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Interpersonal therapy

Interpersonal therapy (IPT) is a structured, time-limited psychotherapy treatment that focuses on interpersonal issues. Psychological problems are believed to be based on communication problems that developed through insecure attachments and early life experiences.

IPT was originally developed as a research intervention for severe depression. It is now empirically validated as a treatment for depression and other mood disorders, anxiety disorders and eating disorders. It is appropriate for all age groups.

IPT:

  • is structured
  • is time-limited (12–16 weeks)
  • focuses on interpersonal relationships and communication
  • focuses on here-and-now relationships
  • aims to improve symptoms, interpersonal functioning and social support.

IPT model

The interpersonal triad is a model that links psychological distress to three factors – interpersonal crisis, biosocial vulnerability and social support.

Interpersonal crisis

A stressful life event usually precedes the psychological distress. A strong link exists between these life events and the onset and continuation of depression.

Biosocial vulnerabilities

The person's ability to manage the stress is affected by biosocial vulnerabilities, such as:

  • attachment style
  • genetic vulnerability to illness
  • personality
  • temperament.

Social support

The context in which the distress occurs and what supports the person has affect the person's ability to manage distress. Supports include general social support and current close relationships.

Interpersonal and social rhythm therapy

Interpersonal and social rhythm therapy (IPSRT) is a form of interpersonal therapy. It includes elements that focus on the connection between disruptions in daily routines or rhythms and mood destabilization.

The Interpersonal and Social Rhythm Therapy website offers free resources for clinicians and clients, including online clinical training, assessment tools and video role plays.

What happens in IPT

IPT is time-limited and structured. It addresses current problems and relationships rather than childhood or developmental issues. Therapists are active, non-neutral, supportive and hopeful, and offer options for change.

IPT includes three phases that occur over 12–16 weeks.

Initial phase (1–3 sessions)

  • The clinician performs a diagnostic evaluation and documents the client's psychiatric history. This history is collected through an interpersonal inventory that reviews the person's current relationships, capacity for intimacy and social patterns. Changes in relationships are noted and provide context.
  • IPT focuses on four problem areas: grief, interpersonal role disputes, role transitions and interpersonal deficits.
  • The client is assigned the "sick role," which recognizes the person's depression or other disorder as an illness and sets the framework for therapy and recovery.
  • In interpersonal and social rhythm therapy (IPSRT), the therapist helps the client to track and regulate social rhythm regularity.

Middle phase

  • The therapist and client address the interpersonal problem area.
  • Addressing the interpersonal problem may involve mourning in the case of grief, resolving a struggle in the case of interpersonal role disputes, letting go of an old role and assuming a new one in the case of role transitions and decreasing social isolation in the case of interpersonal deficits.

Final phase (3 sessions)

  • The therapist supports the client's new or regained sense of independence and solidifies therapeutic gains.
  • The therapist helps the client to anticipate, identify and manage depressive symptoms that may reoccur.

Watch this video to hear a panel discussion at the University of Iowa about IPT.

When is IPT used?

IPT is one of two empirically based psychotherapeutic interventions for mood disorders (the other is cognitive-behavioural therapy).

IPT is used to treat:

  • adolescent disorders
  • anxiety
  • bulimia nervosa
  • chronic fatigue
  • depression in later life
  • mood disorders associated with HIV
  • mood disorders such as depression, bipolar and dysthymic disorders.

IPT has been adapted for:

  • couples therapy
  • group therapy
  • telephone therapy
  • counselling by non–mental health workers.

IPT and self-help

Related therapies

  • Interpersonal and social rhythm therapy (IPSRT) uses IPT and social rhythm elements together. Social rhythm is about the connections between disruptions in daily routines or rhythms and mood destabilization.
  • Cognitive-behavioural therapy is also structured and time-limited. However, unlike IPT, it requires that the client do homework, which involves monitoring and recording thoughts that contribute to emotional problems and considering ways to reframe those thoughts.
  • Solution-focused therapy is a more creative and flexible style of therapy that encourages the client to envision a preferred future and strategies for attaining those goals.

Evidence summary

International Society for Interpersonal Psychotherapy. (2014). About IPT. Iowa City, IA: Author.

Markowitz, J.C. (Ed.). (1998). Interpersonal Psychotherapy. Washington, DC. American Psychiatric Press.

Markowitz, J.C. & Weissman, M.M. (2004). Interpersonal psychotherapy: Principles and applications. World Psychiatry, 3(3), 136–139.

Zaretsky, A. (2011). Psychotherapy in primary care. In D. Goldbloom & J. Davine (Eds.), Psychiatry in Primary Care: A Concise Canadian Pocket Guide (pp. 249–264). Toronto, ON: Centre for Addiction and Mental Health.


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