• Quick overview of IPSRT
• Basics of Interpersonal Psychotherapy
(IPT) that are incorporated in IPSRT
• Introduction to circadian biology and
social zeitgeber theory
• Discussion of bipolar disorder with a focus
on psychotherapeutic issues
• Nuts and bolts of IPSRT
• Empirical support for IPSRT
Disclosures
• Ellen Frank, PhD
– Consultant: Servier
– Grant Support: Pittsburgh Foundation, Fine Foundation,
NIMH
– Royalties: Guilford Press, American Psychological
Association
• Holly Swartz, MD
– Consultant: Navigant
– CME Activities: SciMed, Servier
– Royalties: Up To Date
– Grant Support: NIMH
Adaptations, Cont.
• Individual
• Group inpatient
• Group outpatient
• Bipolar disorder
• Unipolar depression
Psychosocial Intervention for Bipolar
Disorder: STEP-BD Results
Sachs, et al. Effectiveness of Adjunctive Antidepressant
Treatment for Bipolar Disorder Depression. New
England Journal of Medicine, 2005.
Miklowitz, et al. Psychosocial Treatments for Bipolar
Depression. Archives of General Psychiatry, 2007.
Social Rhythm Origin of IPSRT
Adding psychosocial treatment to a mood
stabilitizer improves outcomes with patients
who have bipolar disorder:
• reduces time to remission
• supports more stable remissions
I cannot imagine leading a normal life without both
taking lithium and having had the benefits of
psychotherapy…ineffably, psychotherapy heals. It
makes some sense of the confusion, reigns in the
terrifying thoughts and feelings, returns some
control and hope and possibility of learning from it
all…It is where I have believed – or have learned to
believe – that I might someday be able to contend
with all of this.
-Kay Jamison, PhD, An Unquiet Mind, 1995
Essential Elements of Interpersonal
and Social Rhythm Therapy (IPSRT)
Social rhythm therapy (SRT)
• Regularize daily routines
• Emphasizes the link between regular routines and
moods
• Uses Social Rhythm Metric to monitor routines
Interpersonal psychotherapy (IPT)
• Emphasizes link between mood and life events
• Focus on interpersonal problem area (grief, role
transition, role disputes, interpersonal deficits)
Essential Elements, Cont.
IPT Problem areas
role transition grief
role disputes interpersonal deficits
Interpersonal psychotherapy is agnostic in regards
to whether the life events caused the problem area
or whether the problem area caused the life events.
IPSRT draws a link among regular routines,
relevant life events and mood.
Goals of IPSRT
• Stabilize daily routines and sleep/wake cycles
• Gain insight into the bi-directional relationship
between moods and interpersonal events
• Use IPT techniques to ameliorate interpersonal
problems related to grief, role transitions, role
disputes, interpersonal deficits
• Thereby, reduce the frequency of episode
recurrence
