Interpersonal Therapy (IPT)
- Social Work Graduate
- 2 days ago
- 14 min read
Description, core concept, goal, treatment focus, session structure, treatment options, research evidence, interpersonal counselling (IPC)
Four sections follow:
1. Background Material that provides the context for the topic
2. Suggestions for Practice
3. Appendix 1: Session structure
4. A list of References
Feedback welcome!
Background Material
What is Interpersonal Psychotherapy (IPT)?
A central idea in IPT is that psychological symptoms can be understood as a response to current difficulties in everyday relationships with other people. IPT is a form of psychotherapy (talk therapy) that focuses on relieving symptoms by improving interpersonal functioning. It addresses current problems and relationships rather than childhood or developmental issues. Therapists are active, non-neutral, supportive and hopeful, and they offer options for change. IPT:
is structured
is time-limited (the active phase is usually 12–16 weeks, once weekly)
focuses on interpersonal relationships and communication
focuses on here-and-now relationships
aims to improve interpersonal functioning and social support (CAHM, n.d.; PsychDB, 2024).
IPT helps clients to understand their emotions as social signals, to use this understanding to improve interpersonal situations, and to mobilize social supports. Its success in a series of research studies has led to its inclusion in numerous national and international treatment guidelines (ISIPT, 2025).
The premise of IPT is that whatever the ultimate causes, depression and other psychiatric disorders occur in a social and interpersonal context. Understanding the development of symptoms in this context and finding better ways of handling them can help relieve symptoms (Mootz et al, 2024). Its basic principles assume that helping clients to improve problematic interpersonal relationships or circumstances that are directly associated with the current mood episode will result in symptom reduction. Iteratively, improvement in mood will lead to additional spontaneous improvement in interpersonal functioning which, in turn, will lead to further reductions in mood symptoms (Cleveland Clinic 2024; ISIPT, 2025).
Numerous adaptations of IPT have appeared over the years, including a publicly available group IPT version and the simplified version called interpersonal counselling (IPC). There is little difference between IPT and IPC. Practitioners tend to call it IPC when the treatment is brief, 4 to 8 sessions or even fewer, and it is guided by community health workers or others without professional mental health degrees (Mootz et al., 2024).
Rationale
IPT uses the medical model as a conceptual framework for clients’ mood symptoms. In the context of initiating IPT, the therapist conducts a psychiatric history and diagnoses a current episode of major depression according to DSM 5 criteria. The IPT therapist likens the depressive episode to other medical illnesses (“no different than asthma or diabetes or pneumonia”) and further explains that the client has an inherited, biologic vulnerability to depression. Using the medical model as a framework, the IPT therapist stresses that it is not the client’s “fault” for developing depression, any more than it is someone’s “fault” for developing pneumonia. Using a stress-diathesis model to explain the interaction between biological vulnerability and stressful life events, IPT further posits (and makes explicit to clients) that although individuals are not to blame for their illness, they are in an excellent position to help themselves recover from depression by attending to the interpersonal factors that may serve as triggers for the underlying biologic illness (ISIPT, 2025).
Core concept and goal
IPT's core concept is that interpersonal relationships alone do not cause depression. However, depression can develop within an interpersonal context and affects relationships and the roles of people within those relationships. By addressing interpersonal issues, IPT puts emphasis on the way symptoms are related to a person's relationships, including their family and peers (PsychDB, 2024).
The overall goal of IPT is to help clients adapt to life changes, connect with social supports, and improve communication. IPT seeks to achieve this by affective exploration of relationships to foster adaptation, and connection with supports.
· The immediate goals of IPT are rapid symptom relief and improved social adjustment.
· The long-term goal of IPT is to enable those with depression to make their own needed adjustments. This allows clients to better cope with and reduce depressive symptoms (PsychDB, 2024).
Focus areas
In IPT, the therapist selects one of four interpersonal problem areas as the focus for treatment. The four IPT problem areas are:
Grief is chosen as a problem area when the onset or maintenance of the depressive episode is associated with the death of a person close to the client.
