What is Interpersonal Psychotherapy (IPT)?
IPT is a form of psychotherapy that focuses on relieving symptoms by improving interpersonal functioning. It addresses current problems and relationships rather than childhood or developmental issues. Therapists are active, non-neutral, supportive and hopeful, and they offer options for change.
IPT:
- is structured
- is time-limited (active phase is usually 12–16 weeks)
- focuses on interpersonal relationships and communication
- focuses on here-and-now relationships
- aims to improve interpersonal functioning and social support.
IPT is delivered in one-to-one and group formats.
How does Interpersonal Psychotherapy (IPT) work?
A central idea in IPT is that psychological symptoms can be understood as a response to current difficulties in everyday relationships with other people.
IPT focuses on four areas:
- conflict in relationships that is a source of tension and distress
- life changes, such as job loss or the birth of a child, that affect people’s feelings about themselves and others
- grief and loss
- difficulties in starting or sustaining relationships
When people learn effective strategies for dealing with their relationship problems, their symptoms often improve.
The structure of IPT
The opening sessions (1-3) focus on collecting information and making decisions about the focus of therapy. The therapist helps the patient create a list of all the key relationships in the patient’s life (interpersonal inventory). These relationships are grouped according to the four main problem areas.
In the middle sessions (4 – 14), the patient concentrates on trying to improve the chosen problem area or areas with the support of the therapist. The patient and therapist work to develop solutions to the problems, and the patient tries to implement the solutions between sessions.
The final sessions (15 – 16) focus on dealing with any sense of loss associated with the end of therapy as well as reviewing the issues that were identified in the interpersonal inventory and the progress made in dealing with them.
Who can Interpersonal Psychotherapy (IPT) benefit?
IPT is most often used during the acute phase of major depression, but it can also be provided as a maintenance treatment to help prevent relapse and recurrence of illness.
It is also used to treat:
- anxiety
- bulimia nervosa
- chronic fatigue
- mood disorders such as bipolar and dysthymic disorders.
IPT has been adapted to treat patients from adolescence to old age. It is effective as a stand-alone treatment and in combination with medication.
Related Programs & Services
Cost of Interpersonal Therapy
While there can be significant differences in the cost of therapy depending on your geographical region, expect to pay somewhere between $75 to $175 per session. It never hurts to ask about a reduced rate or sliding scale, as some therapists will give discounts to clients who are within a certain income bracket, or who are willing to pay upfront for several sessions at a time.
While not every therapist accepts insurance, many therapists are in network with health insurance companies. The rate you pay per session will be based on the specifics of your plan as well as the deductible. For the most accurate quote, contact your insurance carrier to confirm the amount of your co-pay and how many sessions they will cover.6
How to Find an Interpersonal Therapist
A good place to start looking for an interpersonal therapist is the online directory of the Interpersonal Therapy Institute or Choosing Therapy’s directory. One important thing to keep in mind is that most state laws require a therapist to be licensed in the state of your residence. So, if you’re moving soon or taking an extended trip, it may impact the relationship with your therapist.7
If you’d like to use your health insurance, you can call the member services number on the back of your insurance card and ask for a list of therapists in your network that are located close to you. This would also be a great time to ask any questions that you might have about your deductible and copay.
8 Key Questions to Ask an Interpersonal Therapist
If you are using your insurance for the therapy session, it’s a good idea to verify whether or not they are in network with your insurance. However, there are other questions to ask in order to assess whether a therapist is an appropriate fit. Many therapists even offer a free consultation where they welcome your questions about their background.8
Here are eight key questions to ask before starting interpersonal therapy:
- What type of interventions do you use?
- How often do you recommend clients attend sessions?
- Can you explain your treatment style to me?
- What is your ideal client to work with?
- How familiar are you with interpersonal therapy?
- What is important for me to know when working with you?
- What’s your favorite part about being a therapist?
- How do you help your clients deal with stressful life events?
