Interpersonal Psychotherapy

About

Interpersonal Psychotherapy

What is interpersonal psychotherapy?

Interpersonal psychotherapy (IPT) focuses on relieving psychological stress by improving how you function with other people in relationships and social settings. IPT therapists believe that changes in a patient’s social environment is a key factor in the onset of depression, or the worsening of existing depression. The loss of a loved one or social isolation can cause a spiral into depression, or worsen existing depression or mood disorders.

IPT focuses on resolving interpersonal problems, reducing symptoms, and teaching the patient how to improve their lives. It addresses interpersonal deficits such as social isolation or involvement in unfulfilling or negative relationships. It’s also used to help patients manage unresolved grief, or deal with difficult life transitions like divorce, moving to another city, or retirement. It has also been used effectively to deal with disputes that emerge among partners, family members, close friends, or coworkers.

IPT is a short-term, evidence-based approach that can relieve the symptoms of a variety of mood disorders. Therapists using the IPT approach follow a closely structured process that can be completed in 12-16 weeks. 

What is the goal of interpersonal psychotherapy?

The immediate goals of IPT are to quickly reduce symptoms and improve interpersonal relationships and social functioning. IPT identifies patterns that interfere with forming and maintaining good relationships, such as excess dependency or hostility. Long term, the goal is to empower people with depression to make their own adjustments in behavior and thought. Once they accomplish these skills, patients are better able to cope with and reduce their depression.  

Another goal is to create a support system during the course of treatment. This helps the patient independently regulate their distress by using the social skills and adaptations they’ve developed with their therapist.

When is interpersonal psychotherapy used?

Although it does not apply to all disorders, IPT can be used in a variety of situations, including with patients who:

  • Are no longer helped by antidepressant medications because the drugs have stopped working, never fully relieved their depression, or have permitted previously controlled symptoms to relapse
  • Do not respond to antidepressant medications, refuse to take them, or cannot afford them
  • Are adolescents or children with depression
  • Have eating disorders
  • Suffer from drug or alcohol addiction 
  • Have chronic depression
  • Have postpartum depression
  • Have bipolar disorder
  • Have post-traumatic stress disorder (PTSD)
  • Have anxiety disorders

What does interpersonal psychotherapy treat?

The therapy helps patients understand their emotions as social signals, use this understanding to improve interpersonal skills, and mobilize their social support system.

IPT has demonstrated effectiveness for:

  • Major depression, both as an acute and maintenance treatment for patients of all ages (it’s at least as effective as short-term treatment with antidepressant medications)
  • Bipolar disorder, bulimia, and binge-eating disorders, where it’s used as a companion therapy to medication 
  • Social phobia
  • PTSD
  • Borderline personality disorder
  • Insomnia
  • Interpersonal disputes or conflicts that happen in couples, families, school, social and work settings that can happen when the people involved have different expectations of a situation
  • Role transitions that occur with changes in work or social situations, or as the result of a life event, and force the patient to adapt to changes 
  • Grief that has become excessive or long term
  • Interpersonal deficits such as having few or no personal relationships, or unfulfilling relationships

IPT is somewhat less effective for PTSD and anxiety disorders. Research trials did not support the use of IPT for substance misuse problems.

The American Psychological Association maintains a frequently updated list of evidence-based practice guidelines for treatment and diagnosis, at the Division 12 link: https://div12.org/treatments/

How does interpersonal psychotherapy work?

Together the patient and therapist examine interpersonal relationships or circumstances that are causing distress or depression. It can be provided to an individual, a group, couples, or via telephone or video sessions. It’s usually completed in 12-16 weekly sessions. The treatment is very structured and includes patient homework and continuous assessment.

During the first one to three sessions, the therapist evaluates the patient’s symptoms, discusses their social history and close relationships. Any changes in relationship patterns and expectations are noted. The patient and therapist make a list of interpersonal issues that are causing distress. The issues are ranked and the patient decides which one or two issues are most important in terms of their depression. Once the issues are identified, the focus turns to modifying the patterns that are causing distress. Adjustments that the patient can make are developed and implemented. Problem areas can change as treatment progresses. 

