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Interpersonal Psychotherapy. By S. Stuart and M. Robertson. (Pp. 315; £24.99.) Arnold: London. 2003.

While officially titled Interpersonal Psychotherapy: A Clinician’s Guide, the real title of this book, and the one that would make sense of its position in the IPT world, should in fact be Interpersonal Psychotherapy: The Next Generation. In the preface, Scott Stuart and Michael Robertson acknowledge their great debt to Gerald Klerman, Myrna Weissman and the other authors of the 1984 text Interpersonal Psychotherapy of Depression. But they go on to argue that while the original manualized version of interpersonal psychotherapy (IPT) therein described enjoys good empirical support for its efficacy, little is known about its effectiveness in clinical settings. They argue further that ‘requiring strict adherence to a manual outside of a research protocol is likely to diminish the effectiveness of the treatment because it discourages therapists from exercising their clinical judgement ’ (their italics). Having thus set the scene for divergence from the manual in such a way that it is hard for a reasonable man to object, Stuart and Robertson go on to describe their version of IPT, which departs in some notable ways from the original. The book is well organized in six coherent sections. The first introduces basic theoretical ideas behind IPT, relying heavily on Bowlby’s Attachment Theory, but also describing communication and social theories. There is a useful section on the therapeutic relationship, making clear why IPT uses this for information and the facilitation of therapy rather than explicitly working with the transference, but doing so in a way that does not diminish therapies that are transference based. The next section describes the initial sessions of IPT, and it is here that some of the important differences emerge. The book endorses the biopsychosocial model of mental disorders, and is at least implicitly critical of the ‘medical model ’, which underlies the original version of IPT. Thus, there is no talk of ‘giving the patient the sick role ’ – a necessary component of the original therapy – and the emphasis on ‘focus ’ is replaced by a more complete formulation, of which the interpersonal focus forms only one part. This section also contains a chapter on the crucial Interpersonal Inventory – a comprehensive description of the patient’s interpersonal world that will form the basis for understanding their current interpersonal problems. Sadly, however, while this chapter explains clearly what the therapist should be trying to do, it does not give good advice about how to do it ; and the Interpersonal Inventory Form, contained in the appendices and demonstrated in the text, bemusingly allows space for the description of one relationship only, thus begging the question of how to track multiple problems in the patient’s relationships. By contrast, Section 3, which describes IPT techniques, gives useful advice in a number of areas, particularly in the detailed description of the analysis of ‘Interpersonal Incidents’. Section 4 of the book describes the four main areas of focus of IPT. Here again differences emerge. The Klerman et al. (1984) description of ‘Grief ’ makes explicit that this can be used only in the case of loss by death of a significant other. Stuart andRobertson are more flexible, allowing this to be used for loss by other means, although acknowledging that such losses could still be dealt with under the rubric of ‘Role Transition’. Stuart and Robertson have also renamed ‘Interpersonal Deficits ’ as ‘Interpersonal Sensitivity’, arguing that this is a less pejorative label to give to the patient, and raising the issue that this may be different from the other foci in that it represents a baseline attachment and personality style rather than an acute social stressor. Section 5 of the book discusses the issues of Concluding IPT – thankfully renaming the ‘Termination’ phase of the original version – and Section 6 discusses a variety of other issues, including an overview of research in IPT, and Psychological Medicine, 2004, 34, 949–953. f 2004 Cambridge University Press Printed in the United Kingdom