“The effects of unresolved trauma can be devastating. It can affect our habits and outlook on life, leading to addictions and poor decision-making. It can take a toll on our family life and interpersonal relationships. It can trigger real physical pain, symptoms, and disease. And it can lead to a range of self-destructive behaviors.” ~Peter A. Levine
Interpersonal psychotherapy (IPT), also referred to as “interpersonal therapy,” is a focused, short-term, evidence-based “talk therapy”.
It is especially useful for children, teens, and young adults with mental health conditions, mood disorders, eating disorders, and interpersonal (social) issues. IPT can also be used to help individual adults, couples, and families improve their relationships.
Table of Contents
- What is Interpersonal Psychotherapy (IPT)?
- What Are the Different “Types” or Approaches of IPT?
- Can IPT Be Done in a Group Format?
- What is the Premise, Foundation, or “Belief System” of IPT?
- What is the Ultimate Goal of IPT?
- What Conditions and Issues Are Treated With IPT?
- What are the Pros and Cons of IPT?
- How Effective Is IPT? What is the Future Outlook?
- How Long Does IPT Last?
- What Techniques Do IPT Therapists Typically Use?
- What Should I Expect During IPT?
- Will I Be Required to Take Medications While in Therapy?
- How Can I Find a Good IPT Therapist?
- What Happens After Therapy Ends?
- Can I Practice IPT Exercises at Home?
- In Summary…
What is Interpersonal Psychotherapy (IPT)?
The primary goal of IPT is to ease an individual’s mental and emotional distress by improving his interpersonal relationships and social interactions with loved ones, romantic interests, co-workers, and even acquaintances and strangers.
Thus, interpersonal therapists aim to teach you communication and problem-solving strategies that will help you resolve issues and manage your mental health conditions more effectively.
This type of therapy is mostly used to help those, suffering from mood disorders like bipolar disorder, postpartum depression, and clinical depression, and anxiety and eating disorders. However, it can also be used to treat a wide variety of other mental health issues.
Some of the main issues addressed during interpersonal therapy include
- Interpersonal difficulties, such as dysfunctional, controlling, demanding, or unsatisfying relationships, and social awkwardness and social avoidance from others.
- Unresolved grief from a separation or divorce, breakup, or the death of a loved one.
- Transitions or stressful life changes, such as “empty nest,” retirement, divorce, adoption, or relocation to a new school, job, city, state, or even country.
- Interpersonal conflicts, disputes, and disagreements between partners, spouses, relatives, friends, strangers, co-workers, and/or acquaintances.
Are There Different “Types” or Approaches of IPT?
Yes! There are different “types” or “approaches to IPT. What are the “types” and what does that mean? “Types” refers to the various approaches IPT therapists can take to help people resolve their interpersonal or social issues. These “types” or approaches act as “guides” for IPT therapists.
In other words, they help IPT therapists decide how to help individuals with their problems – i.e. what exercises, techniques, and activities to use with a specific individual. The “type” or “types” are based on a specific framework (concept, foundation, belief, or premise) to develop a treatment plan for the individual.
In other words, the techniques, methods, activities, and exercises are based on a chosen framework. It is important to understand that there are different “types” or approaches to IPT therapy for two reasons:
- It helps the individual decide which approach she will feel most comfortable with, so she can choose a therapist, who will yield the best results.
- It helps the therapist determine which therapy approach will help the individual be successful.
Those two factors are important for a successful therapy outcome. Keep in mind that IPT therapists may use one or more “types” or approaches during therapy. For instance, a therapist may combine holistic (integrative) therapy, cognitive-behavioral therapy, and/or psychoanalysis to help an individual, who has poor social skills, or who struggles to interact with others in social settings.
So, the “type” or approach, along with the methods, depends on the particular therapist. That is why it is important to ask what “type” or approach an IPT therapist plans to use with you before you officially select one.
Keep in mind that IPT therapists have always incorporated other “closely-related” therapy approaches into the therapy process. Thus, the goal of IPT has always been to successfully address specific interpersonal issues and mental health conditions. The different “types” or approaches of IPT include dynamic interpersonal therapy and interpersonal and social rhythms therapy.
What Are the Different “Types” or Approaches of IPT?
Listed below are the different “types” or approaches of IPT:
- Dynamic Interpersonal Therapy
Dynamic interpersonal therapy (DIT) is a “type” of IPT that examines the relationship between “tricky” or challenging interpersonal interactions and an individual’s symptoms. In other words, it focuses on how prior events are triggering, contributing, or worsening your current symptoms.
During DIT sessions, a therapist will help you identify and address negative, dysfunctional, and unhealthy interpersonal habits or patterns that may have originated during childhood, but that have continued to wreak havoc on your life and relationships.
The therapist will encourage you to take an in-depth look at how past experiences have “colored” or affected how you think and feel about things now (in the present).
Once, you have a firm understanding of why you think and feel the way you do, the therapist will help you set goals and make changes that will help you interact with others more positively and productively, and develop and maintain healthier relationships with others.
- Interpersonal and Social Rhythms Therapy
Interpersonal and social rhythms therapy (IPSRT) is also a “type” of IPT that was created to help people, struggling with bipolar disorder, better manage their symptoms. IPSRT therapists believe that people with this mood disorder have dysfunctional, faulty, or irregular circadian rhythms (your internal clock – the mechanism that is responsible for regulating your sleep and wake cycles).
