Interpersonal therapy (IPT)

Interpersonal therapy, or IPT, is a short, structured talk therapy for depression. It starts from a simple idea: our moods and our relationships affect each other. A loss, a fight with someone close, or a big life change can bring on depression. Depression, in turn, can strain the people around us.^6,1

IPT does not dig deep into childhood. It works on one or two problems happening in your life right now. It helps you handle them in ways that ease your mood. This page explains how IPT works, what the research shows, and why it can be a good fit in later life.

What is interpersonal therapy?

"Interpersonal" means "between people." IPT was first developed in the 1970s to treat major depression.¹ It is time-limited, which means you and your therapist agree on a set number of sessions from the start.¹

Early on, the therapist explains depression as a common, treatable illness and works to give you hope. Then you look closely at what was happening in your life and your relationships when the depression began or got worse.¹ Rather than trying to change your thoughts directly, IPT works on how you relate to others and how you respond to life events.⁴

A therapist trained in IPT follows a written guide called a manual. This keeps the therapy focused and similar to how it was tested in studies.⁴

The four focus areas

At the start, you and your therapist pick one main problem to work on, sometimes two. These fall into four areas.¹

Each area has its own set of strategies.¹ In every area, the goal is the same: to help you feel more supported by others and more able to handle the problem.¹

What happens in IPT sessions

IPT moves through three phases.¹

1. Beginning (often the first few sessions). The therapist asks about your symptoms and explains depression and how it is treated. Together you review the important people in your life. This review is sometimes called an interpersonal inventory. You agree on a focus area and goals.¹
2. Middle. Most of the work happens here. You work on the problem you chose, using strategies matched to that focus area.¹ Each week you may talk about what happened with the people involved. You may practice new ways of handling hard talks, try them out between sessions, and look at how they went.
3. Ending. You review what has changed and the skills you learned. You also make a plan for spotting early warning signs of depression and what to do if they come back.¹

How long it lasts. The American Psychological Association (APA) describes IPT for depression as usually 16 to 20 weekly sessions.² England's national guideline group, NICE, says courses usually run 8 to 16 sessions. People with other health problems or complex needs may need more.⁴ A shorter form, called interpersonal counseling, has also been studied.¹

Ways to take part. IPT can be one-on-one, in a group, or by video. A group version was designed by the World Health Organization (WHO) with Columbia University. It uses 8 group sessions.⁸

Does IPT work? What the research shows

For depression

A large review in 2016 pooled 90 studies of IPT with more than 11,000 people. Most of the studies were about depression.¹

• Compared with no therapy or usual care, IPT clearly helped depression. In plain terms, for about every 3 people treated with IPT, 1 more person improved than would have without it.¹ Strong evidence
• Compared with other therapies such as CBT, IPT worked about equally well.¹
• Compared with antidepressant medicines, there was no clear difference. The results leaned slightly toward medicine, but the difference was small and not certain.¹
• IPT plus medicine worked somewhat better than IPT alone.¹

These results match national advice. The APA guideline lists IPT among several recommended treatments for depression in adults. It says that if medicine is being considered, it can be combined with IPT.² The WHO also lists IPT among effective talk therapies for depression.⁹

The review also noted that many studies had weak points. Only 16 of the 90 met all of its quality checks.¹ Even so, the overall picture for depression is strong.

For keeping depression from coming back

Depression often returns. In the 2016 review, people who kept having monthly IPT "maintenance" sessions after they got better were less likely to have depression return.¹ This held both for people also taking medicine and for those who were not.¹ There were only 7 studies, and none was rated low risk for bias, so this finding is less certain.¹ Moderate evidence

During pregnancy and after birth

IPT is one of the two main therapies used for depression during pregnancy and after birth. The other is CBT.⁶ In 2019, the U.S. Preventive Services Task Force (USPSTF), a panel of national experts, advised doctors to offer or refer at-risk pregnant and new mothers to counseling to prevent depression.⁵ Moderate evidence

In the studies, counseling lowered the chance of depression by about 39%. One IPT program for pregnant women, called ROSE, cut the risk by about half.⁵ ROSE uses 4 or 5 group sessions in pregnancy and one private session after the baby is born.⁵ Read more in types of depression.

