Interpersonal Therapy for Mood Disorders and Substance Abuse
Overview of Interpersonal Therapy
- Interpersonal therapy (IPT) is a time-limited therapy commonly used to treat severe depression and other mood disorders.
- It is based on the principle that interpersonal relationships (or the way we relate to others) significantly impacts our mental health.
- Appointments are held once a week, usually in a mental health clinic or primary care setting.
- Research shows IPT is effective in the treatment of depression. But it may not be as effective in treating those with depression and anxiety.
- Evidence suggests that IPT may be effective in treating addictions, such as cocaine abuse and eating disorders.1, 10
What Is Interpersonal Therapy?
IPT is not primarily used to treat addiction. But it may be used when a person suffers from a mental health disorder and an addiction—also known as dual diagnosis.
Principles of Interpersonal Therapy
IPT has 2 major principles:
- Mental health disorders, like depression, develop from adverse life events and dysfunctional interpersonal relationships (or ways of relating to others).
- These disorders are treatable by focusing on building stronger interpersonal skills.
- This is usually done with a therapist, where the patient then learns to generalize these skills with others in his or her life.
Goals of Interpersonal Therapy
Interpersonal therapy’s goals are to:
- Resolve the person’s problem or troubling life event.
- Help them improve their social skills.
If the therapist and person can address the underlying problems, then the person is less likely to experience depression.
How Interpersonal Therapy Works
Interpersonal therapy usually lasts between 12 and 16 weeks and has 3 phases.
- Therapist diagnoses the client and determines the event, or interpersonal factors, that are connected to the symptoms.
- If the client has depression, the therapist looks at the client’s symptoms, as well as his or her current relationships.
- The therapist stresses that the client’s mood disorder is an illness and not the client’s fault.
- The therapist and client establish expectations for therapy.
- The therapist develops strategies catered to the client’s problem.
- The client is encouraged to express his or her needs and take risks in social settings—as well as in the therapy office.
- The therapist assures the client that anger, or other “negative” emotions, are valid emotional responses and he or she should express them in a healthy manner.
- The client’s accomplishments during treatment are reviewed to promote confidence.
- The therapist reminds the client that ending therapy is an interpersonal event, which can have positive and negative features. The client is encouraged to notice feelings about this.
- Since many people with a mood disorder have recurring episodes, sometimes a therapist may schedule ongoing treatment.
Frequency of Appointments, Setting and Cost
- Frequency of appointments. Therapy sessions are typically once a week.
- Settings. Interpersonal therapy is available in mental health clinics and primary care settings. 4, 5 It is starting to be adapted to developing countries. 6
- Cost. Interpersonal therapy’s cost depends on the treatment program and how much the client’s insurance covers.
- Therapist’s approach. An IPT therapist supports and congratulates the client when he or she makes progress and offers sympathy when situations don’t go as planned. During these times, the therapist brainstorms solutions and uses role play to prepare the client for future situations.
Effectiveness in Treating Addiction and Mental Health DisordersIPT has received a large amount of research support in treating depression. Some evidence suggests that it may be helpful for treating eating disorders and addiction.
While these other disorders may not have received much research attention, IPT has been used clinically for several years with a wide range of mental health and substance abuse disorders.
How IPT Can Help With Addiction Treatment
While IPT is not typically used to treat addictions alone, it may be used when addictions co-occur with mental health disorders.
- Depression and drug use. Improving an individual’s social skills (and ultimately mood) through IPT will have an impact on behavioral choices they make—including the use of drugs, or how they relate to others who use drugs (e.g., being able to say “no,” or spending less time with those people).
- Eating disorders. An individual can learn through IPT how to relate differently to people; this may provide them with a greater sense of control, which will have an impact on their food choices.