What to Expect at Your First Therapy Appointment
Every therapist conducts their first session differently, but you should expect to answer questions about yourself and share some of your stresses. Your therapist may also provide you with a standardized questionnaire about your symptoms. Using an interpersonal therapy approach, they will link a diagnosis to a current life event and take inventory of your close relationships, social supports, and behavioral patterns within relationships.1
Your first therapy appointment may feel awkward as you get to know your therapist and they get to know you. There may be topics you don’t get to discuss, but you can delve deeper in subsequent sessions. If you have seen multiple therapists, are taking prescribed medication, or have recently been hospitalized psychiatrically, it’s important to bring this information to your therapist at the first session.
Remember that it’s completely acceptable to go at your own pace. Always let your therapist know if you’re feeling uncomfortable or would like a quick break. It’s typical in the first session to establish rapport and start identifying specific goals. Your therapist may also spend some time outlining their confidentiality policy.9
Is Interpersonal Therapy Effective?
There is overwhelming evidence that interpersonal therapy can be an effective intervention for mood disorders, and it is one of the most commonly used treatments for major depressive disorder, anxiety disorders, and bipolar disorder.10 Its effectiveness for other mental health disorders is still being researched, although numerous studies have shown it can be effective in treating depression and decreasing the likelihood of relapse once symptoms have resolved.
Additionally, interpersonal therapy can be effective in family therapy when there is a family member with a diagnosis of depression, and as an intervention for eating disorders and some anxiety disorders.5 In a study conducted on individuals diagnosed with a personality disorder, interpersonal therapy was shown to decrease the severity of symptoms.11 In general, it highlights the link between relationships and mental health, which is highly relevant due to the fact that humans are social beings who benefit from connections with others.12
Interpersonal therapy is recognized as an effective technique by the following associations:
History of Interpersonal Therapy
Interpersonal therapy was created in the 1970s by Gerald Klerman, Myrna Weissman, and Eugene Paykel as a result of researching the effectiveness of combining medication with psychotherapy as a treatment for depression. The initial studies of interpersonal therapy focused on the same approach of combining medications with psychotherapy where the therapist played a very active role. Today, it is thought of as being a “high contact” therapy method as it is structured and sessions are conducted on a weekly basis.2
Derived from psychodynamic theory, interpersonal therapy can be a great fit for individuals who are more curious about psychodynamic interventions. There is a basic assumption that in order to move forward, one must address past relationships and experiences. The relationship between therapist and client is especially significant due to the level of trust and openness required for honest dialogue.13
In general, interpersonal therapy can be less stigmatizing for clients because they are not blamed for their symptoms or diagnosis. It is all seen as a product of their relationships, circumstances, or a break in significant relational attachments or social roles.14
What Is Interpersonal Therapy?
Interpersonal therapy (IPT) is a short-term form of psychotherapy, usually 12 to 16 sessions, that is used to treat depression and other conditions. As its name suggests, IPT focuses on your interpersonal relationships and social interactions—including how much support you have from others and the impact these relationships have on your mental health.
When IPT was first developed, many mental health professionals conceptualized depression as “person-based.” That is, depression was not considered to be based on a person’s environment. IPT, on the other hand, recognizes that a person’s relationships can have a huge impact on mental health.
Types of Interpersonal Therapy
There are a couple of different adaptations of interpersonal therapy that you may encounter, including dynamic and metacognitive.
Dynamic Interpersonal Therapy
Dynamic interpersonal therapy (DIT) is also sometimes referred to as psychodynamic interpersonal therapy or mentalization-based therapy. DIT is designed to help you better understand your own thoughts and feelings, as well as the thoughts and feelings of others. It generally consists of 16 sessions over the course of five months.
Metacognitive Interpersonal Therapy
Metacognitive interpersonal therapy (MIT) is an integrative approach to address personality disorders with prominent emotional inhibition (holding back your emotions) or avoidance. One 12-week study found that engaging in MIT helped reduce depression symptoms and improve the ability to identify emotions.
Interpersonal therapy is also sometimes used in a modified form of couple’s therapy, such as when marital troubles are contributing to depression.
Techniques
Because IPT takes the approach of improving depression by improving relationships, it begins with the therapist conducting an interpersonal inventory. This inventory is a detailed review of your significant relationships, both current and past. These relationships are then grouped according to four main problem areas.
Grief
Depression can occur as a result of the loss of a loved one. While it is normal to go through the stages of grief in this type of situation, a major loss can also result in unresolved grief. This is grief that is delayed (remains for a long time after the loss), distorted, or grief in which you may not feel emotions, but instead experience other symptoms related to depression such as insomnia and fatigue.