Role Dispute is chosen as a problem area when the onset or maintenance of the depressive episode is associated with an unsatisfying interpersonal relationship characterized by non-reciprocal role expectations between the two parties.
Role Transition is chosen as a problem area when the onset or maintenance of the depressive episode is associated with difficulty coping with changes in current life circumstances. Role transitions may occur in many domains including employment, relationship status, physical health, living conditions, socioeconomic status, etc. The transition is conceptualized as moving from one social role to another social role (i.e., from a student to an employee, from military to civilian status, from single to married, etc.).
Interpersonal Deficits is chosen as a problem area when there is no clear acute interpersonal event associated with the onset or maintenance of the depressive episode and the individual describes a long standing history of impoverished or contentious interpersonal relationships. Although many clients seeking IPT treatment have deficits in interpersonal functioning, the interpersonal deficits category is reserved for cases where no other treatment focus is apparent (ISIPT, 2025; PsychDB, 2024; Psychology Today, 2022).
IPT structure
IPT has three phases: beginning, middle, and end. The initial phase can last up to three sessions. During that time, the therapist has specific tasks (viz., obtain a psychiatric history and interpersonal inventory, offer a case formulation). The middle phase is focused on resolving the chosen interpersonal problem area in order to improve mood symptoms. The final phase focuses on termination or a “good goodbye” (ISIPT, 2025).
The opening sessions (1-3) focus on collecting information and making decisions about the focus of therapy. The therapist provides a supportive, nonjudgmental and safe environment for the person to talk openly about interpersonal and life issues, e.g. stressful life events, grief, arguments or disputes with others, life transitions and social isolation.
The therapist develops an alliance with the client; psychoeducation is provided about depression. The client is also assigned the “sick role,” i.e. has an illness to be treated—is not a defective person.
Focus on collecting information and making decisions about the focus of therapy.
The therapist helps the client create a list of all the key relationships in the client’s life (interpersonal inventory)
These relationships are grouped according to the four main focus areas outlined above.
In the middle sessions (4 – 14), the client concentrates on trying to improve the chosen problem area or areas with the support of the therapist. The client and therapist work to develop solutions to the problems, and the client tries to implement the solutions between sessions. These sessions involve the IPT techniques outlined below.
Grief | Disputes | Transitions/Life change | Loneliness and isolation |
Mourn and accept loss by reconstructing relationship with deceased prior to, during, and after death. Explore new or re-establish old interests and relationships. | 1. Identify disputes and their stage · Renegotiation (parties arguing to find solution) · Impasse (parties stopped communicating) · Dissolution (one or both want to end relationship) 2. Explore options · Renegotiation (determine issues, differences in expectations, and find alternatives) · Impasse (open up communication and renegotiate) · Dissolution (resolve ending in least harmful way) | Give up past and deal with loss by reconstructing what was lost. Accept new role in as positive light as possible. Develop new skills and relationships to support change. | Reduce isolation by understanding the origins and current encounters. Encourage and assist in developing opportunities for relationships. |
The final sessions (15 – 16) focus on dealing with any sense of loss associated with the end of therapy as well as reviewing the issues that were identified in the interpersonal inventory and the progress made in dealing with them (CAHM, n.d.; Cleveland Clinic, 2024; PsychDB, 2024).
A more detailed outline of these phases can be found in the Appendix that follows the Suggestions for Practice section below.
IPT techniques (ISIPT, 2025; Mootz et al., 2024; PsychDB, 2024)
The IPT techniques are not new or different from those commonly used in clinical practice. For example, they elicit conversation through use of open-ended questions and reflections of clients’ statements to check therapist understanding. They are also careful to validate and normalize clients’ experiences so clients know they are not alone or in the wrong for how they feel about something. Providing affirmations and noticing clients’ strengths supports clients’ sense of self-efficacy to harness for improving interpersonal problems. Techniques often used in IPT include:
Communication analysis
During communication analysis, therapists elicit a detailed account of a recent interaction between clients and a significant other to help them identify their communication patterns. They suggest ways of rectifying faulty communication to help the client communicate more effectively.
