Interpersonal psychotherapy
Interpersonal psychotherapy (IPT) was developed by Gerald Klerman, MD., and Myrna Weissman, Ph.D. in 1969. It was created as a brief approach for treating depression, emphasizing the importance of interpersonal relationships in the development of mood disorders. IPT has evolved over the past 50 years and is now used as an intervention for a variety of mental health issues. Here is what you need to know about the concepts and techniques behind interpersonal therapy.
Summary
- Interpersonal psychotherapy (IPT) was developed in 1969 as a brief treatment for depression, emphasizing the role of interpersonal relationships in mental health.
- IPT focuses on relationship factors rather than individual thought patterns, distinguishing it from cognitive-behavioral therapy (CBT).
- The four domains of IPT include grief, role disputes, role transitions, and interpersonal deficits, with treatment tailored to each category.
- Common IPT techniques include interpersonal inventories, grief analysis, communication analysis, role-playing, problem-solving, and social skills training.
- IPT has strong evidence for treating depression and has been adapted for anxiety and eating disorders, with some studies suggesting effectiveness equal to or better than CBT. Download free anxiety worksheets.
- Training in IPT is available through organizations such as the International Society of Interpersonal Psychotherapy (ISIPT) and the IPT Institute, offering courses, books, and certification.
- By leveraging an EHR like TheraPlatform, therapists can easily organize treatment plans.
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What is interpersonal therapy?
Interpersonal Therapy is a brief intervention, normally completed in 12-16 weeks. It views mental illness as the result of disruptions in interpersonal relationships, rather than the fault of the individual. While this medical model perspective may seem mainstream today, it was somewhat radical when it was created. The emphasis on relationship factors sets it apart from cognitive-behavioral therapy (CBT), which focuses on individual distorted thought patterns as the culprit behind most mental health disorders.
Main concepts of interpersonal therapy
Interpersonal therapy professionals operate under the following beliefs:
- Mental illness is due to a disturbance in significant attachments and social roles, not something inherent in the individual. This is often termed the “sick role”.
- Social support acts as a protection from depression and other disorders.
- Interpersonal therapy addresses current social functioning to improve symptoms but recognizes that past attachment issues may affect current relationships.
What are the 4 domains of interpersonal therapy?
According to Interpersonal Therapy, the following negative life events or circumstances place vulnerable individuals at risk for a depressive episode and other problems:
- Grief regarding the death of a loved one.
- Role disputes. These are conflicts one person has with another based upon dissatisfaction with their role and expectations within the relationship. For example, a fight with a lover over not having enough sex or someone wanting their friend to be more attentive.
- Role transitions. These are difficulties due to life disruptions or losses. For example, being fired from a job or getting divorced.
- Interpersonal deficits. This domain is not linked to any specific life event. Instead, the individual has long-standing difficulties with interpersonal relationships that have led to Isolation and lack of social support.
IPT therapists will assess clients and categorize them into one of these four areas; subsequent treatment will depend on which domain they are addressing.
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Interpersonal therapy techniques
The following techniques are commonly utilized in IPT:
Interpersonal inventory
The interpersonal inventory is conducted at the beginning of therapy. It is a review of the client’s past and present relationships in order to evaluate their difficulties and place them in one of the four interpersonal domains.
- The closeness circle is a valuable tool to assist in this process.
Grief analysis
This technique addresses unresolved grief that may be leading to depressive feelings and other mental health difficulties. Grief analysis is performed through three steps:
- Educate the client as to how grief may lead to depressive feelings.
- Facilitate the expression of emotion to fuel catharsis.
- Find new relationships and activities to help the client move forward after the loss of a loved one.
The goodbye letter is a useful resource for grief analysis.
Communication analysis
Communication analysis improves interpersonal functioning by improving communication skills. The therapist will often ask their client for a “movie script” of an exchange between themselves and another person. This includes the context and tone of the communication in addition to what was exactly said.
The therapist then questions the client about what was intended to be communicated compared to what the client believes was communicated. The goal is to make the client aware of the potential weaknesses in their communication style and improve their effectiveness. Part of communication analysis is the use of clarification to clear up misunderstandings and address discrepancies in interpersonal communication.
- The wanting to be heard worksheet facilitates an understanding of communication patterns that will improve interpersonal relationships.
Role-playing
Role-playing is frequently used in IPT to help with role disputes, role transitions, and general interpersonal functioning. The therapist usually plays the role of the other person and acts out situations that the client has encountered or is likely to encounter in the future. By practicing these interactions, the client improves their interpersonal effectiveness and is more likely to attain their intended results.