For people with bipolar disorder, these cycles are easily disrupted when something (i.e. day-to-day routines or “social patterns”) happens to throw them off. Thus, the goal of IPSRT is to help these individuals develop and maintain consistent daily routines and rituals or “social patterns” (i.e. self-care – eating, exercising, and resting), so their circadian rhythms and mood remain balanced and stable.
The focus of this therapy “type” or approach is to improve your relationships and social interactions, make sure you’re receiving the right medications, if you have a mood disorder, and you’re educated about your condition and your healthcare options.
Can IPT Be Done in a Group Format?
Yes, interpersonal therapy (IPT) can be done in a group-setting; however, it is most commonly conducted in an individual setting. Keep in mind that some individuals may be hesitant about sharing their concerns, issues, and fear (at least at first) in group therapy.
But, once they become more comfortable with the other clients and patients, they are typically more willing to open up and immerse themselves in the therapy process.
Some of the reasons some individuals cite for the hesitancy include privacy and confidentiality concerns, shyness, embarrassment, shame, and guilt, and uneasiness about sharing personal information with a group of people they’ve never met before.
However, some individuals cite the advantages of group therapy as:
- Being a member of an IPT group feels almost like being part of a “family.” In other words, being part of a group, primarily consisting of other people, who are experiencing the same or similar issues, is “freeing” and “supportive” for the members. It helps to have others, who can relate to your struggle. And, those, who understand what you are going through and who have walked in your shoes at one time or another.
- You can learn a lot simply by observing other people in IPT group therapy. For instance, you can learn healthier ways to interact and conduct relationships with others. You can also learn what not to do in social situations and relationships, so you don’t make the same mistakes as others.
- IPT Group therapy is a great place to learn and practice new skills. It’s safe, secure, and confidential. You can practice these skills before you apply them to your real-life situation. This gives you a chance to receive feedback from the IPT group leader (therapist) and other members of the group, so they will be more effective once you use them with the people in your life (i.e. relationships and social interactions).
- You can learn and improve your skills simply by watching how IPT group members interact with one another. It’s a great way to tweak your skills and learn what to do and what not to do in social situations.
- Even though the main role of any therapist is to be supportive towards their patients and clients, IPT group therapy doubles the support you receive because you get it from group members and the group leader (therapist). The extra support can make you feel more self-assured and confident, and stronger and more empowered.
Note: IPT group therapy may involve one’s family and friends, instead of strangers or acquaintances. There are different “versions” or “varieties” of group therapy. It can be performed in an office-setting or within a larger group-setting (i.e. conference room, meeting, room, auditorium, etc.)
What is the Premise, Foundation, or “Belief System” of IPT?
IPT therapists believe that the key to success in therapy and life is a change in your social environment. According to this “belief system,” mental health conditions, such as depression, anxiety, eating disorders, etc., along with interpersonal issues stem from poor social rhythms or “patterns.”
Thus, by changing your environment – the people you interact with and the unhealthy relationships you have entered into, you can improve your quality of life – i.e. strengthen your communication skills, improve your social skills, reduce your symptoms, and form healthier and more positive friendships and relationships with others.
Keep in mind that your personality (thoughts and behavior) is “shaped” or “defined” by your interactions with others. So, an IPT therapist aims to inspire you to examine the true cause of the distress you feel in relationships and during interactions with others.
The purpose is to help you focus on your current social interactions and relationships, and explore why you’re experiencing interpersonal conflict, disputes, and stress.
Therefore, the premise or “ultimate belief” in IPT is that problems and issues are caused by problematic, destructive, unhealthy, and negative interactions and relationships. The goal? To “fix” or repair these interactions and relationships.
The foundation of IPT stems from three main theories, such as:
- Attachment Theory: Attachment theory examines how personal attachments (relationships) can affect your emotional, physical, and mental/psychological development. Thus, the main premise of attachment theory is symptoms and issues will lessen or disappear if an individual has healthy and positive interactions and relationships with others.
But, for this to occur, the interactions and relationships must provide the individual with a sense of security and constancy and offer you opportunities to “grow,” as an individual and as a partner or friend.
- Interpersonal Theory: Interpersonal theory is more detailed-based. In other words, it focuses on the details associated with these interactions and relationships.
For instance:
-
- What happened during the event or in the relationship?
- What did you do when….happened?
- How did you respond? How did the other person respond? What did you say? What did she say?
- When do things like this typically occur?
- What happens before, during, and afterward?
This theory delves deeply into the – who, what, when, and where of interactions and relationships, to “correct” faulty interactions and remove unhealthy patterns.
- Communication Theory: This is a multidisciplinary theory or “belief system” that involves components of math, psychology, syntax, grammar, and semantics, sociology, and computer science. This theory explores how information (messages) is transferred from one person to the next.
What is the Ultimate Goal of IPT?
The ultimate goal of the therapy is to address specific problems – interpersonal issues like social skills, life transitions, grief and loss, mental health conditions like anxiety, depression, and eating disorders, etc. And, the ultimate goal of an IPT therapist is to provide effective therapy to clients and patients, either in an individual format or in a group format.
Thus, his goal is to only focus on current (not past) issues, as they related to how you socialize and interact with others, and how you behave in your everyday life and relationships.
