Interpersonal & Social Rhythm Therapy

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Think about a time when you got into a disagreement with your partner, friend, or family member. Did that interaction stick with you for an extended period of time, leaving you feeling anxious, moody, or unhappy?

Conflicts in relationships and other stressful life events affect us all differently. Some people can shake it off and move on relatively quickly. For others, these conflicts and disruptions can be extremely difficult to cope with, particularly for those with mood disorders like bipolar disorder.

Fortunately, there are methods for treating bipolar disorder patients (and other mood disorders or mental health conditions) through an effective treatment modality known as interpersonal and social rhythm therapy (IPSRT).

Keep reading to learn about interpersonal and social rhythm therapy, how it can help, and what it can do to benefit those with bipolar disorders.

What is interpersonal and social rhythm therapy (IPSRT)?

Interpersonal and social rhythm therapy is an evidence-based treatment modality that is studied in the field of biological psychiatry and is effective in helping individuals manage mood disorders and live abundant, fulfilling lives.

When used for the treatment of bipolar disorder, patients receiving interpersonal psychotherapy treatment showed significant improvement in time between episodes and higher regularity and success of daily routines. This psychotherapy is often paired with family focused therapy, group therapy, and other modalities of therapy to address interpersonal deficits.

Oftentimes, those with mood disorders struggle to find stability in their daily lives, and when their routines are interrupted, it can be very triggering.

In IPSRT, patients learn how to improve their mood and overall mental health by creating regular routines they can rely on and improving their interpersonal relationships to be more productive and fulfilling.

What mental health conditions does IPSRT treat?

First and foremost, interpersonal and social rhythm therapy is effective in treating bipolar disorder and other mood disorders.

Research has shown that conflict in relationships and disruptions in daily routines can trigger mood episodes in individuals with mental illness.

Establishing and building healthy relationships and maintaining social rhythms helps those with bipolar disorder to manage disruptions in their daily lives, avoid depressive symptoms and mood swings, and improve coping skills for potentially stressful life events.

Along with bipolar disorders, interpersonal and social rhythm therapy (IPSRT) is also used to treat depression, comorbid anxiety disorders, PTSD, and schizophrenia. For individuals who struggle with depressive symptoms associated with disruptions in their social rhythms and lifestyle, IPSRT is often the most effective treatment plan.

IPSRT formats & techniques

Interpersonal and social rhythm therapy can be performed in various settings. This includes individual therapy settings with the patient and therapist working side by side to create a plan.

IPSRT can also be done in group settings, with multiple patients working with one or more mental health professionals. Group settings allow patients to build connections with other people living with mood disorders and create their own community.

IPSRT can also be performed in a remote setting; from over the phone to video conferencing platforms like Zoom, a therapist can effectively provide treatment in either of these settings.

The stages of interpersonal and social rhythm therapy

When using IPSRT to treat bipolar disorder and other mood disorders, there are several phases that each patient will go through with a therapist.

These stages include the following:

1. Initial phase of interpersonal and social rhythm therapy

In the initial phase of IPSRT, a patient meets with a therapist regularly. The initial phase takes several weeks to complete because there’s a level of relationship building that has to occur between the patient and the doctor.

Together, you’ll work alongside your therapist to discover the following:

  • The medical factor in the mood changes you experience and why this is not your fault
  • Your specific mood patterns (existing and past) and how they affect your daily routines
  • Specific relationships that may have an impact on your mood and why
  • Behaviors (your own and others) that can impact changes in your mood

In this phase, you will also determine what you’d like to work on during IPSRT, whether that’s your interpersonal relationships, your communication style, or coping strategies, among many others.

2. Intermediate phase of interpersonal and social rhythm therapy

In the intermediate phase, the patient will receive the Interpersonal Inventory and Social Rhythm Metric tracking tool that they’ll use to track their social rhythm regularity throughout the week.

Social rhythms encompass the routine parts of your day that you come to expect. These include:

  • When you wake up in the morning
  • When you start work, school, or any other primary task of the day
  • Your first social interaction of the day
  • Meal times
  • When you go to bed

By determining these social rhythms beforehand, building consistency becomes more manageable. In turn, the patient will learn how to manage and cope when these daily events get disrupted or have to temporarily change (i.e. if you have a dentist appointment, go on a weekend trip, or have a guest staying in your home).

At future visits, the patient and therapist review the previous week’s tracking and work together on the selected area of improvement. The patient will begin to regulate disruptions to their social rhythms and daily routines through learned coping skills and building self-confidence.

3. Maintenance phase of interpersonal and social rhythm therapy

The final phase, the maintenance phase, consists of maintaining stability and regularity in the patient’s daily routine while working towards slowing therapy sessions over time.

Patients will continue to apply the skills they’ve acquired through the first two phases to maintain stability in their daily rhythms and practice preventing interpersonal distress through communication.

Benefits of interpersonal and social rhythm therapy (IPSRT)

By establishing important social rhythms and prioritizing interpersonal relationships, IPSRT can provide many improvements and benefits in a patient’s life. Some of these include:

  • Improving self-confidence and your role in relationships
  • Building healthier, fulfilling interpersonal relationships
  • Improving medication adherence and openness to treatment
  • Easing role transitions, like a new job, new child, or moving homes
  • Creating better sleep patterns and reducing disrupted sleep
  • Create consistent eating habits and exercising
  • Decreasing depressive episodes that are fueled by disruptions in social routines
  • Create coping strategies for stressful events, manic symptoms, and unresolved grief

Effectiveness of IPSRT

As patients gain an understanding of their circadian rhythm and how to reduce mood episodes and manic symptoms through stability, the efficacy of interpersonal and social rhythm therapy can be highly beneficial.

Many studies and research has shown that for those with bipolar depression, IPSRT can help reduce depressive symptoms, improve daily function, and even improve responses to medication, including mood stabilizers, that help treat bipolar disorder.

Undergoing treatment for IPSRT varies greatly by the individual; some people will see improvements in their mood episodes quickly after working with a therapist for several sessions, while others may have to invest more time in treatment.

Like every other form of therapy, IPSRT is highly personal, and the benefits and outcomes directly reflect the effort and commitment of the patient.

Considerations about IPSRT

While IPSRT is proven to be highly effective, it is commonly used in conjunction with other forms of therapy, including cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT), to treat mental health conditions like bipolar disorder.

To be clear, interpersonal and social rhythm therapy is not designed to replace medication or other modalities like cognitive therapy but to be used as an adjunctive treatment option under the care of a licensed therapist.

Get help with your mood disorder through evidence-based virtual treatment options.

If you’re struggling with mood episodes associated with bipolar disorder, social rhythm therapies may be worth exploring. Early intervention can make all the difference to your treatment and recovery.

With Clear Recovery’s Virtual Program, we offer a fully-online intensive outpatient program for California residents. We understand that some patients aren’t able to travel for in-person treatment but still seek mental health services for their conditions.

Through virtual therapy, our care team works alongside patients to design a custom treatment plan that’s designed to treat their individual needs. Learn more about our virtual program here.

Last Updated on January 24, 2023

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