Problem-solving
Problem-solving is a valuable skill to help the client deal with difficult interpersonal relationships and role transitions. The therapist will brainstorm with the client for potential solutions and help them decide which one will provide the best outcomes. Or, they may use problem-solving tools to help their client see their situation more positively. For example, the client may be asked to create a list of pros and cons regarding the transition to single life after 10 years of marriage. This exercise shows the client that their divorce, although difficult, has some beneficial features.
Social skills
For those with interpersonal deficits, social skills training is often utilized. Working on social skills can help clients improve every aspect of their personal connections. Common areas of focus include assertiveness training, empathy, conflict resolution, and active listening.
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Does IPT work?
For many years, IPT was almost solely focused on treating depression. As a result, most of the research on the effectiveness of IPT involves participants with major depressive disorder. While IPT has an abundance of research supporting its treatment of depression, its proven effectiveness with other disorders is in the earlier stages.
- In this meta-analysis, IPT significantly reduced depressive symptoms but not more so than CBT.
- Interpersonal therapy is effective in treating major depressive disorder in adults. Even better results were found when IPT was combined with medication than when used alone.
- Although depression has always been the primary focus of IPT, it also improves symptoms of depression, anxiety, and eating disorders. In some cases, it works even better than CBT.
Training resources
Therapists can use the following resources to further their training in IPT:
- The International Society of Interpersonal Psychotherapy (ISIPT) website is one-stop shopping for everything IPT. It has links to books, research, and relevant training. It also provides the information necessary to obtain certification as an IPT therapist.
- The focus of the IPT institute is to provide training for clinicians in IPT. They offer in-person and online training at all levels, from the basics of administering IPT to becoming an IPT trainer.
- For beginners, Interpersonal Therapy acts as a primer for those who may want to begin to practice as an IPT therapist.
- Written by the founders of IPT, the Clinician’s Quick Guide to Interpersonal Psychotherapy, provides all the basics to become an IPT therapist.
- For those more visually inclined, this video, entitled Interpersonal Therapy Techniques gives a quick summation of IPT.
Interpersonal therapy is a proven intervention for psychiatric disorders. Although originally imagined as a brief therapy for depression, it has since been adapted for use with a wide variety of mental health conditions.
Streamline your practice with One EHR
- Scheduling
- Flexible notes
- Template library
- Billing & payments
- Insurance claims
- Client portal
- Telehealth
- E-fax
Resources
Theraplatform is an all-in-one EHR, practice management and teletherapy solution that allows you to focus more on patient care. With a 30-day free trial, you have the opportunity to experience Theraplatform for yourself with no credit card required. Cancel anytime. They also support different industries including mental and behavioral health therapists in group practices and solo practices.
More resources
- Therapy resources and worksheets
- Therapy private practice courses
- Ultimate teletherapy ebook
- The Ultimate Insurance Billing Guide for Therapists
- The Ultimate Guide to Starting a Private Therapy Practice
- Mental health credentialing
- Insurance billing 101
- Practice management tools
- Behavioral Health tools
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- Free on-demand insurance billing for therapist course
- Free mini video lessons to enhance your private practice
- 9 Admin tasks to automate in your private practice
References
Casablanca, S. & Peterson, T. (2021, June 10). Psych Central. All about interpersonal therapy (IPT) for depression and relationships. https://psychcentral.com/lib/interpersonal-therapy-ipt#history
Cuncic, A. (2024, January 16). Verywell Mind. An overview of social skills training. https://www.verywellmind.com/social-skills-4157216
Cuijpers, P., Donker, T., Weissman, M. M., Ravitz, P., & Cristea, I. A. (2016). Interpersonal Psychotherapy for Mental Health Problems: A Comprehensive Meta-Analysis. American Journal of Psychiatry, 173(7), 680–687. https://doi.org/10.1176/appi.ajp.2015.15091141
Markowitz, J. C., & Weissman, M. M. (2012). Interpersonal psychotherapy: past, present and future. Clinical psychology & psychotherapy, 19(2), 99–105. https://doi.org/10.1002/cpp.1774
Rajhans, P., Hans, G., Kumar, V., & Chadda, R. K. (2020). Interpersonal Psychotherapy for Patients with Mental Disorders. Indian journal of psychiatry, 62(Suppl 2), S201–S212. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_771_19
van Hees, M.L.J.M., Rotter, T., Ellermann, T. et al. (2013) The effectiveness of individual interpersonal psychotherapy as a treatment for major depressive disorder in adult outpatients: a systematic review. BMC Psychiatry 13, 22. https://doi.org/10.1186/1471-244X-13-22
Zhou, S. G., Hou, Y. F., Liu, D., & Zhang, X. Y. (2017). Effect of Cognitive Behavioral Therapy Versus Interpersonal Psychotherapy in Patients with Major Depressive Disorder: A Meta-analysis of Randomized Controlled Trials. Chinese medical journal, 130(23), 2844–2851. https://doi.org/10.4103/0366-6999.219149
