Interpersonal therapy (IPT)

What is IPT?

Interpersonal therapy is a structured, time-limited therapy originally developed by Gerald Klerman and Myrna Weissman for the treatment of depression. It is now recommended by NICE as a first-line treatment for depression and has a strong evidence base across several other difficulties.

IPT works from the well-established observation that our mood and our relationships are closely intertwined. When we experience difficulties in our relationships, our mood suffers. When our mood is low, our relationships tend to deteriorate. IPT targets this cycle directly by helping you identify and address the interpersonal issues that are contributing to your current difficulties.

The therapy focuses on one or two key problem areas drawn from four categories: grief and loss, role disputes (conflicts in important relationships), role transitions (major life changes such as retirement, parenthood or relationship breakdown), and interpersonal deficits (longstanding patterns of isolation or difficulty forming close relationships). By concentrating on a specific area, IPT offers a focused and practical approach to creating meaningful change.

IPT does not aim to restructure your personality or explore your entire history. Instead, it helps you understand the interpersonal context of your current difficulties and develop more effective ways of communicating, negotiating and connecting with the people around you.

What distinguishes IPT from many other therapies is its explicit focus on relationships as the primary vehicle for change. While other approaches might explore your thinking patterns or your early experiences, IPT keeps the lens trained on what is happening between you and the important people in your life right now. This makes it a practical, forward-looking therapy that many people find immediately relevant to their everyday experience.

IPT also takes the position that depression is a medical illness, not a personal failing. This is deliberate and therapeutic. By framing your difficulties in this way, IPT helps reduce the guilt and self-blame that often accompany depression, freeing you to focus your energy on recovery rather than on questioning whether you should just be able to pull yourself together.

When it helps

IPT has strong research support for a range of difficulties, including:

• Depression and recurrent depression
• Perinatal mental health difficulties, including postnatal depression
• Grief and complicated bereavement
• Relationship conflicts and communication difficulties
• Adjustment to major life changes
• Social isolation and loneliness
• Eating disorders, particularly bulimia nervosa
• Anxiety in the context of interpersonal difficulties
• Bipolar disorder (as part of a wider treatment plan)

IPT is particularly well suited to situations where your difficulties are clearly linked to something happening in your relationships or social world, or where a significant life change has destabilised your sense of identity or connection. If you can point to a relationship, a loss or a transition that seems connected to how you are feeling, IPT is likely to be a good fit.

It is also a strong option for people who prefer a structured, practical approach. IPT is not open-ended and does not require extensive exploration of your past. It works in the present, with a clear focus and concrete goals, which suits people who want to understand what is going wrong and take active steps to change it.

What to expect

IPT is typically delivered over 12 to 16 weekly sessions and follows a clear three-phase structure.

The initial phase (sessions 1 to 4)

In the initial phase, your psychologist will help you explore your current symptoms and map out your key relationships using an interpersonal inventory. This is a thorough but focused review of the important people in your life, looking at the quality of each relationship, what works well, where there are difficulties and how these connections relate to your mood.

Together, you will identify the one or two problem areas that will become the focus of therapy and agree on clear goals. Your psychologist will also help you understand the link between your symptoms and your interpersonal situation, which for many people is itself a significant step forward. Understanding that your low mood is not simply happening to you in isolation but is connected to specific relational circumstances can feel both validating and empowering.

During this phase, your psychologist will also give you a formal “sick role,” explicitly acknowledging that you are dealing with an illness and that it is appropriate to adjust your expectations of yourself during this period. This can be particularly helpful for people who tend to push through and criticise themselves for not coping.

The middle phase (sessions 5 to 12)

The middle phase makes up the bulk of the work. Depending on your focus area, sessions may involve exploring feelings about a loss, improving communication in a conflicted relationship, adapting to a new role, or building skills for forming and maintaining closer connections.

If your focus is grief, your psychologist will help you process the loss and gradually rebuild a life that accommodates the absence while maintaining meaningful connections. If the focus is a role dispute, you will work on understanding the nature of the conflict, clarifying your expectations and developing more effective ways of communicating. For role transitions, the work involves mourning what has been lost, recognising what is gained and building the skills and confidence needed for your new situation. For interpersonal deficits, you will explore patterns that may be keeping you isolated and practise new ways of connecting.

Your psychologist may use techniques such as communication analysis, where you examine specific conversations in detail to identify what went well and what could be different. Role play is sometimes used to practise new approaches before trying them in real life. Problem-solving techniques help you break down complex interpersonal situations into manageable steps.

