Interpersonal Therapy: Strengthening Relationships to Support Mental Health
The relationships we have with others are some of the most essential and meaningful aspects of our lives. Close friends at college, parents you see for holidays, and coworkers you spend lunch with each have a special impact on who we are.
When we begin to find ourselves overthinking, upset, or sad in our daily life, it can be helpful to look towards our relationships and wonder if they could be a factor in these feelings.
Have you recently graduated from college? Are you feeling sad about this transition? Rather than a problem within yourself, you may be missing the close-knit circle of friends who were only a walk down the hall.
Did you recently move away from home for the first time? Are you feeling anxious and restless? It might not be that this new place “isn’t right for you,” but maybe that you are missing your family and are adjusting to being a family member who is no longer close to home.
Interpersonal Therapy is a type of therapy that suggests the difficulties we may face are not from something “broken” within us, but from normal changes that occur within our relationships.
What is Interpersonal Therapy?
Interpersonal Therapy (IPT) is a type of psychotherapy that focuses on the connection between one’s relationships and their mental health. IPT suggests that our mental health does not just exist within ourselves, but exists with our outer community and support systems as well. The core belief is that challenges with friends, family members, or romantic partners can be the root cause of daily stressors.
In Interpersonal Therapy, depression, anxiety, and other symptoms begin with a specific event like losing one’s job, getting engaged, or moving away from home for the first time. IPT refers to this event as a provoking agent. Other factors, such as having difficulty with confrontation, a history of people-pleasing behaviors, or a tendency to cut people off after conflict, are defined as vulnerability agents. These vulnerability agents do not causesymptomatic behaviors to begin, but it is the combination of these agents with a provoking agent that causes issues to interfere with daily life and motivate individuals to seek support or help.
IPT is a short-term therapy, focused on the present, rather than the past. This focus does not mean that therapists do not acknowledge the client’s past, as they learn about past relationships to understand potential patterns that have emerged that could now be shaping one’s present.
Through Interpersonal Therapy, clients can:
Learn how to create stronger and more social connections
Acknowledge the links between their relationships, past and present, and symptoms
Better understand their emotional responses to life transitions or events
Improve interpersonal skills such as communication skills, conflict resolution, and setting boundaries
Is Interpersonal Therapy Right For Me?
Interpersonal Therapy may be a good fit for you if you…
Are struggling to keep existing relationships that are important to you and want to learn ways to keep these connections growing
Have been feeling isolated and wish you had more close relationships in this phase of life
Feel guilty for putting yourself first and feel like you are abandoning your role as a sibling, child, or friend
Have started a new phase of life (college student, full-time worker, serious relationship partner) and are unsure how to navigate these new expectations and rules
Are dealing with unresolved grief
What Does Interpersonal Therapy Help With?
Role Transitions: Whether it’s going from single to being in a serious romantic relationship or transitioning from a college student to a full-time worker, changes in social roles can be difficult, anxiety-producing, and even scary. Through therapy, individuals can learn to manage these transitions by grieving the old role they were once in, and preparing to become more confident and excited for the new role and chapter that is coming.
Role Disputes: When someone has an expectation of how one should behave, and the other party disagrees, arguments about “roles” emerge. For example, say your partner believes you should take care of the cleaning, while you believe it should be a shared duty. When these roles are unspoken, they can leave the relationship strained as both individuals are expecting behaviors that are not happening.
Are both parties looking to find a solution to their conflict? Has communication halted, with resentment rising to the surface? Are both individuals unable to see eye-to-eye, and is it time to reevaluate the conflict or relationship entirely? With support, the individual and therapist can determine the magnitude of the dispute that is occurring, and determine next steps.
Interpersonal Deficits: Relationships, and the amount that we have, shift throughout your life. Perhaps you have moved away from home for the first time or just started college. Social connection, especially in times of transition, is important for our mental health. Therapy can help individuals feel less lonely, learn strategies to make new relationships, and create ways to sustain old relationships through distance and conflict.
Grief: Grieving is a long and difficult process. When individuals have a hard time moving through the stages of grief, or feel “stuck”, therapy focuses on guiding the client through continued mourning and helping them reestablish relationships and interests that may have been set aside.
What Does Interpersonal Therapy Look Like in the Therapy Room?
Interpersonal Therapy is a collaborative therapy, where the therapist’s main goal is to help clients understand the connection between their relationships and mental health. During sessions, the therapist will help the client understand their mental health, their symptoms, and the impact of their social environment. While IPT is primarily short-term, it can also be integrated into long-term therapy.
IPT typically lasts between sixteen and twenty sessions. These sessions are divided into three phases, with each phase focusing on a different aspect of the healing process.
Initial Phase: The initial phase of IPT lasts one to three sessions. During this phase, the therapist and client spend time getting to know one another and discuss what drove the client to seek support at this point in their life. Time will be dedicated to the client introducing the therapist to significant individuals in their life, including grandparents, parents, siblings, friends, coworkers, and romantic partners. Formally called the Interpersonal Inventory, this tool helps the therapist get a clearer image of the client's past and present social connections.