This therapist aims to provide you with an interactive, non-judgmental therapy process, designed to help those, grappling with interpersonal problems successfully manage challenging or overwhelming situations.
Note: IPT sessions are both highly-focused and extremely intense.
Clients and patients are encouraged to take what they learn during sessions and apply them to their real-world, during therapy, and once it has ended. Therefore, “homework assignments” play an important role in the effectiveness and success of this treatment.
What Conditions and Issues Are Treated With IPT?
IPT was originally designed, as a short-term therapy, to help people suffering from depression, however, now, there are a variety of other conditions and issues that it also treats, such as perinatal depression, eating disorders (anorexia nervosa, bulimia nervosa, excessive eating, bingeing and purging, extreme dieting and exercising, starvation, and/or the abuse of weight loss pills), substance abuse and drug and alcohol addiction, dysthymia, social phobia, bipolar disorder, clinical depression, postpartum depression, anxiety, developmental delays in young children, and PTSD.
It is still most commonly used to strengthen social skills, reduce symptoms, and improve interactions and relationships in those, suffering from depression. Why depressed individuals? Because people with depression tend to experience a wide-range of interpersonal issues in their relationships and their interactions with others.
Note: Understand that depression, in and of itself, is not always a consequence of relationship issues or unhealthy relationships, rather, relationship issues or unhealthy relationships may be present before the onset of depression. In other words, a poor relationship can lead to depression similar to how depression can lead to a poor relationship.
Once interpersonal issues have been identified, healthy, supportive, and positive social interactions and relationships can serve as a “support system” for people suffering from depression, other mood disorders, or mental health conditions. This is especially important during the healing and recovery process.
Listed below are the various subsets of IPT treatment:
Interpersonal Psychotherapy for Depression
Research suggests that IPT is extremely beneficial for those suffering from clinical depression, bipolar disorder, and postpartum depression (Feijo de Mello, De Jesus Mari, Bacaltchuk, Verdeli, & Neugebauer, 2005). Why? Because the goal of IPT for depression is to focus on how the condition is affecting the individual’s interactions and relationships.
What happens during IPT for depression? The therapist selects one or two issues and focuses on helping you address them. These issues may include family conflicts, dysfunctional friendships and relationships, the loss of a loved one or pet, workplace disputes, “empty nests syndrome,” and major life changes, such as retirement, loss of a job, an addition to the family, moving, illness, aging, divorce, etc.
Keep in mind that the goal is not to examine inner conflicts stemming from past experiences (i.e. childhood trauma); rather, the aim is to stay in the present and deal with interpersonal issues affect or being affected by your depression. IPT therapists teach you how to find better ways to cope with and manage your depression – and any accompanying problems.
There are two categories of IPT – IPT-S and IPT-M. IPT-S is the short-term or “brief” treatment for “acute” or “temporary” depression (a depressive episode). This category involves meeting with an IPT therapist once-a-week for approximately 2-4 months. In this scenario, treatment is completed once the symptoms ease.
IPT-M is a longer treatment for depression. The goal of IPT-M is to prevent or decrease the frequency of future depression “flares” or “relapses.” It is typically used with people, who have chronic or on-going depression.
The form of IPT may involve seeing an IPT therapist for “follow-up” sessions every month, possibly for years. It is a “maintenance” form of IPT. It provides long-term support and guidance for you.
These “sessions” may go on for two or three years – or even longer, in some cases. Remember, IPT explore your current reality – not past experience. The aim is to explore how the things that are happening in your life are stemming from or causing your depression.
The truth is mood disorders like clinical depression, post-partum depression, and bipolar disorder can negatively affect interactions and relationships.
In fact, it can cause some people with depression to “act out” or push friends and loved ones away, especially if they are having a difficult time coping with depression. IPT can help them manage their depression, so it doesn’t damage or ruin friendships and relationships.
Some of the issues surrounding depression that could impact your interactions, friendships, and relationships are (1) unresolved grief stemming from the loss of a loved one, (2) the beginning of a new relationship or a breakup, separation, or divorce, (3) a chronic health condition or diagnosis of a new health condition, (4) “empty nest syndrome,” (4) relationship dissatisfaction, dysfunction, and/or other issues, and (5) conflict at work with co-workers or your boss.
An IPT therapist can help you identify and address current events in your life that could be triggering or worsening your depression – and vice versa. The goal of the IPT therapist is to teach you healthy stress-management skills, so you can cope with challenging, difficult, and upsetting events in more positive ways.
As treatment progresses, your therapist may suggest you get out and socialize more often, spend more time with friends and family, join groups, volunteer, etc. In other words, step outside of your comfort zone and do something new and/or different. Meet people. Why? Because, it is a good way of practicing your newfound coping, communication, and problem-solving skills.
***The prognosis is positive for depressed individuals, who complete IPT treatment.
Interpersonal Psychotherapy for Eating Disorders
IPT can also be used to treat eating disorders – i.e. anorexia, bulimia, bingeing and purging, excessive dieting and exercise, and weight loss supplement abuse. Researchers have identified a positive correlation (relationship) between interpersonal issues and the development and continuation of eating disorders (Kluck, Dallesasse, English, Kluck, & English, 2017).
IPT for eating disorder is typically conducted in an individual format or group therapy. Therapy usually lasts for approximately 20 sessions, conducted weekly. The first step of this form o IPT is to select a specific interpersonal issue(s) to work on during therapy.
