How Interpersonal Therapy Improves Depression And Social Issues
By Julia Thomas
Updated June 04, 2020
Reviewer Aaron Horn
Interpersonal therapy (IPT) was first developed in the 1970s, when tricyclic antidepressants were the main treatment for unipolar depression. In fact, the tactics and techniques of IPT were designed for use in a treatment trial that would be used to determine the best combination and duration of treatment with tricyclic antidepressants and psychotherapy. Interpersonal therapy proved to be more effective than anyone imagined.
Now, IPT, along with cognitive behavioral therapy, are recognized as the two most effective psychotherapeutic treatments for depression. This treatment has also proven effective for anxiety, drug and alcohol addiction, bipolar disorder, persistent mild depression (dysthymia), eating disorders and social phobia.
Interpersonal Therapy Definition
Interpersonal therapy is a type of talk therapy that takes into account your physical, mental, and social vulnerabilities, along with cultural and spiritual factors. Its main focus is on social roles and relationships because these factors have proven to be significant as precursors to depression and other mood and non-mood disorders.
A Scientific Treatment
IPT is a scientific approach and has been studied in over 250 trials. Just as in cognitive behavioral therapy, in interpersonal therapy, the therapist must forge a bond with the client, giving empathy and helping the client feel understood. The therapist guides the client in dealing with their emotions by offering a clear and precise treatment, which then leads to success.
Are Mental Disorders in Our Biology?
What makes interpersonal therapy different from cognitive behavioral therapy are the concepts and techniques behind the treatment. First, the person with the disorder is viewed as having a medical condition. It isn't their fault, and there is no reason to blame themselves for not doing better or trying harder. Depression, etc., happens to them; it is not caused by them.
Social Factors Behind Disorders
Another unique feature of interpersonal therapy is that it highlights the connection between the client's mood and any disturbing life situations (such as grief, divorce, or losing a job) that may have caused or compounded their disorder. A complete interpersonal therapy definition must also include the fact that IPT is a short-term, present-focused treatment method that is based on attachment theory, communication theory, and the biopsychosocial/cultural/spiritual genesis of disorders.
Every type of therapy has its own goals. For instance, cognitive behavioral therapy has the goal of changing thoughts so that feelings and behaviors can also change. In interpersonal therapy, the goals are a bit different. For IPT, the primary goals are to reduce psychiatric symptoms, work on interpersonal relationships, and build a network of social support.
Concepts Behind Interpersonal Therapy
Several concepts, also called tactics, make up the core of interpersonal therapy. Aside from the biopsychosocial/cultural/spiritual basis of IPT already discussed, this therapy assumes an Interpersonal Triad and makes use of an Interpersonal Inventory. The main treatment takes place as you and the therapist discuss your interpersonal problems and agree on goals for improving your interpersonal coping skills.
IPT theory suggests that depression and other mental disorders begin after an acute interpersonal crisis. This crisis may be somewhat relieved, or it might be exacerbated, depending on your attachment style and biopsychosocial/cultural/spiritual strengths and weaknesses. If you also have inadequate social support, the problem is compounded further. The Interpersonal Triad, then is this combination of factors that add up to cause your distress. The Triad includes:
- An acute interpersonal crisis
- Your own strengths and vulnerabilities (attachment style, personality, biopsychosocial/cultural/spiritual)
- Lack of social support
When all three factors in the Triad are going against you, it's more likely you'll succumb to a mental disorder.
What Is It Like to Have Interpersonal Therapy?
Interpersonal therapy may be quite different from what you imagine therapy to be. It is a focused, intensive, brief modality that follows a specific set of rules and procedures. So, what is it like to see a therapist for IPT? Although your therapist will tell you everything you need to know to complete therapy with IPT, learning more may make the experience less stressful for you.