Effectiveness Treating Depression
Cuijpers and colleagues, in the American Journal of Psychiatry, reviewed 38 studies on the efficacy of IPT. Results revealed that IPT is effective in treating depression, both independently and in combination with medication. 2
A study that compared 7 different therapies revealed that IPT was slightly more effective than the other 6 for treating depression. 3
Effectiveness Treating Substance Abuse
One study compared IPT to a preventative treatment in cocaine users. Those receiving the preventative treatment were more likely to maintain abstinence for 3 consecutive weeks and to be categorized as recovered upon termination. 1
Drawbacks of IPT
Trials revealed that IPT helped to prevent recurrence of major depression in persons 60 to 69 years old. But it appears to be less effective in persons 70 years old and older. 7 Often, people who suffer from depression also experience anxiety. IPT is proven to be very effective in treating those with depression. But it is less effective in treating people with both depression and anxiety. 8 One study revealed that if a depressed person has poor social functioning, then IPT is less effective in the treatment of depression. 9
Find a Treatment Program
Contact a treatment support specialist at if you’re looking for an addiction treatment program that offers interpersonal therapy or another type of behavioral therapy.
. Carroll, K., & Rounsaville, B. (1991). A comparative trial of psychotherapies for ambulatory cocaine abusers: Relapse prevention and interpersonal psychotherapy. Am J Drug Alcohol Abuse. 17(3):229-47. Retrieved October 21, 2015, from http://www.ncbi.nlm.nih.gov/pubmed/1928019
. Cuijpers, P. et al. (2011). Interpersonal Psychotherapy for Depression: A Meta-Analysis. American Journal of Psychiatry. 168(6): 581-592. Retrieved October 21, 2015, from http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2010.10101411
. Cuijpers, P., Van Straten, A., Andersson, G., & Van Oppen, P. (2008). Psychotherapy for depression in adults: A meta-analysis of comparative outcome studies. J Consult Clin Psychol. 76(6):909-22. Retrieved October 21, 2015, from http://www.ncbi.nlm.nih.gov/pubmed?term=19045960
. Alexopoulos, G., Reynolds, C., Bruce, M., Katz, I., Raue, P., Mulsant, B., Ten Have, T. (2009). Reducing suicidal ideation and depression in older primary care persons: 24-month outcomes of the PROSPECT study. Am J Psychiatry. 166(8):882-90. Retrieved October 21, 2015, from http://www.ncbi.nlm.nih.gov/pubmed?term=19528195
. Talbot, N., Chaudron, L., Ward, E., Duberstein, P., Conwell, Y., O’Hara, M., Stuart, S. (2011). A randomized effectiveness trial of interpersonal psychotherapy for depressed women with sexual abuse histories. Psychiatr Serv. 62(4):374-80. Retrieved October 21, 2015, from http://www.ncbi.nlm.nih.gov/pubmed?term=21459988
. Verdeli, H., Chlougherty, K., Bolton, P., Speelman, L., Lincoln, N., Bass, J., Weissman, M. (2003). Adapting group interpersonal psychotherapy for a developing country: Experience in rural Uganda. World Psychiatry 2(2):114-20. Retrieved October 21, 2015, from http://www.ncbi.nlm.nih.gov/pubmed?term=16946913
. Reynolds, C. et al. (1999). Nortriptyline and interpersonal psychotherapy as maintenance therapies for recurrent major depression: A randomized controlled trial in persons older than 59 years. JAMA 281(1):39-45. Retrieved October 21, 2015, from http://www.ncbi.nlm.nih.gov/pubmed?term=9892449
. Feske, U. et al. (1998). Anxiety as a predictor of response to interpersonal psychotherapy for recurrent major depression: An exploratory investigation. Depress Anxiety 8(4):135-41. Retrieved October 21, 2015, from http://www.ncbi.nlm.nih.gov/pubmed?term=9871814
. Sotsky, S. (1991). Patient predictors of response to psychotherapy and pharmacotherapy: Findings in the NIMH Treatment of Depression Collaborative Research Program. Am J Psychiatry 148(8):997-1008. Retrieved October 21, 2015, from http://www.ncbi.nlm.nih.gov/pubmed?term=1853989
. Wilfley, D. et al. (2002). A Randomized Comparison of Group Cognitive-Behavioral Therapy and Group Interpersonal Psychotherapy for the Treatment of Overweight Individuals with Binge-Eating Disorder. JAMA Psychiatry 59(8):713-721. Retrieved October 26, 2015, from http://archpsyc.jamanetwork.com/article.aspx?articleid=206650