Note: The issue(s) is determined by you and your therapist.
Some possible issues include (1) differences in family, friend, or relationship “roles,” (2) changes in “roles” or life changes or transitions, (3) inadequate or unhealthy interpersonal skills, and/or (4) grief and loss.
Interpersonal challenges that could be triggering an eating disorder or an eating disorder that could be triggering interpersonal difficulties are explored during IPT. The IPT therapist may also encourage you to “take the lead” or make the necessary interpersonal changes in your life to effect change or improve your interactions and relationships.
A IPT therapist’s main objectives is to make sure you stay focused on the problem areas, educate you on what is causing and continuing the issue, inspiring you to want to make changes, and helping you find positive ways to improve your situation, skills, interactions, and relationships.
After that, your therapist schedules “follow-up” sessions with you here-and-there to provide you with support and additional guidance. It’s also to prevent future “relapses.”
IPT was originally designed as an individual therapy treatment, primarily for adults with depression and anxiety; however, it is now also used to treat a variety of issues and mental health conditions (like eating disorders) in children, teens, and young, middle-age, and even older adults.
It is an effective tool because it addresses underlying interpersonal and personal issues that could be contributing to the eating disorder. It also encourages and motivates these individuals to make positive changes in their lives and to apply the skills learned during therapy to their everyday lives.
More specifically, during IPT therapy, your therapist teaches you stress-management techniques that can help you better cope with the stress and anxiety that often accompanies awkward, tense, and/or unhealthy social interactions. It can also help boost your self-esteem, so you feel more confident socializing and interacting with others, and being in a relationship.
Note: IPT treatment for eating disorders is typically combined with other psychotherapies, such as family therapy, group therapy, and/or cognitive-behavioral therapy (CBT).
***The prognosis is favorable for those, who seek IPT for interpersonal issues that could be causing or worsening their condition.
Interpersonal Psychotherapy for Anxiety
IPT can also be used to help mitigate interpersonal issues that could be triggering or aggravating – or anxiety that could be causing or worsening your interpersonal issues. The most common form of anxiety treated with IPT is social anxiety disorder (SAD), although all forms of anxiety can be treated with this therapy approach.
However, it is important to note that research into the effectiveness of using IPT to reduce SAD symptoms is currently inconclusive. More specifically, research in this area is still in the beginning stages (Magni, Carcione, Ferrari, Semerari, Riccardi, Nicolo, & Rossi, 2019). Still, to date, there have only been a few studies on the effectiveness of IPT for SAD (Norton & Abbott, 2018).
One extremely small study (nine participants) found that approximately 78% of the participants experienced an improvement in social anxiety after IPT therapy (Lipsitz, Markowitz, Cherry, & Fyer, 1999).
Some of the improvements they reported are a success at work and/or school, more friends and healthier relationships, a higher self-esteem and self-confidence, better coping skills, and a reduction in symptoms – i.e. panic attacks.
An IPT benefit for anxiety is that it is now available for download, so younger people; suffering from social anxiety can receive the help they need in a format that is natural, familiar, and comfortable for them.
However, studies indicate that this “online self-help” structure is less effective than individual IPT and group IPT (Markowitz, Lipsitz, & Milrod, 2014). But, even though limited study results are promising, more research is needed to accurately determine how effective IPT is for SAD and other forms of anxiety.
***The prognosis is positive for anxiety sufferers, who seek IPT treatment.
IPT for PTSD
Studies suggest that IPT may be just as effective as prolonged exposure therapy, cognitive processing therapy, and trauma-focused cognitive-behavioral therapy (CBT) in the treatment of post-traumatic stress disorder (PTSD) (Markowitz, et. al., 2015).
IPT therapists help PTSD sufferers “re-attune” their perceptions. They also help these individuals recognize and acknowledge their emotions, focus on the present-day impact of interpersonal trauma on their lives and encourage these individuals to reach out and lean-on friends, family, and mental health professionals – to keep them stable and re-center them when their perspective shifts.
Truth-be-told, the most common treatment for PTSD, regardless of age, is CBT, however, new studies have indicated that IPT may be an effective alternative or supplement to CBT (Rafaeli & Markowitz, 2011).
Moreover, some studies imply that non-trauma-related psychotherapies may be equally effective, citing a higher therapy retention rate, possibly because these individuals are not forced to relive or rehash old hurts, betrayals, and traumas (Watkins, Sprang,& Rothbaum, 2018). Interpersonal psychotherapy focuses mostly, if not entirely, in the present.
How does IPT help those with PTSD? Well, IPT is a practical, realistic, easy-to-learn, “client-friendly,” “brief” or time-limited psychotherapy that focuses on both the real and the imaginary, along with “perceived” losses, conflicts, life changes, and poor interpersonal skills.
And, although PTSD stems from a past trauma, IPT does not focus on that past trauma. Rather, it teaches those with PTSD how to manage their symptoms, so it doesn’t “taint” their interactions with others or damage or destroy their friendship and relationships.
A treatment plan for PTSD may involve a multi-focused therapy approach involving both CBT and IPT. It may also involve psychotropic medications, such as
- Antidepressants – i.e. Zoloft and Paxil,
- Benzodiazepines – i.e. tranquilizers, Ativan, and Valium
- Beta-blockers – i.e. Inderal, Betachron E-R, etc.