In community and group settings

IPT can be taught to people without mental health degrees, as long as they are trained and supervised.⁸ In a well-known 2003 trial in rural Uganda, villagers took part in 16 weekly group IPT sessions. Afterward, only about 1 in 15 (6.5%) still had major depression. In villages without the groups, more than half (55%) still did.⁷

For other conditions

IPT has been tried for anxiety, eating disorders, and other problems. The results are more mixed.¹

• Anxiety: Overall, IPT did about as well as other therapies. But in the best-designed studies, other therapies did better.¹ For anxiety, ask about CBT and exposure therapy too. Limited research
• Eating disorders: IPT did about as well as other therapies overall, though changes in eating behavior slightly favored other therapies, mainly CBT. The authors called this finding uncertain.¹

A related therapy for bipolar disorder adds a focus on daily routines and sleep. It is called interpersonal and social rhythm therapy (IPSRT). See therapy for bipolar disorder.

IPT and older adults

Later life often brings exactly the kinds of changes IPT was built for. These include the death of a spouse or friends, retirement, moving out of a long-time home, new health problems, and becoming a caregiver. Losing a driver's license or hearing can also shrink a person's social world. See loneliness in later life.

Older adults are one of the groups where IPT has been studied.¹ The APA depression guideline recommends IPT for older adults. It also suggests pairing IPT with an antidepressant when medicine is being considered.³ This combined approach may suit people who want to work on what is happening in their lives as well as take medicine.

Some reasons IPT can fit well in later life:

• It is practical. It deals with today's problems, not the distant past.
• It is short. A set number of sessions can feel less daunting.
• It respects relationships. Many older adults care most about family, friends and community. IPT puts those at the center.
• It can be combined with medicine. This matters for people who also see a doctor for depression.³

Family caregivers face a major role change too. If caring for a parent or spouse has left you depressed, IPT's focus on role transitions and conflicts may help. See caregiver stress and caregiver burnout.

For more on how depression shows up later in life, see depression in later life.

Is IPT right for you?

IPT may be a good fit if:⁴

• Your low mood started or got worse after a loss, a conflict, or a big change.
• You want a short, focused therapy.
• You are willing to look at your relationships.
• You would like to avoid medicine side effects, or you want a therapy to use alongside medicine.

You might choose a different approach if you would rather work directly on thoughts and habits. In that case, CBT, behavioral activation or problem-solving therapy may suit you better. For a side-by-side look, see our therapies overview.

Finding an IPT therapist and paying for it

Many psychologists, social workers, counselors and psychiatrists use IPT. Not all have formal IPT training. When you contact someone, ask:

• "Are you trained in interpersonal therapy?"
• "How many sessions do you usually plan?"
• "Do you offer video sessions or groups?"

Our guide on how to find a therapist explains directories, insurance and language matching. If English is not your first language, ask whether a therapist can work in your language or with an interpreter.

Medicare. Medicare Part B covers individual and group psychotherapy. Covered providers include psychiatrists, clinical psychologists, clinical social workers, nurse practitioners, marriage and family therapists, and mental health counselors.¹⁰ After the Part B deductible, you usually pay 20% of the Medicare-approved amount.¹⁰ See what Medicare covers for mental health and paying for therapy.

Questions people ask

Is IPT the same as couples or family therapy?

No. IPT is usually one-on-one or in a group of people who do not know each other. It focuses on your relationships, but the other people are not usually in the room. Sometimes a family member may join for a session, if you and your therapist agree.

Will I have to talk about my childhood?

Not much. IPT focuses on what is happening now. The therapist may ask about past relationships to understand patterns, but the work is about the present.¹

Can I do IPT on my own?

IPT is designed to be done with a trained therapist or group leader. You can still use some of its ideas. Think about which of the four areas fits your life right now. Then take one small step, like calling a friend or planning a calm talk with a family member. Our self-help for depression page has more ideas.

Should I stop my antidepressant if I start IPT?

No. Do not stop or change any medicine on your own. Many people use therapy and medicine together. Talk with your doctor or pharmacist before changing anything.

When to get help now

If depression is getting worse, or you are thinking about ending your life, reach out today. Call or text 988 to reach the 988 Suicide & Crisis Lifeline, any time, day or night. Call 911 if someone is in immediate danger. See get help now and our safety plan tool. Depression is treatable, and help works.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.