Three Phases of Treatment
Interpersonal therapy is a highly-structured treatment that has three distinct phases. No matter what happens during the 45-60-minute weekly sessions, treatment continues along this path in standard IPT. The three phases are:
- Beginning - This is the assessment period that includes the Interpersonal Inventory, psychiatric history, etc. This phase is designed to take place in the first 3 sessions.
- Middle - The middle is the heart of the treatment. This is where the work of IPT is done. You focus on resolving the interpersonal problem area that you've set out to improve.
- Final phase - In the last phase of treatment, the only goal is to end the therapeutic relationship on a positive note.
If you begin interpersonal therapy, you might begin by taking a test called the Interpersonal Inventory. This tool helps the therapist understand where you're getting or lacking social support, who you confide in and how healthy those relationships are, who you're romantically attached to and what the status of that relationship is currently in, how you communicate with others in daily life, and any problems in your relationship that might have led to your depressive episode.
Interpersonal Problem Areas
Since IPT is a scientific treatment, it has specific rules about how to proceed. The first step after the interpersonal assessment is to identify the interpersonal problem area to focus on. In interpersonal therapy, there are only four options to choose from here. They are:
- Grief - when a loved one has died.
- Role dispute - when a close personal relationship is marked by differences in role expectations.
- Role transition - when you're transitioning from one role to another, such as when you change jobs or move.
- Interpersonal deficits - when none of the other three options fits and you've had ongoing problems with interpersonal relationships for a significant period of time.
Interpersonal Therapy Techniques
Many of the techniques used in interpersonal therapy are quite different from those used in cognitive-behavioral or other types of therapy. The focus, as always with IPT, is on improving interpersonal relationships.
Interpersonal incidents are things that happen in a relationship. When you or your loved ones behave in ways that keep you from meeting your interpersonal needs, you have an interpersonal crisis that may lead to symptoms of a mental disorder. The therapist must examine and analyze this situation to help you find better ways of behaving within it.
Role playing is a common technique used in many different treatment modalities. It is especially helpful in interpersonal therapy, because it gives you the opportunity to explore interpersonal situations you're in and work on your interpersonal skills.
Your therapist may do an exercise called communication analysis to help you find problems in your interpersonal communication skills. You begin by thinking of an interaction that happened between you and another person. You write out the scene as if you were writing a play, including setting and all the words and gestures of the "actors."
The therapist will read your "movie script" and may ask you questions about it. For example, they might ask you what you or the other person intended when they said or did something. They might then ask you to tell what they actually communicated. After you've analyzed this incident of interpersonal communication, the therapy might proceed to a role-playing exercise in which the therapist coaches you on better ways to handle such an incident.
What's the Bottom Line?
Explaining interpersonal behavior requires a certain amount of detail. Theories and details help explain this treatment, but at this point, you may be wondering, "Yes, but what's the bottom line? How does IPT really help with mental disorders like depression and social phobia?"
The key is in the word "interpersonal." IPT is designed for situations where the problem is poor interpersonal functioning. IPT assumes that what happens between you and the people you interact with is the cause of your mental disorder. Assuming that is true, the best possible solution is to improve your interpersonal skills.
Finding a Therapist for Interpersonal Therapy
Perhaps you find yourself having an interpersonal crisis. You're grieving, arguing with your partner, or settling into a new position at work. If you recognize that you're getting depressed, anxious, or otherwise disturbed, you may realize that the problem lies in your interpersonal skills. If so, you might want to try interpersonal therapy.
Finding a therapist for interpersonal therapy may be easy or difficult, depending on what your personal resources are and where you live. Transportation may be an issue for people who live in rural areas or have to drive through heavy traffic to reach the therapist's office.
Fortunately, you can have convenient, inexpensive mental health treatment by going online to Better Help. There, licensed therapists are available to help you learn better ways to interact, build your support system, and gain physical and emotional strength. With Better Help, you can have treatment wherever you like. You can remain anonymous if you choose, too. In addition, there are therapists with different specialties so that you can choose someone with experience in the type of therapy you prefer, whether that's cognitive-behavioral or interpersonal therapy.