- Anticonvulsants – i.e. Tegretol, Tegretol XR, Lamictal, etc.
- Atypical antipsychotics – i.e. Risperdal or Zyprexa.
***The prognosis is positive for PTSD sufferers, who attend IPT sessions.
What are the Pros and Cons of IPT?
As with any treatment, there will be pros and cons. Before you settle on IPT, it is important to know and understand the advantages and disadvantages of it. Some of these pros and cons are:
Pros
There are a variety of benefits associated with interpersonal therapy.
Listed below are the most common pros of IPT:
- Stronger and healthier relationships and interactions with others
- Ways to cope with issues and interactions in more positive ways
- Improved social, problem-solving, and communication skills
- An outlet to process and manage the loss (through a separation, break-up, or divorce, or abandonment or death) of someone or something in a safe and confidential environment
- A noticeable decline in self-destructive, negative, unhealthy, damaging, dangerous, or hostile behaviors
- More effective an healthier ways of expressing your emotions
- An enhanced self-awareness when it comes to unhealthy and problematic interpersonal (social) habits
- A lower risk of angry outbursts and hostility
- Mood stability
- Can be conducted individually or in a group-setting with children, adolescents, adults, couples, and families
Cons
There is also a variety of a few disadvantages of IPT.
Listed below are the most common cons of IPT:
According to studies, the threshold for cons or limitations is low (Van Hees, Rotter, Ellermann, & Evers, 2013). However, there are still some things you may want to consider before beginning IPT sessions.
- IPT is based on the idea or belief that an individual participates in therapy because he wants to change. If you do not want to change, and you’re doing it because someone else wants you to do it, then there’s a good chance therapy will not work for you.
- IPT will only work if you are willing to explore and own your role in the problem.
To effectively address and work them, you must also be self-aware. In other words, you must have a good or semi-good understanding of what “interpersonal issues” are and how they can affect social interactions and relationships The problem is some people are not self-aware, due to developmental delays, an emotional disconnect, a lack of maturity, and/or other mental health issues.
- The IPT structure can be very challenging if you are used to a more “traditional” therapy approach. Remember, IPT is a controlled, focused, short-tern approach, so for some, adapting to this different therapy style can be difficult.
How Effective Is IPT? What is the Future Outlook?
According to numerous studies, IPT is a highly-effective and useful treatment for a wide-range mental health conditions, such as depression, eating disorders, and anxiety (Ferizi, Mashhadi, Yazdi, & Noferesti, 2015). It is also certified by the American Psychological Association (APA) and the National Institutes of Health (NIH), as an effective and adaptable treatment for depression and other mood disorders.
However, it is important to understand that although IPT may not be effective for every person, studies suggest that IPT can reduce depression symptoms in some individuals (Ferizi, Mashhadi, Yazdi, & Noferesti, 2015). Researchers have also found that IPT is “just as effective” as antidepressants for some depressed people (Ferizi, Mashhadi, Yazdi, & Noferesti, 2015).
Studies also suggest that depressed or anxious people, along with those, who suffer from eating disorders, who receive a combination of medication and therapy, have the best long-term prognosis (Raykos, McEvoy, & Fursland, 2017). In other words, these individuals have fewer “flares” and continue to happier and more productive indefinitely or for many, many years.
Thus, study results indicate that IPT can be effective and beneficial “brief” treatment for those, suffering from depression, especially depression that stems or is caused by interpersonal issues like awkward or uncomfortable social interactions and unhealthy or dysfunctional relationships (Raykos, McEvoy, & Fursland, 2017).
The key to success lies in focusing on current events – not things that happened in the past. A positive outcome also depends on the individual’s ability to identify, acknowledge, and address her patterns of interacting, socializing, and relating to others – in and out of her inner circle.
How Long Does IPT Last?
Interpersonal therapy is designed to be short-term or “brief,” which means it is typically completed within 20 sessions or less. Each session is 45-60 minutes long, and they usually occur weekly or bi-weekly. Some IPT therapists have begun to conduct 8-week sessions for those will more “milder” (not as complicated) issues. Most, however, are between 12-20 sessions.
You and your therapist will work together to determine the number of sessions that will be needed to achieve success. This will largely depend on the problem, condition, or issue, and the format or structure (individual vs. group) you’d feel most comfortable in. It also depends on your age or who else is involved.
What Techniques Do IPT Therapists Typically Use?
IPT is an “adjustable” form of “talk therapy.” What does that mean? It means it can be “adapted” or “altered” to fit most mental health problems and issues, especially if there is a “social” or relationship component triggering or worsening them.
Because, this form of therapy can be used with different populations (i.e. ages and groups), a therapist will talk with each person individually, at first, to better understand the issue or issues plaguing the individual, couple, or family.
The treatment plan will be based on these factors, however, they may include a variety of techniques designed to help you and your family with interpersonal issues like misunderstandings, poor or a lack of communication, unhealthy or dysfunctional relationships, inadequate or inappropriate social skills, eating disorders, grief and loss, life transitions, and mental health conditions like depression and anxiety.
The IPT therapist may use a variety of techniques to improve the way you communicate and interact with each other and/or other people. These techniques may also help you develop and maintain healthier relationships, manage an eating disorder, and/or work through life changes, or grief and loss issues.
