Interpersonal Therapy: How It Works, Cost, & What to Expect

Interpersonal therapy is a time-limited and structured approach to therapy that centers on resolving interpersonal conflict. It is typically used to address the symptoms of specific mental illnesses like depression and anxiety. The usual length of treatment is three to five months (12 to 16 sessions), and while session fees can vary, interpersonal therapy is often covered by an insurance provider.¹

What Is Interpersonal Therapy?

Interpersonal therapy works on the premise that there is a significant connection between psychological trauma and interpersonal distress. Social factors such as relationships and romantic connections can impact an individual’s ability to cope with stress and distressing events. The focus of treatment during interpersonal therapy is resolving symptoms and improving overall functioning and social support.²

One important aspect of interpersonal therapy is that it shifts the blame from the individual and places it on their diagnosis or interpersonal situation. For many, this approach can be empowering and less stigmatizing. Instead of focusing on the need to make behavior changes, interpersonal therapy teaches the individual that their symptoms of depression and anxiety are more closely linked to their interpersonal relationships and social supports.³

In interpersonal therapy, your therapist plays a very active role in treatment instead of being non-directive and simply listening to you. During the process, there are opportunities to receive feedback and discuss what is going well and what is challenging in your interpersonal relationships.

The 3 Phases of Interpersonal Therapy

There are three phases of interpersonal therapy: Formulation, Middle, and Graduation. Each phase can last three to five sessions depending on the severity of symptoms and the interpersonal distress the client is experiencing.¹

1. Formulation Phase

The first phase consists of assessing your mood as well as current life events. The therapist also gathers information on previous relationships, sources of social support, and your history. Additionally, there is a psychoeducational aspect of linking symptoms to circumstances and relationships. Typically, a plan is determined and the focus of sessions fits into one of the following categories: complicated bereavement, role transition, role dispute, or interpersonal deficits.¹

2. Middle Phase

The second phase involves a variety of strategies used to address one of the four categories of distress. The therapist usually begins each session by asking you about recent life events. If you’ve seen improvement, the focus turns to how things have changed, and if relationships have been positively impacted. If there’s been no change or an increase in symptoms, your therapist will work with you to identify interpersonal challenges.

3. Graduation Phase

The end of interpersonal therapy is marked by focusing on your improved confidence and sense of independence. If there has not been a change, the lack of improvement is attributed to the therapy and not you as an individual. However, treatment is not considered a failure if you do not have a decrease in your symptoms. Often a client will transfer to another therapist and create a new treatment plan.²

Interpersonal Therapy Techniques

In interpersonal therapy, therapists play an active role and use a variety of directive and nondirective techniques, including guidance, education, reassurance, and behavioral approaches like role-playing. During interpersonal therapy sessions, the role of the therapist is to remain realistic and avoid being too educational or reactive.⁴

The focus is on helping you to acknowledge feelings that can be painful but possibly appropriate under the circumstances. You’ll be gently challenged to start intentionally developing and learning to label new emotions. Additionally, your therapist will bring attention to the logical implications of your emotions and encourage you to clarify.⁴

During the course of treatment, you may engage in role-play exercises in order to draw conclusions about the health of your relationships and identify the connection between your relationships and your symptoms. This technique also helps you adjust the way you relate to the world around you.

What Is Interpersonal Therapy Used to Treat?

Interpersonal therapy has been shown effective for treating mood disorders, including major depressive disorder, dysthymia, and bipolar disorder. It’s also used as an intervention for non-mood disorders such as post-traumatic stress syndrome, social anxiety, and eating disorders.¹ Additionally, interpersonal therapy has positive results as a treatment for various substance abuse disorders. Multiple studies show that it can be effective when used in conjunction with prescription medication.²

Interpersonal Therapy for Every Age

Research studies have shown that interpersonal therapy is useful for individuals of all ages ranging from adolescents to older adults. It can also be conducted in a group setting with children, adolescents, and adults. This is because the focus of therapy is on stressful life events and helping clients to improve connections with social supports.⁵

You are most likely a good candidate for interpersonal therapy if you are encountering a stressful life event like the death of a loved one, relationship conflict, a recent life transition, or social isolation.⁵ It’s important to remember that not every treatment modality is effective with everyone, so don’t be afraid to tell your therapist if you feel the focus of therapy isn’t meeting your needs.

Cost of Interpersonal Therapy

While there can be significant differences in the cost of therapy depending on your geographical region, expect to pay somewhere between $75 to $175 per session. It never hurts to ask about a reduced rate or sliding scale, as some therapists will give discounts to clients who are within a certain income bracket, or who are willing to pay upfront for several sessions at a time.

