A 75-year-old widower walks into your practice to request therapy services. He has grieved the loss of his wife for the last 28 months; they were married 50 years.
- Explain the significance of interpersonal deficit as it relates to interpersonal therapy
- Describe how you would ask “very good” questions to facilitate the patient’s ability to see their own experiences.
Submission Instructions:
- Should be at least 500 words, formatted, and cited in current APA style with support from at least 2 academic sources. Scholarly articles from the past 5 years.
- Focus on Interpersonal Therapy and Grief
Interpersonal Deficit and Interpersonal Therapy in the Context of Grief: A Case of a 75-Year-Old Widower
Interpersonal therapy (IPT) is a time-limited, evidence-based treatment model that primarily focuses on the interpersonal relationships of individuals and how these relationships affect their emotional well-being. It is especially effective in addressing grief, interpersonal conflicts, role transitions, and interpersonal deficits. In the case of a 75-year-old widower who is still grieving the loss of his wife after 28 months, the focus of therapy may encompass both unresolved grief and interpersonal deficits, which can significantly impair his social functioning and emotional health.
Interpersonal Deficit in Interpersonal Therapy
Interpersonal deficit, as conceptualized within IPT, refers to chronic issues in forming and maintaining healthy interpersonal relationships, often due to poor social skills, emotional isolation, or long-standing personality traits (Weissman et al., 2018). For a widower married for 50 years, the loss of his spouse may represent not only the loss of a loved one but also the loss of his primary, and perhaps sole, social support. If his marriage was the central relationship in his life, he may not have cultivated or maintained other close relationships, leaving him vulnerable to isolation after his wife’s death.
In older adults, grief compounded by interpersonal deficits can lead to prolonged grief disorder, depression, and even physical health deterioration (Ghesquiere et al., 2020). IPT helps patients recognize how their interpersonal issues contribute to their emotional distress. For the widower, therapy would involve exploring the nature of his relationship with his wife, how he coped with her loss, and his current social functioning. The goal is to strengthen existing relationships, build new ones, and develop healthier interpersonal skills to combat isolation and promote emotional healing.
Using “Very Good” Questions in Therapy
Facilitating therapeutic insight requires the use of open-ended, reflective, and empathetic questions. These “very good” questions are designed not to interrogate but to invite exploration, allowing the patient to consider their experiences in a new light. With the widower, questions would need to be sensitive to his loss while encouraging deeper self-reflection and emotional processing.
Examples of “very good” questions might include:
-
“Can you tell me what a typical day looks like for you now compared to when your wife was still with you?”
This question helps the patient reflect on the functional and emotional shifts in his life since the loss. -
“What are some of the things you miss most about your wife, and how have you been trying to cope with her absence?”
This promotes the expression of grief and helps identify current coping mechanisms. -
“Were there other people in your life you used to spend time with or feel close to? What has happened to those relationships?”
This begins to explore the presence or absence of a social network and interpersonal deficits. -
“If your wife were here with you now, what do you think she might encourage you to do to take care of yourself?”
This can help reframe the loss in a way that empowers the patient, linking his wife’s memory with self-care and future connection. -
“Have there been moments in the last 28 months when you felt more connected or less alone? What was different about those times?”
This encourages recognition of existing strengths or potential pathways to healing.
These questions help facilitate emotional awareness, acknowledge grief, and gently guide the patient toward re-engagement with others.
Conclusion
The grieving process, especially in older adults, can be prolonged and complicated by interpersonal deficits. Interpersonal therapy offers a structured approach to address these concerns by helping patients understand the role of relationships in their emotional distress and develop strategies to rebuild their social world. For the 75-year-old widower, skillful use of “very good” questions within IPT can foster self-reflection, validate his grief, and facilitate re-engagement with life. Encouraging connection, meaning, and emotional expression are central to the healing process.
References
Ghesquiere, A. R., Shear, M. K., Duan, N., & Skritskaya, N. (2020). Prolonged grief disorder in older adults: Clinical characteristics and cognitive-behavioral therapy outcomes. Depression and Anxiety, 37(6), 569–577. https://doi.org/10.1002/da.23008
Weissman, M. M., Markowitz, J. C., & Klerman, G. L. (2018). The guide to interpersonal psychotherapy: Updated and expanded edition. Oxford University Press.