Interpersonal and Social Rhythm Therapy (IPSRT)
Interpersonal and social rhythm therapy (IPSRT) is a therapeutic approach developed specifically to target bipolar disorder. IPSRT focuses on the relationship between the stability of a person, their daily routines and their mood symptoms. It is helpful in the treatment of bipolar disorder, as it targets an individual’s unique balance between activation and downtime.
The primary goal of IPSRT is to help individuals develop and maintain stable social rhythms. This is done by working with individual to identify and regulate their sleep, meals, and leisure activities, as well as any other daily routines that may be affecting their mood. The therapist works with the individual to create predictable and consistent patterns and helps the individual to maintain these routines even in times of stress.
Social rhythms refer to the daily patterns of activity and sleep that people engage in, and they can have a significant impact on a person’s mood and emotional state. When these rhythms are disrupted, the individual is at risk of experiencing mood instability. The intervention emphasizes creating and maintaining social rhythms because adhering to a regular schedule can have a regulatory effect on mood. We use a variety of techniques to help individuals maintain their social rhythms, including education, problem-solving, mindfulness, and behavioral changes. In addition, individuals are encouraged to add activities that help boost mood and improve social connectedness, such as regularly spending time with friends and family. The individual and therapist will work together to identify disruptive triggers that interfere with routines, such as travel or shift work, and develop strategies to cope with them.
IPSRT also focuses on the individual’s interpersonal relationships and how these may be impacting their social rhythms. When meeting with clients, we examine their social landscape, paying close attention to conflict, major life events, role transitions such as childbirth, marriage, and retirement, and social skills proficiency. In addition to exploring a client’s social dynamics, IPSRT identifies “grief for the lost healthy self” as a potential contributor to mood problems.
The Origins of IPSRT
IPSRT builds off the success of interpersonal therapy, because the basic problems with relationships that underlie depression may also pose challenges for people with bipolar disorder. However, researchers also believe that disruption of daily rhythms, especially sleep patterns, can contribute to bipolar disorder.
Individuals with bipolar disorder often have both genetic and developmental/environmental vulnerabilities that predisposes individuals to experience greater-than-usual consequences in the event of:
Major life events, such as a loss or an important role change
Disruptions in social rhythms
To address this challenge, practitioners borrow techniques from social rhythm therapy and cognitive behavioral therapy (CBT) to help individuals reduce the frequency of manic and depressed episodes and lengthen the time between episodes.
How IPSRT Works
IPSRT, like interpersonal therapy starts by narrowing in on the relationship aspects of one’s life that contribute to symptom severity. In addition to the four basic problems that interpersonal therapy focuses on, IPSRT identifies “grief for the lost healthy self” as a potential contributor to mood problems.
In addition to identifying underlying interpersonal problems, IPSRT also works to identify an individual’s routine, or lack of routines, and encouraging the individual to establish and maintain for consistent structure. There is emphasis on prioritizing activities necessary to basic health maintenance, such as meal times, exercise, and especially going to bed and waking up at regular times. In addition, individuals are encouraged to add activities that help boost mood and improve social connectedness, such as regularly spending time with friends and family. The individual and therapist will work together to identify disruptive triggers that interfere with routines, such as travel or shift work, and develop strategies to cope with them.