While some therapists are not in network with insurance, there are others who participate as providers with various health insurance companies. The rate you pay per session will be based on the specifics of your plan as well as the deductible. For the most accurate quote, contact your insurance carrier to confirm the amount of your co-pay and how many sessions they will cover.⁶

How to Find an Interpersonal Therapist

A good place to start looking for an interpersonal therapist is the online directory of the Interpersonal Therapy Institute or Choosing Therapy’s directory. One important thing to keep in mind is that most state laws require a therapist to be licensed in the state of your residence. So, if you’re moving soon or taking an extended trip, it may impact the relationship with your therapist.⁷

If you’d like to use your health insurance, you can call the member services number on the back of your insurance card and ask for a list of therapists in your network that are located close to you. This would also be a great time to ask any questions that you might have about your deductible and copay.

8 Key Questions to Ask an Interpersonal Therapist

If you are using your insurance for the therapy session, it’s a good idea to verify whether or not they are in network with your insurance. However, there are other questions to ask in order to assess whether a therapist is an appropriate fit. Many therapists even offer a free consultation where they welcome your questions about their background.⁸

Here are eight key questions to ask before starting interpersonal therapy:

1. What type of interventions do you use?
2. How often do you recommend clients attend sessions?
3. Can you explain your treatment style to me?
4. What is your ideal client to work with?
5. How familiar are you with interpersonal therapy?
6. What is important for me to know when working with you?
7. What’s your favorite part about being a therapist?
8. How do you help your clients deal with stressful life events?

What to Expect at Your First Therapy Appointment

Every therapist conducts their first session differently, but you should expect to answer questions about yourself and share some of your stresses. Your therapist may also provide you with a standardized questionnaire about your symptoms. Using an interpersonal therapy approach, they will link a diagnosis to a current life event and take inventory of your close relationships, social supports, and behavioral patterns within relationships.¹

Your first therapy appointment may feel awkward as you get to know your therapist and they get to know you. There may be topics you don’t get to discuss, but you can delve deeper in subsequent sessions. If you have seen multiple therapists, are taking prescribed medication, or have recently been hospitalized psychiatrically, it’s important to bring this information to your therapist at the first session.

Remember that it’s completely acceptable to go at your own pace. Always let your therapist know if you’re feeling uncomfortable or would like a quick break. It’s typical in the first session to establish rapport and start identifying specific goals. Your therapist may also spend some time outlining their confidentiality policy.⁹

Is Interpersonal Therapy Effective?

There is overwhelming evidence that interpersonal therapy can be an effective intervention for mood disorders, and it is one of the most commonly used treatments for major depressive disorder, anxiety disorders, and bipolar disorder.¹⁰ Its effectiveness for other mental health disorders is still being researched, although numerous studies have shown it can be effective in treating depression and decreasing the likelihood of relapse once symptoms have resolved.

Additionally, interpersonal therapy can be effective in family therapy when there is a family member with a diagnosis of depression, and as an intervention for eating disorders and some anxiety disorders.⁵ In a study conducted on individuals diagnosed with a personality disorder, interpersonal therapy was shown to decrease the severity of symptoms.¹¹ In general, it highlights the link between relationships and mental health, which is highly relevant due to the fact that humans are social beings who benefit from connections with others.¹²

Interpersonal therapy is recognized as an effective technique by the following associations:

• The American Psychiatric Association
• The American Psychological Association
• The National Institute for Health and Clinical Excellence

History of Interpersonal Therapy

Interpersonal therapy was created in the 1970s by Gerald Klerman, Myrna Weissman, and Eugene Paykel as a result of researching the effectiveness of combining medication with psychotherapy as a treatment for depression. The initial studies of interpersonal therapy focused on the same approach of combining medications with psychotherapy where the therapist played a very active role. Today, it is thought of as being a “high contact” therapy method as it is structured and sessions are conducted on a weekly basis.²

Derived from psychodynamic theory, interpersonal therapy can be a great fit for individuals who are more curious about psychodynamic interventions. There is a basic assumption that in order to move forward, one must address past relationships and experiences. The relationship between therapist and client is especially significant due to the level of trust and openness required for honest dialogue.¹³

In general, interpersonal therapy can be less stigmatizing for clients because they are not blamed for their symptoms or diagnosis. It is all seen as a product of their relationships, circumstances, or a break in significant relational attachments or social roles.¹⁴

Additional Resources for Interpersonal Therapy 

Here are three additional resources on the subject of interpersonal therapy:

• Interpersonal Psychotherapy Institute
• History of Interpersonal Psychotherapy (article)
• International Society of Interpersonal Psychotherapy