Some of the techniques that could be used during therapy sessions include the following:
- Identification of Your Emotions – During this technique, an IPT therapist provides you with an objective perspective to help you identify and understand your current emotions.
- Emotional Expression – This technique involves teaching you how to express your emotions in a healthier and more productive way.
- Impact of Past Issues – This strategy explores past issues to see if any patterns formed during that time are negatively affecting how you communicate, problem-solve, and interacting with others. It also takes an in-depth look at how these issues may be triggering or worsening mental health conditions and psychological distress.
- Clarification – During clarification, the IPT therapist helps you understand how your personal biases and misconceptions could be contributing to your interpersonal issues. This exercise also helps you identify unhealthy patterns that could be impacting what you think and how you feel about yourself and others.
- Role-Playing – Role-playing involves “acting out” possible or “real-life” scenarios to help you “see” situations, experiences, and events in a new and different light (a different perspective). It also allows you to practice the new skills you learned during previous sessions.
Role-playing also provides you with a platform to examine and discuss how you feel when you are required to interact with others. Once you understand your emotions and how they are impacting how you see things, you can apply this newfound knowledge to your everyday life.
- Communication Exploration – One of the most common and most important IPT techniques is “communication exploration.” During this exercise, the IPT therapist instructs you to recall, in detail, an upsetting interaction with someone in your life. He o also instructs you to try to remember every detail of the encounter from any hand gestures, changes in voice tone, the words used, eye contact, body language, volume, statements used, and the feelings the evoked in you.
This technique is beneficial for an IPT therapist because it helps him identify unhealthy or problematic communication and problem-solving habits – habits that are common in depressed people. Some of these habits include passive-aggressive behaviors that cause others to avoid and/or criticize you.
These negative habits help to reinforce depression and other mental health conditions. Once, you have a good idea of how these habits are affecting your life, the goal becomes to break these habits and teach you how to express your emotions in healthier ways.
- Decision Examination – This technique involves examining how you make decisions and learning new and more positive ways to do that. It also involves learning how to resolve disagreements and conflicts, during your interactions, and in your relationships, in healthier and more effective ways.
During this activity, you and your therapist will discuss alternative ways to communicate, problem-solve, and interact with others. The result? You can make an informed decision on how you want to respond to certain people and situations.
What Should I Expect During IPT?
IPT treatment typically involves individual therapy sessions and/or group therapy. It is usually completed within 3-5 months, although it may end earlier or later than this.
The therapy process is structured. More specifically, it is guided and controlled. IPT, for the most part, includes homework assignments, constant evaluations, and on-going therapist-guided interviews.
IPT initially begins with 1-3 “assessment” sessions. During these sessions, the IPT therapist will evaluate or “assess” your symptoms. She will also explore your background in-depth – i.e. close friendships and relationships, and social interactions.
She will be looking for any changes in your behavior, and any social/relationship patterns or habits that could be triggering or worsening your interpersonal issues.
Once you and the therapist have a firm grasp on what is causing your distress, she will develop a customized treatment plan that will help you address and hopefully, resolve your issues. The treatment plan will target specific areas that need to be addressed.
Group therapy sessions are also “brief,” structured, and specifically focused on your interpersonal “experiences” – the way you interact and react to certain situations and individuals. One of the main benefits of group therapy is it provides you with opportunities to “test out” your newly acquired skills – skills you learned during your therapy sessions and/or during the group sessions.
Group therapy provides you with a safe, secure, and confidential environment to “hash out” how you feel, talk about how your interpersonal issues have impacted your life, and learn from others how to effectively manage your emotions.
Group therapy is usually divided into the following categories: (1) pre-therapy, (2) mid-therapy, and (3) post-therapy. The goal of these categories is to develop and review goals, teach you techniques and strategies that may help during these situations, and document your progress during therapy.
Surprisingly, according to recent studies, most clients seeking therapy for issues or mental health conditions favor the “briefness” or short-term format of IPT vs. the longer therapy approach, usually associated with more “traditional” therapy approaches (Lipsitz, Markowitz, Cherry, & Fyer, 1999).
Results suggest that the longer the treatment or therapy, the less likely the client will complete the therapy process (Lipsitz, Markowitz, Cherry, & Fyer, 1999).
Another thing study participants liked about IPT is that it is structured, however, it is also “adaptable,” which means the direction can change, if need be. This is unlike most “traditional” therapy approaches, like cognitive-behavioral therapy, that primarily adheres to one framework or direction.
Listed below are the three stages of IPT:
- Stage 1 – This stage involves the first three stages of IPT, at which time, the IPT therapist “assess” or evaluates your symptoms and examines your social habits, experiences, and relationships. During this stage, unhealthy or damaging social patterns and habits typically emerge.
- Stage 2 – This stage begins during the 4th session. During this stage, the IPT therapist teaches you how to adopt healthier coping mechanisms and strategies, specifically aimed at your problem areas. Most of your time will be spent in this stage.
- Stage 3 – This is the last stage of IPT. During this stage, the IPT therapist helps you prepare for “life after therapy.” This stage typically involves a lot of role-play scenarios and resources to help you once you no longer have therapy to “fall back on” during challenging times.
Note: Keep in mind that for IPT to work you must be internally-motivated to change – for the better. You must also be willing and ready to examine the role you have played in your current issues. If any of these aspects are missing, IPT therapy will fail.
