Interpersonal and Social Rhythm Therapy (IPSRT) for Bipolar Disorder

Status: Modest Research Support for depression

Description

Interpersonal and Social Rhythm Therapy (IPSRT) is a modification of the Klerman and Weisman Interpersonal Therapy for Depression approach. Drawing on research demonstrating that sleep and schedule disruption is an important component of bipolar disorder, the original interpersonal psychotherapy approach has been expanded to provide techniques for enhancing the regularity of daily routines and schedules. The treatment also includes a focus on mourning the losses associated with bipolar disorder. The interpersonal components of therapy involve focusing on resolution of current interpersonal problems, such as unresolved grief, interpersonal disputes, role transitions, and interpersonal isolation. In the Frank et al. (2005) study, participants were randomly assigned to receive IPSRT in two forms: acute therapy (weekly sessions for several months) or maintenance sessions (monthly for two years). Of note, acute treatment lead to significant improvements in symptoms; maintenance sessions did not.

Key References (in reverse chronological order)

• Miklowitz, D. J., Otto, M. W., Frank, E., Reilly-Harrington, N. A., Kogan, J. N., Sachs, G. S., et al. (2007). Intensive psychosocial intervention enhances functioning in patients with bipolar depression: Results from a 9-month randomized controlled trial. American Journal of Psychiatry, 164, 1340-1347.
• Frank, E., Kupfer, D. J., Thase, M. E., Mallinger, A. G., Swartz, H. A., Fagiolini, A. M., et al. (2005). Two-year outcomes for interpersonal and social rhythm therapy in individuals with bipolar I disorder. Archives of General Psychiatry, 62, 996-1004.
• Frank, E., Swartz, H.A., & Kupfer, D.J. (2000). Interpersonal and social rhythm therapy: Managing the chaos of bipolar disorder. Biological Psychiatry, 48, 593-604.
• Frank, E., Kupfer, D. J., Ehlers, C. L., Monk, T. H., Cornes, C., Carter, S., et al. (1994). Interpersonal and social rhythm therapy for bipolar disorder: Integrating interpersonal and behavioral approaches. The Behavior Therapist, 17, 143-149.

Clinical Resources

• Frank, E. (2005). Treating Bipolar Disorder: A Clinician's Guide to Interpersonal and Social Rhythm Therapy. New York, NY: Guilford Press.
• Klerman, G. L., Weissman, M. M., Rounsaville, B. J. (1995). Interpersonal Psychotherapy of Depression. New York, NY: Basic Books.

Training Opportunities

Information about training, including annual workshops, can be obtained by contacting Ellen Frank, 823 Bellefield Towers, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, FrankE@upmc.edu.

*Although findings of two trials indicated that IPSRT lead to reduced depression, IPRST has been labeled as having modest research support due to null results in the maintenance phase of the Frank et al. (2005) trial.