Background

Interpersonal and Social Rhythm Therapy was developed as a treatment for mood disorders. The interpersonal elements of the program are based on Interpersonal Psychotherapy (IPT) for depression, a time-limited treatment that focuses on the bidirectional relationship between mood and life events. IPT also emphasizes strategies to improve social support and relationships. The social rhythm elements of the program came from our clinical experience and research showing a connection between daily routine or rhythm disruptions and mood destabilization. There is also a growing body of work about the social zeitgeber theory and mood disorders that contributed to the evolution of IPSRT.

The program focuses on managing the patient's symptoms and improving the patient's interpersonal relations over a limited number of sessions. IPSRT was originally designed as an individual psychotherapy (one patient working with one therapist); however, the program has since been adapted and used in different settings, including group and phone sessions.

Initial Stage

The clinician gathers information about the patient's current mood state and prior mood episodes.  The therapist explores the behaviors and relationships associated with changes in mood state over time. The clinician and patient agree on a primary interpersonal problem area as the main focus of the interpersonal part of the treatment. The initial stage work normally occurs over the first several sessions of treatment.

Intermediate Stage

The patient completes a form to track social rhythm regularity every week and reviews the form with the clinician at the next visit. The clinician helps the patient regulate social rhythms and work on the selected interpersonal problem area. In the maintenance phases, the patient practices the skills learned during the program.  During the later phase of treatment, IPSRT focuses on building the patient's confidence and developing skills to manage shifts in routine such as vacations or job changes. Sessions are usually weekly but change to bimonthly or monthly during the latter phases.

Final Stage

Toward the end of treatment, the clinician and patient work toward terminating therapy or further reducing the number of visits.

Tracking tools have always been a vital part of IPSRT, both as a way of developing necessary information about the patient's habits and as a way of monitoring changes in the patient's rhythms and relationships. These tracking tools include the Interpersonal Inventory and Social Rhythm Metric and are available to all registered site users.