The middle part of therapy focuses on addressing the problem areas or issues and understanding them better. Adjustments the patient can make are identified and applied to current relationships. 

The therapist may use several techniques, including:

  • Clarification to help you recognize your biases in understanding your interpersonal problems
  • Supportive listening
  • Role playing
  • Analysis of communication skills and patterns
  • Encouragement of affect – a process that lets you experience distressful or unwanted feelings and emotions related to your interpersonal problems in a safe environment – makes it easier to accept those feelings as part of your experience
  • Model positive relationships through the therapeutic relationship
  • Homework

Since IPT is time-limited, the therapist gradually reduces their level of intervention and guidance. This enables the patient to intervene on their own and make their own relationship adjustments. Many patients continue to improve their skills for three to six months after therapy ends. 

When using IPT in a group setting, the focus remains on interpersonal dynamics. Groups provide opportunities to:

  • Practice interpersonal skills in a safe and supportive environment
  • Learn skills by observing what other group members are learning
  • Model the adjustments and behavior of other group members
  • See various types of interpersonal interactions to help the individual understand different approaches to making interpersonal adjustments

Group therapy may also include meetings with individual group members to review goals, strategies, and evaluate individual progress. 

The final stage of IPT focuses on making new relationships and applying the relationship skills and adjustments the patient has learned. By encouraging prosocial behaviors, the patient learns to develop and utilize a support network. Ideally, the patient becomes more aware of and confident of their ability to deal with interpersonal problems and better manage their depression symptoms.  

How is interpersonal psychotherapy different from CBT?

Cognitive behavioral therapy (CBT) and IPT are the two main psychotherapies for mood disorders. Both are time-limited, and focus on present problems without dwelling on the patient’s personality traits. Both work to enable the patient to regain control of mood and behavior.

Unlike other psychotherapy approaches, IPT examines current rather than past relationships, and recognizes but does not dwell on internal conflicts. Unlike CBT and cognitive behavioral therapy, IPT works on the maladaptive thoughts and behaviors as they apply to interpersonal relationships. It works to change relationship patterns rather than eliminate symptoms. CBT focuses on unhelpful thought patterns and core beliefs.

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References

Psychology Today. (n.d.) Interpersonal Psychotherapy. Retrieved 3-2-22, {https://www.psychologytoday.com/us/therapy-types/interpersonal-psychotherapy#:~:text=Interpersonal%20psychotherapy%20(IPT)%20is%20a,problems%20within%20four%20key%20areas.}
Markowitz J.C. & Weissman M.M. (2004, Oct.) Interpersonal psychotherapy: principles and applications. World Psychiatry. Retrieved 3-2-22, {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414693/}
Saling J. (2020, Sept.) Interpersonal Therapy for Depression. WebMD. Retrieved 3-2-22, {https://www.webmd.com/depression/guide/interpersonal-therapy-for-depression}
International Society of Interpersonal Psychotherapy. (n.d.) Overview of IPT. Retrieved 3-2-22, {https://interpersonalpsychotherapy.org/ipt-basics/overview-of-ipt/}

Information

Medically reviewed by:

Dr Roy Kedem, MD

Dr Roy Kedem started his premedical studies at Harvard, and research in genetics and gene sequencing at Harvard, Beth Israel. He attended medical school in the UK at the Cambridge Overseas Medical Program in 1998. Dr Kedem then completed his residency in Internal Medicine at Columbia College of Physicians and Surgeons in Stamford, Connecticut and his fellowship in Hospital Medicine at the Cleveland Clinic in Cleveland, Ohio.

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Affordable –
with or without insurance

With Insurance

Therapy

Your copay
Depending on insurance

Without Insurance

Therapy

$99

Initial Visit

$99

Follow Up