Will I Be Required to Take Medications While in Therapy?
It depends. An IPT therapist may determine that you would benefit from “just therapy” or a combination of therapy and medication. The decision will ultimately be made by you and the therapist, based on your individual needs.
However, it is common for IPT therapists to refer clients to a psychiatrist for antidepressants or anti-anxiety medications to be during therapy or indefinitely. Understand that for some, the combination of medication and therapy is the best protocol for success.
How Can I Find a Good IPT Therapist?
If you believe that interpersonal therapy may be beneficial for you, it’s important to find a good therapist. More specifically, you’ll need a therapist, who is highly-trained, and who has extensive and specific knowledge about and skills for interpersonal issues.
One of the most effective ways to find a good therapist in your area is to look online for “interpersonal therapy therapists.” Go to the websites of professional organizations like the American Psychological Association (APA) to find an IPT therapist.
Note: If you cannot find an IPT therapist; most, if not all counselors, psychologists, licensed social workers, psychiatrists, and psychotherapists can help you with your interpersonal issues. Just make sure he has a history of successfully treating people with a variety of interpersonal issues.
You can also find a good IPT therapist by asking around. More specifically, asking friends, family, and acquaintances for referrals. Then, once you have selected a few you’re interested – schedule a consultation and ask them for references you can talk to.
If the mental health professional becomes angry at your request – she is not the right therapist for you. It is unprofessional to not want to provide a potential client or patient with references. So, if that happens – RUN.
Next, you’ll want to contact your health insurance provider to inquire if they will cover some or all of the therapy services. Keep in mind that your health insurance plan may not cover these services or you may be responsible for deductibles or co-pays. So, it is important to find out this information before you make an appointment for IPT.
Also, keep in mind that some mental health professionals have payment plans, sliding-scale fees, and/or discounted fees for those, who don’t have insurance or who are unable to pay for services at the regular rate.
Moreover, some mental health professionals offer a free consultation. If so, take advantage of this session and use it to ask questions about fees, length of therapy, confidentiality, format, techniques, approach, qualifications, etc.
Understand that most health insurance plans do cover therapy services for clinical mental health diagnoses, such as anxiety, depression, or other psychiatric disorder. Contact your insurance provider to determine if they will pay for some or all of the service – if you have a clinical mental health disorder.
The key to finding a good IPT therapist is to select therapists from a mental health association or organization, research them, ask people, check with your health insurance provider, and schedule a consultation with them to discuss the specifics – i.e. fees, length of therapy, required number of days, format, approach, and structure of the therapy, the therapist’s knowledge and background on interpersonal issues, discount programs, etc.
Write down the pros and cons of each therapist, and then select the one you felt most comfortable with and who you believe, based on your consultation, will be able to help you resolve your issues.
What Happens After Therapy Ends?
Approximately 6 months at the end of IPT therapy, your therapist will most likely ask you to come in for a “follow-up session.” This is normal. The reason for the post-therapy session is to help you continue on your path to success.
More specifically, the purpose of the “follow-up” is to “catch-up” (to see how you are doing). If you are doing well, you may only have to come to the office once a year – or maybe, not at all. However, if you have suffered a “relapse” or appear to be struggling, your therapist may request a few IPT sessions or a new round of sessions.
Keep in mind that for many people with anxiety, depression, or other mental health conditions, it is an on-going journey. In other words, some may experience periodic “flares” or “relapses” that require additional support from a therapist. This is also normal and very common.
Follow-up sessions, on the other hand, can lower your risk of “flares” and “relapses,” so you continue on your path of healing, recovery, and success. It can also provide you with an extra measure of “backing” or “reassurance,” so you never feel alone or unsupported.
Can I Practice IPT Exercises at Home?
Yes and no. Although, it is not recommended to try to do IPT therapy solely at home, what you learn in sessions can be reinforced at home.
Listed below are some skills and exercises (learned during sessions) that can be practiced at home:
- SABOTAGE – “SABOTAGE” is a fun IPT exercise that you can do with a group of friends or family in the comfort of your home. The goal of this exercise is to teach those with inadequate or poor interpersonal skills (social and relationship skills) good interpersonal habits, patterns, and behaviors.
This exercise is best performed with a moderately large or large group. You’ll need a group large enough to have two, three, or even four groups of two, three, four, five, or six people.
The first step is to appoint then leader of the exercise. The leader then assigns the groups. Next, she instructs each group to brainstorm for approximately 10-15 minutes. In other words, write down all of the ways a person can sabotage a group assignment. The goal is for each member of the group to participate. No idea is off-limits – the more creative the better.
The leader will then ask one person of each group to list their ideas on a poster board (big enough for everyone to see). The groups will have approximately 5 minutes to do this part of the exercise. Afterward, the leader will collect the poster boards (don’t put your names on them) and instruct everyone to come back together (but stay in their respective groups). She will then mix the poster boards up and place them side-by-side.
Once every person has had time to look at each other’s answers, the leader will instruct each group to reconvene into their groups for another 10-15 minutes and write down on another poster board ways a group activity can be a success.
Repeat the process above – i.e. the leader takes the poster boards and places them side-by-side. Then, everyone comes back together but stays in their groups. However, this time each group gets to vote on the “anonymous” poster board with the best answers. The group that gets the most votes wins a prize (one for each person)!
Note: If there is a tie, the leader will break it.