Decision analysis
When clients present an interpersonal problem, therapists ask clients how they would like to resolve it and encourage them to generate a list of possible solutions. Together with therapists, clients evaluate the pros and cons of each option and select one or a combination of choices that may lead to a better interpersonal interaction.
Role play
Role playing allows clients to practise their newly established communication styles and receive constructive feedback on interpersonal skills and strategies before implementing them in real life.
Who can benefit from IPT?
IPT was initially developed for the treatment of individuals with a major depressive episode and has been adapted for different disorder, ages, cultures, settings, methods of implementation (e.g. group, telephone) and level of therapist training, with over 100 clinical trials. Thus IPT can work for many groups and situations including as a stand-alone treatment and in combination with medication (ISIPT, 2025; PsychDB, 2024).
IPT helps people become more aware of their emotions, thoughts and behaviors, and how they affect their relationships and mood. After IPT, most people adopt healthier ways of relating to others. IPT can’t make stressful situations disappear, but skills people to respond to them more positively and feel better overall. In addition, studies show that IPT therapy combined with medication (like an antidepressant) is more effective at managing major depression than medication alone (Cleveland Clinic, 2024).
IPT can be used to treat:
the acute phase of major depression
anxiety disorders
bulimia nervosa
binge eating disorder
chronic fatigue
mood disorders such as bipolar and dysthymic (persistent depressive) disorders
Post-traumatic stress disorder (PTSD)
Perinatal depression
Alcohol addiction
Dysthymia
IPT can also be provided as a maintenance treatment to help prevent relapse and recurrence of illness (CAHM, n.d.; Cleveland Clinic, 2024; ISIPT, 2025; Psychology Today, 2022).
Research evidence
The evidence for the efficacy of IPT for adolescents and adults with major depression is very strong except for the very oldest depressed clients where results were open to more than one interpretation. Efficacy for depression has been demonstrated across different economic, educational, racial backgrounds and settings in studies from the U.S., Europe, Canada, South America, the Middle East, and Sub-Saharan Africa. The adaptations required have been minimal.
Studies have demonstrated the efficacy of IPT during pregnancy and the post-partum period. The transition problem area fits readily into the issues of pregnancy and childbearing.
The adaptations and evidence for efficacy of IPT for bipolar disorders is very strong in combination with medication and for maintenance treatment.
The evidence for dysthymia or persistent depression is less strong, mainly shown as an adjunct to medication.
The evidence for substance related and addictive disorders are sparse and thus far negative or equivocal. One recommendation is to use IPT in clients once sober to help rebuild their lives.
For eating disorders, no psychotherapy, including IPT, has been shown to be effective for anorexia nervosa. However, the efficacy of IPT for binge eating is very strong both as individual and group treatment.
New findings show the efficacy of IPT for PTSD as an alternative therapy and, also for social anxiety disorder as an alternative to CBT.
The evidence for borderline personality disorder is sparse and no conclusion can be drawn (ISIPT 2025).
ISIPT (2025) explores in some detail how IPT can be used with adolescents, young children, for depression, for late life depression, for eating disorders, for bipolar disorder, for perinatal depression and for PTSD (https://interpersonalpsychotherapy.org/ipt-basics/adaptations-of-ipt-what-works-for-whom/).
Suggestions for Practice
Social workers who are attracted to IPT as an approach to use with clients will find training is available. For example training in Australia can be found at the following sites:
Furthermore, the IPT Institute also offers training that can be accessed online worldwide: https://iptinstitute.com/ipt-training-events/
Besides formal training, the IPT approach offers social workers ideas for incorporating IPT approaches into their work with clients. Using the four focus areas and the central theme that psychological symptoms can be understood as a response to current difficulties in everyday relationships, a social worker will be able to utilise the skills they already have to explore the relationships that are around the presenting problem. The strengths-based approach common to social work has an important place here, as does working from a systems framework. Familiarity with the usual practice approaches, e.g. problem solving, task-centered and solution-focused, will underpin the approach the social worker takes to support the client and assisting the person to find a way forward.