The final phase (sessions 13 to 16)

The final phase focuses on reviewing your progress, consolidating what you have learned and preparing for the end of therapy. Your psychologist will help you recognise the skills you have developed and plan for how to maintain your progress independently. The structured ending is an important part of the process, giving you an opportunity to practise managing a planned transition, which is particularly relevant if role transitions were part of your focus.

The evidence for IPT

IPT is one of the most extensively researched psychological therapies available. It has a robust evidence base established through numerous randomised controlled trials conducted across multiple countries and clinical settings.

NICE recommends IPT as a first-line treatment for moderate to severe depression, placing it alongside CBT as one of the psychological therapies with the strongest evidence. IPT is also recommended within NICE guidance for eating disorders and is referenced in guidelines for perinatal mental health difficulties.

The evidence for IPT in depression is particularly strong. Research consistently shows that IPT is as effective as antidepressant medication for moderate depression, and that combining IPT with medication produces better outcomes than either treatment alone. Studies have also demonstrated that IPT is effective in preventing relapse, with maintenance IPT significantly reducing the risk of future depressive episodes.

Research on IPT for postnatal depression has shown strong outcomes, with several trials demonstrating significant improvements in both depressive symptoms and mother-infant interaction. The therapy’s focus on role transitions makes it a natural fit for the challenges of new parenthood.

IPT has also been adapted and evaluated for adolescents, older adults and people from diverse cultural backgrounds, with consistently positive results. Its focus on universal human experiences, relationships, loss, change and connection, gives it a flexibility that translates well across different populations and contexts.

The evidence for online delivery of IPT is strong. Research conducted both before and during the pandemic has shown that IPT delivered by video produces outcomes comparable to face-to-face delivery. The structured, conversational nature of IPT sessions makes them well suited to the video format.

IPT at The Online Psychologists

At The Online Psychologists, IPT is delivered by HCPC-registered clinical and counselling psychologists who are trained in the interpersonal therapy model. Our psychologists understand how to work with the specific IPT framework while remaining responsive to your individual needs.

Online delivery is a natural fit for IPT. The therapy is primarily conversational, structured around discussion of your relationships and interpersonal experiences, and does not rely heavily on physical materials or in-room exercises. Many clients find that the convenience of online sessions makes it easier to attend consistently, which is important in a time-limited therapy where each session builds on the last.

Being in your own environment during sessions can also be therapeutically useful. You are closer to the context of your daily relationships, which can make it easier to bring specific examples and recent experiences into the session. Some clients find they are more open and reflective when they are in a familiar, comfortable space.

When you contact us, we begin with a matching process to pair you with a psychologist experienced in IPT who is suited to your particular difficulties. We take into account the nature of your concerns, whether that is grief, relationship conflict, a life transition or social isolation, and match you accordingly.

Sessions are held weekly, lasting 50 minutes, with most courses of IPT running between 12 and 16 sessions. The time-limited structure is a core part of the model and helps maintain the focus and momentum that make IPT effective. Your psychologist will agree the number of sessions with you at the start of therapy, based on your formulation and goals.

IPT at TOP may be particularly suited to you if your low mood or anxiety is clearly connected to what is happening in your relationships, if you are adjusting to a major life change such as parenthood, retirement or relationship breakdown, or if you are struggling with grief that feels stuck or unresolved. It is also a good choice if you prefer a practical, structured approach with clear goals and a defined timeframe.

Frequently asked questions

Is IPT just about talking about my relationships? IPT involves focused, structured work on the specific interpersonal issues that are contributing to your difficulties. It is not simply a space to talk about your relationships in general. Your psychologist will help you identify clear goals and work actively towards them, using specific techniques such as communication analysis and role play. The aim is to create concrete change in how you relate to the people around you, which in turn improves your mood and emotional wellbeing.

Can IPT help if I am grieving? Yes. Grief and complicated bereavement are one of the four core focus areas in IPT. The therapy can help you process a loss that feels stuck or overwhelming, understand how the loss has affected your other relationships and daily functioning, and gradually rebuild a meaningful life. IPT is particularly helpful when grief is complicated by factors such as ambivalent relationships with the person who has died, or when the loss has triggered a broader sense of isolation.

What if my problems are not just about relationships? IPT recognises that not all difficulties are purely interpersonal, but research consistently shows that improving your relationships and social functioning has a powerful effect on mood and emotional wellbeing, even when other factors are involved. If your psychologist feels that a different therapeutic approach would be more appropriate, they will discuss this with you openly.

How quickly will I start to feel better? Many people notice some improvement within the first few sessions, particularly once they have a clearer understanding of the connection between their mood and their interpersonal situation. The most significant change typically occurs during the middle phase of therapy as you begin to make active changes in your relationships. However, the pace of progress varies from person to person, and your psychologist will review how things are going with you regularly throughout the therapy.