems may arise with language-related issues and colloquialisms in teaching and supervision. Awareness of cultural and language diversity within China is also paramount. Concerns may be present with language translation with potential loss of accuracy, time involvement and lack of availability of providers and supervisors may also slow the IPT learning process.
Second, the implementation environment will need to be carefully assessed. The Chinese mental health system is unique, and mental health policies, legal considerations, and insurance coverage are all contributing factors to potential challenges for IPT dissemination in China. China's mental health laws since 2013 have restricted the ability of psychologists in mainland China to offer psychotherapy unless they are working with patients in hospitals. These patients have been required to be diagnosed by psychiatrists; otherwise, psychologists have been limited to offer counseling and psychosocial support.
Third, the presence of many “certified” counselors without any clinical experience has created a clinical burden in China. These counselors have passed the standard certification examination but have had little to no experience or supervision applying those principles to patients. Furthermore, psychiatrists are overwhelmed with clinical work from a time perspective. It will be essential to determine who among all mental health practitioners needs to be trained and then to provide them with systematic evidence-based training. These procedures will then need to be consistently duplicated throughout the Chinese mental health system.
China's population is nearly 1.4 billion people, covering a vast geographic area. The international global influence of China is undoubtedly growing rapidly. A consequence of globalization and economic development has been a natural increase in stressors in many aspects of life in China. Psychologists in China are working to professionalize their discipline, even as they respond to legal restrictions and a growing demand for psychotherapy. Providing broad therapy coverage for those who are remote and rural can be a big challenge. However, with today's technology, telehealth services may be vital and incorporated as a necessity for training, clinical services, monitoring, supervision, research, and data collection.
| The Future of Interpersonal Psychotherapy in China|| |
The future of IPT in China is promising. Triggered by the country's new mental health policies and legislations, there is an increasing demand and interest in psychotherapy and counseling. The term “Xinli Re” or “Psycho-Boom” reflects the zeal for knowledge and application of psychology in today's fast-developing China. As IPT gains more visibility in China, there will be additional IPT services delivered to indicated populations. In the next 5–10 years, we expect more clinical and scientific evidence to accumulate regarding the use of IPT in Chinese clients. There will also be more IPT related research, training and professional development, as well as more outreach and international collaborations.
Like any other new treatment modality in the early implementation stage, inside each of the aforementioned challenges is a hidden opportunity. Incorporation of Chinese culture and traditions empowers Chinese therapists to work around potential obstacles to find the best treatment outcome to work toward a new modified version of IPT that more appropriately fits the needs and preferences of the Chinese population – Chinese IPT (CIPT). For IPT training, geographical distance and language barriers can be difficult initially, but new technology and virtual communication may make case supervision and IPT service delivery more accessible over time. Recently, the Chinese Psychological Society has set new criteria for counseling practitioners and training institutions with a goal of increasing the standards of professional counseling practice. Many colleges have launched formal counseling training programs. This creates a unique opportunity for IPT knowledge dissemination. While the Chinese government is in support of increasing the number of mental health clinicians who can deliver interventions to meet the increasing demand for mental health care, the dual requirements of standardized care and evidence-based service will be enforced in hospitals and other clinical settings. IPT falls into this category, and IPT knowledge dissemination is aligned well with this mission and the new mental health policy.
This article calls for awareness of IPT as an evidence-based therapy for the Chinese population. We are confident that IPT, with Chinese cultural adaptation, can be used for a broad spectrum of psychological conditions that are highly prevalent in today's fast-developing China. In the past 3 years, many of our trainees have already put IPT into practice, as evidenced by increased social media discussion of IPT and recent 2021 ISIPT Conference submission of case reports and abstracts. It is our hope that more and more mental health clinicians can learn IPT and use it in daily practice. We also wish that this English article can help us gain more support from worldwide IPT experts to help initiate controlled clinical trials and implementation studies using IPT in China. Data collected from these studies will further inform efforts to fine-tune and adapt the IPT techniques for use in the Chinese population.
We gratefully thank the IPT supervisors for virtual case supervision: Dr. Diana Koszycki (University of Ottawa), Dr. Edward McAnanama (Mount Sinai Hospital, Toronto, Ontario, Canada), Dr. Sarah E. (Betsy) Bledsoe (University of North Carolina), Dr. Danielle Novick (Veterans Aswswsffairs Pittsburgh Healthcare System), Kelly Wells, LCSW (University of Pittsburgh Medical Center), and Dr. Anat Brunstein-Klomek (Interdisciplinary Center Herzliya). The work is also supported by ISIPT, especially Dr. Myrna M. Weissman (Columbia University), Dr. Holly Swartz (University of Pittsburgh), and Dr. Paula Ravitz (University of Toronto).
The ethical statement is not applicable for this article.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3]