***The purpose of this exercise is to help people experience a positive group activity (i.e. communication, problem-solving, and positive social interactions).
FYI: You can make this activity even more fun if you fashion it after “Family Feud!”
- Can I Help?
Another great IPT exercise that you can practice in your everyday life is volunteering. This activity is suitable for people of all ages, even children and teens. This exercise involves gathering a group of friends and brainstorming ways you can “pay it forward” or help someone of something (animals) in need.
Some ideas are Red Cross, Lupus Foundation, animal shelters or recuse mission, domestic violence centers, homeless shelters, tutoring children (helping younger children learn to read, etc.), visiting children at your local hospital, etc.
***The purpose of this exercise is to boost your social skills while helping those, who are less fortunate than yourself. A win-win.
- How Creative Can You Get?
“How Creative Can You Get?” is an IPT exercise that can help those, who tend to be socially-awkward and shy. It is also good for those, who have trouble expressing themselves, developing and maintaining healthy relationships with others, and those, who have recently experienced a life change or the loss of a loved one or pet.
- How do you play?
The key to this exercise is finding a group (preferably with a wide variety of diverse people) to join. Then, walking up to some of them and introducing yourself to them. If the mere thought of doing that makes your skin crawl, simply joining a group and “getting to know other people” through simply being around them and listening to them can help strengthen your listening skills and objectivity.
The best part is eventually you’ll most likely become comfortable interacting with one, two, or even three or more of your peers. This, in turn, will improve your social skills and your self-esteem, so you develop friendships with others.
So, tap into your “inner passion(s)” and find a group or groups where you can express yourself freely and interact with others, such as an art or music group, sport’s team, chess club, cheerleading, etc.
In Summary…
Although interpersonal psychotherapy (IPT) is not as widely known as CBT and other psychotherapies; it is proving to be a viable competitor when it comes to interpersonal issues, adjustment issues, and a variety of mental health conditions.
This form of “talk therapy” is considered an empirically-validated treatment for many mental health disorders. IPT can be used for anxiety, depression, and eating disorders – to name a few.
Also, it is suitable and effective for people of all ages, from nine years old to ninety-nine years old. Thus, from children to senior adults can enjoy the benefits of IPT.
We all have our good and bad days, and we all struggle with conflicts, life changes, and self-esteem foibles, however, when it starts to impact your life – interactions and relationships, it’s time to see someone, who can help you traverse the unpredictable waters of…life.
IPT therapists “get it.” They know what you’re grappling with. They know what you need to be successful in life and your relationships. They are trained to help you resolve your interpersonal issues, so you can be your best “self.”
References
- Norton, A. R., & Abbott, M. J. (2018). Experiential self‐focus in social anxiety Disorder: Is it beneficial? Journal of Clinical Psychology, 74(3), 480–488.
- Magni, L. R., Carcione, A., Ferrari, C., Semerari, A., Riccardi, I., Nicolo’, G., & Rossi, R. (2019). Neurobiological and clinical effect of metacognitive interpersonal therapy vs structured clinical model: study protocol for a randomized controlled trial. BMC Psychiatry, 19(1), 1–11.
- Lipsitz, J. D., Markowitz, J. C., Cherry, S., & Fyer, A. J. (1999). Open trial of interpersonal psychotherapy for the treatment of social phobia. American Journal of Psychiatry, 156, 1814–1816.
- Markowitz, J. C., Lipsitz, J., & Milrod, B. L. (2014). Critical review of outcome research on interpersonal psychotherapy for anxiety disorders. Depression and Anxiety, 31(4), 316-325.
- Markowitz, J.C., et al. (2015). Is exposure necessary? A randomized clinical trial of interpersonal psychotherapy for PTSD. The American Journal of Psychiatry, 172(5), 430-440.
- Rafaeli, A. K., & Markowitz, J. C. (2011). Interpersonal psychotherapy (IPT) for PTSD: a case study. The American Journal of Psychotherapy, 65(3), 205–223.
- Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12, 258.
- Van Hees, M. L., Rotter, T., Ellermann, T., & Evers, S. M. (2013). The effectiveness of individual interpersonal psychotherapy as a treatment for major depressive disorder in adult outpatients: a systematic review. BMC Psychiatry, 13, 22.
- Ferizi, J. N., Mashhadi, A., Yazdi, S. A. A., & Noferesti, F. (2015). The effectiveness of short-term group interpersonal psychotherapy to symptoms of depression, emotional expressiveness, social skills and quality of life in depressed university students. Journal of Fundamentals of Mental Health, 17(6), 318–324.
- Raykos, B. C., McEvoy, P. M., & Fursland, A. (2017). Socializing problems and low self-esteem enhance interpersonal models of eating disorders: Evidence from a clinical sample. International Journal of Eating Disorders, 50(9), 1075–1083.
- Kluck, A., Dallesasse, S., English, E., Kluck, A. S., & English, E. M. (2017). Family relations and psychopathology: Examining depressive and bulimic symptomatology. Child Psychiatry & Human Development, 48(5), 818–827.
- Feijo de Mello, M., De Jesus Mari, J., Bacaltchuk, J., Verdeli, H., & Neugebauer, R. (2005). A systematic review of research findings on the efficacy of interpersonal therapy for depressive disorders. European Archives of Psychiatry & Clinical Neuroscience, 255(2), 75–82.