Interpersonal Counselling
Mootz et al. (2024) point out that IPT can be simplified to “ interpersonal counselling” (IPC), a brief treatment limited to 4 to 8 sessions. There are at least two authors have explored IPC in some detail: Judd et al. (2004) and Weissman et al. (2014). The former suggests up to 6 sessions can be taken for IPC while the latter suggests IPC can be limited to three sessions. The following outline of IPC derived from these papers may prove useful for social workers who wish to use IPT but do not have the training background.
IPC is designed for people who are in distress and have symptoms due to current stressors in their lives, but who do not have serious concurrent psychiatric disorders or medical conditions that can or should be treated more effectively by medication or other psychosocial treatments. The IPC approach depends on the principle that life events and the social environment affect mood and that mood can affect social and interpersonal functioning and one’s response to the environment (Judd et al., 2004). The choice of IPT vs. IPC will depend on level of training of provider, resources available, and severity of person’s illness. In general, IPC is recommended for use in settings that are not specific to mental health care. Numerous research studies have demonstrated that IPC improves depressive symptoms and functioning (Weissman et al., 2014).
IPC sessions can be flexibly scheduled, weekly or more or less frequently, depending upon the person’s preferences and clinical need. Additional sessions can be added. A person can also choose to have fewer sessions. Sessions are usually 30 to 45 minutes; the first session may be longer. The sessions are conceived as supportive evaluation following an initial assessment of elevated depression symptoms. Sessions will involve: (1) clarification of symptoms and diagnosis, (2) delineation of the social and interpersonal context associated with the onset of the symptoms (which fall into one of the four IPT-based problem areas, grief, dispute, life changes, boredom and loneliness), (3) identification of person resources (e.g., who is there to support the person), and (4) education for strategies in dealing with problems contributing to the person’s depression. From the very first session, the therapist focuses on clarifying the interpersonal problem and providing basic strategies to manage it (Weissman et al., 2014).
The structure of IPC (6 sessions or less) (Judd et al., 2004). Weissman et al. also describe the IPC structure.
The treatment contract Ask the person about recent changes in life circumstances, mood and social functioning, and explore how life circumstances relate to the onset of symptoms. Introduce IPC and suggest the possible relationship between the person’s symptoms of distress and current life stress. Explore the person’s current interpersonal and social situation (interpersonal diagnosis).
Determine the specific problem areas Identify with the person the specific current stress areas that are contributing to the symptoms. Overall, the GP’s task is to assist the person to identify the key person(s) with whom he/she is having difficulties, what type of problems are being experienced, and whether there are ways to make the relationship more satisfactory.
Work on specific stress area Choose one of the four problem areas (grief, interpersonal disputes, role transitions and social isolation) and work with the person to deal with this area. The goals of treatment and potential strategies are included below.
Continue with work
Continue with work
Termination Emphasise the progress made, the supports available to the person, and bolster the person’s sense of his/her ability to cope with future problems. Work with the person to identify potential sources of stress and ways in which the person could cope with these, especially referring to strategies that the person found effective during counselling.
Case studies are included in both papers—Judd et al., and Weissman et al.—and are worth consulting if one is interested in ICP as a practice approach.
Appendix 1 IPT Session Structure
(From Mootz et al., 2024)
The initial phase
In addition to establishing a strong working alliance with clients, in the initiation phase therapists work with clients to complete several activities that will set the stage for future sessions.
Introduce the therapy, explain confidentiality, identify symptoms, and obtain a treatment history.
Explain the procedures of therapy.
Conduct a timeline: Help clients understand how changes in symptoms connect to interpersonal life events.
Assign a recovery (‘sick’) role: the client is someone with an illness that can be treated and is not a “defective” person but someone who needs care. The purpose is to reduce the client’s guilt about poor functioning, provide hope for solution, and ensure the client receives care.