These early sessions also focus on identifying a social stressor (a move, breakup, graduation, etc.) that may have contributed to the symptoms driving the client to therapy. The therapist will spend time focusing on these symptoms and explaining to the client that their thoughts, feelings, and actions are a reflection of the depression or anxiety they are experiencing.
The goal of this is to help clients learn that these symptoms are not a reflection of themselves or their potential, but of the mental health issue itself. Throughout sessions, the therapist encourages the client to identify their true feelings about a situation or person, and acknowledges that these feelings, thoughts, and beliefs are normal. Using psychoeducation, the therapist normalizes the client's experience and educates them on their feelings, the benefits of these sessions, and connects the client's symptoms to their struggles in their interpersonal relationship.
Middle Phase: After the therapist has a greater understanding of their client, they will move on to the middle phase of treatment. This phase begins with the therapist identifying a problem area that will be the focus of their treatment together.
A few things your therapist might incorporate in sessions:
Communication Analysis: Assists the client in understanding their communication with others. This understanding allows clients to improve any communication skills for the future.
Behavioral Activation: A strategy used to plan activities that feel fulfilling and foster a positive mood in the individual. This can include exercising, engaging in club sports, painting or drawing, and more. Rather than wait for motivation to kick in, behavioral activation recognizes that the motivation and positivity may not happen until after the activity.
Decision Analysis: A strategy where the therapist helps the client make decisions by identifying and weighing options. This is especially helpful for clients who feel there is “no other option” to navigate their current situation.
Role Plays: Therapists may use role plays to help a client understand their feelings about a situation, take a look at communication styles, and increase self-confidence. Role plays can include practicing talking with your sister about how you want to spend more time together, preparing for asking for a raise with your boss, or telling a friend you need some more space. No matter the situation, role-playing gives you a safe space to prepare and express yourself with no judgment.
Final Phase: The final phase of treatment focuses on the end of the therapy relationship. During this time, the therapist and client reflect on how the client’s symptoms have dissipated, and more importantly, what techniques have helped the client the most. The most essential part of this phase is to prepare the individual for future social conflicts that may occur, and leave them with more tools now than they had at the beginning of therapy.
While traditional Interpersonal Therapy is a short-term therapy, entering the final phase of treatment does not have to mean that the therapeutic relationship or therapeutic journey has to conclude if the individual is not ready for it to end. Many individuals continue Interpersonal Therapy in a maintenance form, seeing their therapist even every other week to continue having a support system.
Is Interpersonal Therapy an Effective Treatment?
Interpersonal Therapy is a widely researched and effective treatment in the psychotherapy field. Originally, IPT was designed to treat depression, but because of its acceptance and success in treatment, researchers began to expand their work. Now, IPT is effective in treating postpartum depression, bipolar disorder, anxiety disorders, substance use disorder, and eating disorders. Additionally, Interpersonal Therapy can be used in group settings as well as with adolescents.
The main difference between Interpersonal Therapy and other types of psychotherapy like Psychodynamic, Cognitive-Behavioral Therapy (CBT), or Acceptance and Commitment Therapy (ACT) is the focus on the present day and the experience of interacting with the therapist in real time. Additionally, IPT focuses on changing the problem, the interpersonal relationship, rather than shifting thought patterns.
Main Concepts From Interpersonal Therapy
Mental Health is Equivalent to Physical Health: Just like someone with a cold or broken bone, emotional distress is an illness that deserves our attention. Interpersonal Therapy acknowledges that people struggling with their mental health may be unable to engage in all social roles or environments they once were able to. This doesn’t mean that these feelings and behaviors will last forever, but acknowledging and accepting one’s current limitations will allow healing and growth to begin.
Interpersonal Conflict, Not Internal Conflict: IPT heavily focuses on the struggles in relating to others that are present in one's life. While individuals may experience thought patterns or behaviors, these are only addressed when they relate to and contribute to relationships.
An Active and Positive Therapist: During IPT, the therapist supports and encourages their client to make positive changes in their life. Through listening, understanding, and empathy, the therapist helps the client to create a relationship with themselves and others. Additionally, the therapist helps the client brainstorm strategies to make new friendships and relationships, gives suggestions to improve conflict with others, and educates the client on how their social environment is impacting their mental health.
Focus on the “Here and Now”: The therapy process will examine how the client’s relational patterns outside the therapy room show up in the therapy room. Therapy is a unique experience to notice and understand the process of relating to another person. The therapist will invite conversations about what the client experiences in relation to the therapist.
Sources
Frank, E. & Levenson, J. C. (2011). Interpersonal Psychotherapy. American Psychological Association.
Lipsitz, J.D. & Markowitz, J.C. (2013). Mechanisms of Change in Interpersonal Therapy (IPT). Clinical Psychology Review. 33(8), 1134 - 1147. https://doi.org/10.1016/j.cpr.2013.09.002.
Ravitz, P. & Watson, P. (2014). Interpersonal Psychotherapy: Healing with a Relational Focus. Focus, 12(3), 275-284. https://https://doi.org/10.1176/appi.focus.12.3.275.
Swartz, N. (2024, August 20). What is IPT (interpersonal therapy)? Reach Behavioral Health https://reachbh.org/what-is-an-ipt/