Role Dispute
Role disputes occur when you and the significant people in your life have different expectations about your relationship. An example of this is if you feel that your spouse should display more affection or ask more questions about your day. The disconnect between expectations and real-life behavior can cause feelings of depression.
Role Transition
Depression may occur during life transitions, when your role changes and you don’t know how to cope with that change. Getting married, getting divorced, becoming a parent, and retiring are all examples of role transitions.
Interpersonal Deficits
If you find it difficult to form and maintain good quality relationships, IPT can help identify your interpersonal deficits. This can include any feelings of inadequacy you may have, whether you find it difficult to express your emotions, and other feelings or beliefs that are preventing you from communicating effectively.
Your therapist can help you determine which area is the most responsible for your current problems. Therapy is then directed at helping you deal with this specific interpersonal issue.
What Interpersonal Therapy Can Help With
IPT was originally created to be a short-term treatment for depression. However, it has also been shown to be an effective treatment for a number of other conditions including:
It may also be helpful for dealing with attachment issues, grief, life adjustment and transitions, and relationship conflicts,
Benefits of Interpersonal Therapy
Interpersonal therapy can have a number of important benefits, including:
- Improved relationships: IPT can help patients understand how their relationships affect their life. The goal is two-fold: to help patients function better socially and to reduce their feelings of depression.
- Decreased depression: This form of psychotherapy is based on the notion that depression occurs in the context of relationships. In other words, your relationships can potentially increase or decrease your depression, and feeling depressed can impact your relationships. As such, the goal of IPT is to relieve your depressive symptoms by improving the way you interact with others.
Unlike some of the other forms of psychotherapy for depression, IPT does not attempt to delve into your inner conflicts resulting from past experiences. Rather, it focuses primarily on your current relationships, how they may be impacting your depression symptoms, and ways that you can improve your interactions for a healthier state of mind.
Interpersonal therapy recognizes that depression is not always a “person issue,” but can also be caused by relationship issues.
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Effectiveness
IPT has been found to be effective for treating different types and severity of depressive disorders as well as other mental health conditions. This type of therapy may be best when combined with medication in certain circumstances.
- A 2013 review of the research found that IPT was as effective as CBT for the treatment of major depressive disorder and could be recommended as a first-line treatment for the condition.
- Some research has found that interpersonal therapy can help prevent the development of major depression. Engaging in IPT regularly may also help prevent depression relapses.
- Research has also found that IPT showed significant effects in the treatment of eating disorders, anxiety disorders, substance use disorders, as well as other mental health conditions.
- Engaging in IPT as a couple has been found to improve depression and reduce relationship issues.
Things to Consider
While IPT can be an effective and appealing treatment option, it may not be the best choice for everybody. Motivation plays a pivotal role in the treatment process; it can be difficult to create change if a person is not motivated or is unwilling to examine and address the role they play in their relationships.
It is also important to note that conditions such as depression and eating disorders may be recurrent conditions. Even after initial treatment, you may need maintenance sessions to help prevent relapse, reinforce skills, and maintain progress. This might involve a monthly session to brush up on skills or address changes in your life.
How to Get Started
You should expect your treatment to last for approximately 12 to 16 weeks. Sessions are structured and involve regular assessment, therapist interviews, and homework assignments.
During your first few appointments, your therapist will learn more about you, your symptoms, and your relationship history. Next, you will work with your therapist to address specific problem areas. The strategies used can be adapted as treatment progresses, so your goals, assignments, and sessions may change as your therapist continues to assess your progress.
IPT is available in a variety of formats ranging from individual to group sessions, and sessions in which you can either participate in person or through online therapy.
It may also be beneficial to combine IPT with other depression treatments. For example, research shows that combining therapy with medication is often more effective than doing either one on its own.
Interpersonal therapy can help effectively treat depression and other mental health conditions by focusing on aspects of your relationships that might be fueling your condition. In some cases, it may even be helpful to bring significant others into the therapy process directly. Your doctor can help you determine whether IPT is right for your needs, as well as if it would work better if combined with other treatments.