Conduct an interpersonal inventory to identify important people in clients’ lives. IPT therapists ask about and write down key relationships and how the relationships bring comfort to clients or are problematic.
Determine key problem areas. There are four core interpersonal problems areas as conceptualised in IPT:
Grief—A loss following a death of someone important.
Dispute—An open or hidden argument with someone significant.
Transitions (life changes)—Positive or negative transitions in life, already experienced or anticipated.
Loneliness—An absence of close relationships, feelings of loneliness or emotional distance from others that could be lifelong or more recent.
Work with the client to decide on the focus of treatment for the middle phase.
The middle phase
Resolving the identified problem area(s) is the primary goal of the middle phase. In the middle sessions, therapists encourage clients to make changes and view the problem and their relationships from different perspectives. Understanding the details of daily events, problems, and relationships that work well can guide solutions.
Review the symptoms and problems since the last session. Middle sessions start with tracking progress of symptoms through use of a standardized mental health questionnaire. Therapists also initiate sessions with a brief check-in about how clients’ mood has been over the past week or since the last session. Therapists then hear from clients about their perception of how any changes in symptoms and mood might relate to their problem area(s) and social context.
Work on strategies for solving problem areas such as those that follow:
Grief | Disputes | Transitions/Life change | Loneliness and isolation |
Mourn and accept loss by reconstructing relationship with deceased prior to, during, and after death. Explore new or re-establish old interests and relationships. | 1. Identify disputes and their stage · Renegotiation (parties arguing to find solution) · Impasse (parties stopped communicating) · Dissolution (one or both want to end relationship) 2. Explore options · Renegotiation (determine issues, differences in expectations, and find alternatives) · Impasse (open up communication and renegotiate) · Dissolution (resolve ending in least harmful way) | Give up past and deal with loss by reconstructing what was lost. Accept new role in as positive light as possible. Develop new skills and relationships to support change. | Reduce isolation by understanding the origins and current encounters. Encourage and assist in developing opportunities for relationships. |
The table included in the Suggestions for Practice section above provides other strategies that may be useful for these four areas.
The termination phase
The time of the ending and the termination phase is usually negotiated and discussed in the initial phase.
Deal with feelings about ending. Identify and discuss feelings.
Review progress and strategies for identifying and dealing with recurrences. Therapists help clients plan for the future by imagining situations that could trigger distress and pre-emptively designing strategies to cope if those problems arise.
Discuss options for future treatment, if needed
References
CAMH: Centre for Addiction and Mental Health. (n.d.) Interpersonal psychotherapy (IPT). https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/interpersonal-psychotherapy
Cleveland Clinic. (2024). Interpersonal psychotherapy (IPT). https://my.clevelandclinic.org/health/treatments/interpersonal-psychotherapy-ipt
ISIPT: International Society of Interpersonal Psychotherapy. (n.d.) Overview of IPT. https://interpersonalpsychotherapy.org/ipt-basics/overview-of-ipt
Judd, F., Weissman M., Davis, J., Hodgins, T., & Piterman, L. (2004). Interpersonal counselling in general practice. Australian Family Physician, 33(4), 332-337.
Mootz, J., Yangchen, T., & Weissman, M. (2024). Interpersonal psychotherapy methods in brief. In M. M. Weissman & J. J. Mootz (Eds.), Interpersonal psychotherapy: A global reach (pp. 8-15). Oxford University Press.
PsychDB: Psychiatry DataBase. (2024). Interpersonal therapy (IPT). https://www.psychdb.com/psychotherapy/ipt
Psychology Today. (2022). Interpersonal psychotherapy. https://www.psychologytoday.com/au/therapy-types/interpersonal-psychotherapy
Weissman, M. M., Hankerson, S. H., Scorza, P., Olfson, M., Verdeli, H., Shea, S., Lantigua, R., & Wainberg, M. (2014). Interpersonal Counseling (IPC) for Depression in Primary Care. American journal of psychotherapy, 68(4), 359–383. https://doi.org/10.1176/appi.psychotherapy.2014.68.4.359
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