Interpersonal & Social Rhythm Therapy (IPSRT): Techniques, Benefits, & Uses

What Is Interpersonal & Social Rhythm Therapy (IPSRT)?

Interpersonal and social rhythm therapy (IPSRT) is a form of psychotherapy used to explore how a person’s social and daily routines impact their mood. This technique was first developed in the 1990s as a treatment for a variety of mood disorders, but is most commonly used for those with bipolar disorder. The “interpersonal” piece of IPSRT refers to identifying how relational stress and conflict can cause disruptions in one’s sleep quality, wake cycle, and other important aspects of daily life.¹

Social Rhythm Metrics in IPSRT

Social rhythm metrics are used in IPSRT to keep track of a person’s daily activities, engagements, and responsibilities. Developing this set routine can help a client and their therapist understand how certain social disruptions can impact their sleep, depression symptoms, or stress levels.²

Examples of social rhythm metrics include:

• The time you eat breakfast
• When you go to bed
• What time you eat dinner
• What time you exercise
• The amount of time spent watching television
• When you start the work or school day
• When you first communicate with someone each day

The Social Zeitgeber Theory

The social zeitgeber theory focuses on how routine events or actions in a person’s life are linked to their natural rhythm. The term “zeitgeber” refers to these aspects, such as meal times, drinking habits, and other daily activities. In an IPSRT setting, a therapist will review these zeitgebers to look for how changes in this series can impact one’s mental state. The theory suggests that disruptions in a person’s natural rhythm can result in mood disturbances.

What Can IPSRT Help With?

IPSRT is most commonly used for those who experience mania and bipolar symptoms. However, this approach can be used for other conditions as well, often in conjunction with another form of treatment.³ It is not designed to be a standalone method and should not be considered in lieu of medication.

IPSRT may be used in the treatment of:

• Depression
• Schizophrenia
• Anxiety disorders
• Post-traumatic stress disorder (PTSD)
• Bipolar disorder

How Does Interpersonal and Social Rhythm Therapy Work?

IPSRT therapists employ a variety of methods and tools throughout the treatment process. Sessions may be provided individually, in a group, or a combination of the two. There are three stages of IPSRT—the initial stage, intermediate stage, and the final or maintenance stage.

Here’s what a client can expect during each phase of IPSRT:

Initial Stage

During the initial stage of IPSRT, a clinician will review a person’s daily routine, the person’s current emotional state, and any recent changes in the person’s life. The therapist will help the client understand how certain relational and behavioral patterns can lead to mood changes. A client and their therapist will then discuss what the goals of treatment are and how they can be achieved.

Intermediate Stage

After identifying their goals, a client will be asked to complete a log of their daily routine. This will include both their own individual actions as well as those they take with others. One’s social rhythm metrics will provide insight into how the person’s social patterns (the time they wake up, eat, or communicate with others) impact their overall mood. As a client gets used to this process of tracking, sessions will decrease from a bi-weekly schedule to once a month.

Final & Maintenance Stage

In the final stages of IPSRT, a clinician and client work together to decrease the frequency of sessions with the goal of ending treatment entirely. To do so, the therapist will continue to help a person identify and prepare for disruptions in their social rhythm so they can maintain the work they have completed throughout the IPSRT process.

Benefits of IPSRT Therapy

There are several benefits of IPSRT, as a person may never realize just how much minor disruptions in their daily rhythm can result in increased symptoms of mania, bipolar, or depression. Additionally, IPSRT can help clients recognize how the actions of others harm them, possibly allowing them to identify what changes they need to make in their interpersonal relationships.

Benefits of IPSRT include:

• Improved mood: Using IPSRT can help improve a person’s overall well-being as it encourages one to address any behaviors and patterns that negatively impact their life.
• Improved sleep quality: IPSRT can help a person improve their sleep quality and possibly lessen insomnia. Identifying daily habits or events that affect a person’s sleep routine can allow them to make necessary changes.
• Improved relationships: After experiencing positive changes in mood, a person may be better able to engage with others and maintain healthy relationships.
• Improved overall health: When a person recognizes negative patterns that are impacting their life, any positive changes can help them feel better both physically and emotionally.

Is Social Rhythm Therapy Effective?

IPSRT is effective as part of a traditional treatment plan for mood disorders, and studies suggest that it is particularly beneficial for young adults.² IPSRT is commonly administered in conjunction with dialectical behavior therapy (DBT), cognitive behavioral therapy (CBT), and medication. It is important that a person remains honest with their therapist about their daily routine and patterns in order for treatment to be successful.

Limitations & Criticisms of IPSRT

One of the main limits and criticisms of IPSRT is that there isn’t significant research to support its efficacy for the treatment of depression. It is also important to note that it is not a treatment modality on its own, rather it is used as an additional tool to support the daily management of the treatment of bipolar disorder.

Is IPSRT a Good Fit for Me?

Many people have found success from IPSRT for treating their bipolar disorder, depression, and schizophrenia. However, before starting therapy, you should explore different options to find the one that works best for you. One person might react positively to IPSRT while another may not. If you are interested in IPSRT, you should first consult with a therapist or medical provider to determine if it will be a beneficial element of your treatment plan.

How to Find an IPSRT Therapist

When looking for an IPSRT therapist, it’s important to find one who specializes in this treatment approach. They will have ample experience in the IPSRT process and help you determine concrete goals. You can use an online therapist directory to get started, or consider online therapy options. You can also ask your primary care physician for a referral, or contact your insurance company directly.

Cost of IPSRT

IPSRT is considered a standard treatment approach for bipolar disorder. This makes it more accessible, as IPSRT tends to be covered by health insurance the same way as other forms of psychotherapy. Costs per therapy session can vary from $20-$60 as a copay to $120-$200 if you’re paying out-of-pocket.

Does Insurance Cover IPSRT?

Mental health insurance tends to cover IPSRT as a psychotherapy as long as your provider is in-network or able to support submitting the claim to your insurance company. With insurance, the cost can be as low as $20 a session or whatever your copay may be for mental health treatment.

Final Thoughts on IPSRT

Interpersonal social rhythm therapy can be beneficial for those who live with mood disorders, particularly individuals with bipolar disorder. Making healthy changes in your daily routine can help you prepare for and prevent mood disturbances and negative symptoms.