Interpersonal and Social Rhythm Therapy (IPSRT)

Sufferers of bipolar disorder experience drastic changes in their energy, motivation, and mood. This has a great impact on their social relationships. One way of providing them with help and tools is via the following therapy.
Interpersonal and Social Rhythm Therapy (IPSRT)
Valeria Sabater

Written and verified by the psychologist Valeria Sabater.

Last update: 29 August, 2023

Living with bipolar disorder means living with significant instability, suffering, and frustration. For example, there are days when the sufferer is unable to fulfill any of their scheduled tasks. In fact, sometimes, they can barely find the energy to get out of bed. However, at other times, they feel like they can conquer the world.

In this type of clinical condition, the social and relational sphere is the most affected. When the sufferer experiences a depressive phase, they avoid all contact and responsibility. Their life weighs heavily on them, as does their mind. Moreover, they’re full of self-contempt and may even feel like they want to disappear forever. It’s a harsh condition.

According to the World Health Organization (WHO), about two to three percent of the general population suffers from bipolar disorder. At the beginning of the century, Dr. Ellen Frank, from the University of Pittsburgh developed an effective therapeutic strategy for its treatment.

Interpersonal and Social Rhythm Therapy (IPSRT) makes it easier for the patient to care for and regulate their social and biological patterns.

Fragmented mind symbolizing Interpersonal and Social Rhythm Therapy (IPSRT) treatment
People diagnosed with mood disorders often experience disturbances in their circadian rhythms.

The goals of Interpersonal and Social Rhythm Therapy (IPSRT)

Interpersonal and Social Rhythm Therapy (IPSRT) aims to get patients to regulate their moods through their biological and social routines. To understand the purpose of this model, we must first take into account the nature of mood disorders.

Sufferers of cyclothymic disorder, depression, anxiety, and bipolar disorder, exhibit dysregulated lifestyles and experience difficulties in integrating healthy routines. A study conducted by the aforementioned Dr. Ellen Frank and colleagues states that patients benefited from her therapeutic modality, as a result of the guidelines they were given for regulating their social habits.

The social and interpersonal rhythm in this therapy refers to the need to promote more adjusted, constant, and healthy biological and relational routines in sufferers of mood disorders. Ultimately, they achieve greater emotional stability as well as a better quality of life in all areas.

The goals of IPSRT

The main goal of IPSRT is to prevent and better regulate any disturbances in the patient’s mood and behavior. It empowers them via new knowledge and strategies, so they’re able to adopt more regular and beneficial habits.

In the case of bipolar disorder, this therapy doesn’t exclude drug treatment.

The objectives of IPSRT are to:

  • Improve the sufferer’s rest and eating habits.
  • Promote the management and prevention of stress in social relationships.
  • Help the sufferer to fulfill their daily goals and vital purposes.
  • Help them recognize the factors that affect their mood destabilization.
  • Allow them to heal and face possible traumatic events from the past.

Interpersonal and Social Rhythm Therapy (IPSRT) assumes that there are external triggers that activate the symptoms of mood disorders. Adopting new habits and routines (social rhythms) improves sufferers’ quality of life.

Patient in Interpersonal and Social Rhythm Therapy (IPSRT)
During Interpersonal and Social Rhythm Therapy (IPSRT), the patient learns techniques and tools to improve their life habits and social relationships.

The phases of IPSRT

IPSRT consists of three well-defined phases. In 2002, Dr. Ellen Frank and colleagues defined its guidelines in an article. We’re going to analyze them.

Initial stage: understanding

In the first stage of evaluation, the therapist tries to understand the phases or episodes of the patient’s mood changes. To do this, they collect information via interviews, medical reports, etc.

  • They tell the patient that the changes in their moods aren’t their responsibility. It’s important to free them from any feelings of guilt.
  • They study their life habits and identify any dysfunctional routines. For example, sleep, eating, work patterns, etc.
  • They analyze the patient’s relational patterns and the way in which they affect their emotional state.
  • They analyze their communication styles, social skills, etc.

Intermediate stage: designing new social rhythms

In the second stage, the therapist designs a series of guidelines with respect to social rhythm for the patient to comply with. In effect, they establish new habits and routines, both in the biological and relational fields.

At the same time, the therapist trains the patient in a series of basic strategies to improve their quality of life. These are based on:

  • New sleeping habits.
  • Improved eating habits.
  • Taking care of medication guidelines.
  • Practicing sports and having an active life.
  • Applying the communication strategies that the patient has learned in therapy to improve their relationships.
  • Applying the stress management techniques that they’ve learned.
  • Knowing how to react when discouragement, frustration, anger, or negative thoughts appear.

These principles usually define the formula designed for each patient. At each session, these forms are reviewed, worked on, and updated if necessary.

Final stage: closure of therapy and maintenance strategies

The ultimate purpose of IPSRT is for the patient to integrate habits and strategies that allow them to stabilize their state of mind. A life marked by routines and techniques with which to handle difficult moments enables a patient to cease therapy gradually.

Visits are spaced out in this last stage. As a rule, the therapy requires about 16 sessions in total. During this time, the patient gradually perceives how, as the weeks go by, they gain greater control over their lives. However, it should be noted that stopping therapy doesn’t mean giving up pharmacological treatments. In fact, in many cases, this is essential.

IPSRT is highly effective for sufferers of bipolar disorder. Furthermore, interesting benefits have also been seen in other mental health conditions such as recurrent depressive disorder (dysthymia). This therapy favors a better understanding of the condition and optimizes the patient’s lifestyle. Undoubtedly, it’s an extremely beneficial clinical resource.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Frank E, Swartz HA, Boland E. Interpersonal and social rhythm therapy: an intervention addressing rhythm dysregulation in bipolar disorder. Dialogues Clin Neurosci. 2007;9(3):325-32. doi: 10.31887/DCNS.2007.9.3/efrank. PMID: 17969869; PMCID: PMC3202498.
  • Frank, E., Kupfer, D. J., Thase, M. E., Mallinger, A. G., Swartz, H. A., Fagiolini, A. M., … & Monk, T. (2005). Two-year outcomes for interpersonal and social rhythm therapy in individuals with bipolar I disorder. Archives of General Psychiatry, 62(9), 996-1004.
  • Frank, E., Prien, R. F., Jarrett, R. B., Keller, M. B., Kupfer, D. J., Lavori, P. W., … & Weissman, M. M. (1991). Conceptualization and rationale for consensus definitions of terms in major depressive disorder: remission, recovery, relapse, and recurrence. Archives of General Psychiatry, 48(9), 851-855.
  • Frank, E., Swartz, H. A., & Kupfer, D. J. (2000). Interpersonal and social rhythm therapy: managing the chaos of bipolar disorder. Biological Psychiatry, 48(6), 593-604.
  • Steardo, L., Luciano, M., Sampogna, G. et al. Efficacy of the interpersonal and social rhythm therapy (IPSRT) in patients with bipolar disorder: results from a real-world, controlled trial. Ann Gen Psychiatry 19, 15 (2020).

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.