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Interpersonal and Social Rhythm Therapy: An Overview

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Interpersonal and Social Rhythm Therapy (IPSRT) is a therapeutic intervention designed for the treatment of mood disorders.

In this approach, emphasis is placed on addressing rhythm dysregulation in the lives of individuals with mood disorders.

By focusing on the intersection of interpersonal relationships and daily social rhythms, IPSRT aims to stabilize mood and improve overall functioning in patients.

Concept and Goals of IPSRT

Interpersonal and Social Rhythm Therapy

Interpersonal and Social Rhythm Therapy (IPSRT) is an evidence-based treatment method designed to help individuals with mood disorders, such as bipolar disorder and major depressive disorder, by focusing on stabilizing their circadian rhythms and interpersonal relationships.

The rationale behind IPSRT is based on the understanding that disruptions in the circadian system play a significant role in mood disorders and that stabilizing daily routines can help improve mood stability and overall functioning.

Effects on Mood Disorders

IPSRT aims to provide support and skills to individuals who suffer from mood disorders. Its primary goal is to stabilize the patient’s mood, reduce manic symptoms, and prevent relapses by focusing on their biological and social rhythms.

IPSRT can be beneficial in managing symptoms of bipolar disorder and major depressive disorder, with positive effects on sleep, social interactions, and overall quality of life.

Stabilizing Biological and Social Rhythms

One of the key components of IPSRT is the focus on stabilizing biological and social rhythms. Patients are encouraged to establish and maintain a regular daily routine, including consistent sleep-wake cycles, meal times, and social activities.

The idea is to use natural “zeitgebers” or time-givers, such as sunlight and social interactions, to help regulate the circadian rhythm and improve overall mood stability.

The focus is on consistency and regularity, which reduces disruptions in the circadian system.

Role of Therapist and Patient


In IPSRT, both the therapist and the patient play important roles in achieving the therapy’s objectives.

The therapist provides guidance, education, and support while the patient takes responsibility for implementing and maintaining the desired changes in their daily routines and interpersonal relationships.

Together, they collaboratively work towards achieving social rhythm regularity and improved mood stability.

The IPSRT Model

Interpersonal and Social Rhythm Therapy (IPSRT) is a therapeutic approach developed by Ellen Frank and her colleagues at the University of Pittsburgh.

The IPSRT model combines elements of Interpersonal Psychotherapy, which focuses on addressing interpersonal issues related to mood disorders, and a behavioral approach called Social Rhythm Therapy.

The latter emphasizes the importance of regular daily routines, sleep patterns, and social interactions for managing mood stability.

Social Rhythm Metrics

A key aspect of IPSRT is the concept of social rhythm metrics. These metrics assist patients in tracking and regulating their daily routines, such as sleep, mealtimes, and social activities.

By maintaining consistent social rhythms, individuals can reduce the likelihood of mood disruptions caused by irregular patterns.

Interpersonal Relationships

Interpersonal Relationships

In addition to addressing social rhythm stability, IPSRT also focuses on interpersonal relationships.

The therapy explores four main interpersonal problem areas that may contribute to mood instability:

  1. Grief or loss: Helping patients process and cope with the loss of a loved one or significant life changes.
  2. Role transitions: Assisting patients in adapting to new roles, such as parenthood or a career change.
  3. Role disputes: Resolving conflicts and improving communication in relationships.
  4. Social or interpersonal deficits: Enhancing patients’ social skills and support networks.

Research has shown that IPSRT is effective in delaying the onset of new episodes of mania or depression in patients with bipolar disorder.

It has been particularly successful in helping patients maintain more stable social rhythms and improve their interpersonal relationships.

IPSRT can be useful as a stand-alone treatment as well as in combination with medications.

Coping Skills and Strategies

Incorporating effective coping skills and strategies is essential for patients undergoing IPSRT.

These may include relaxation techniquesmindfulness practices, and communication skills to navigate interpersonal relationships better.

By developing a robust toolbox of coping mechanisms, patients can more effectively handle challenging situations that may arise in their daily lives and prevent mood episodes from worsening.

Tailoring the coping skills and strategies to each patient’s needs and specific interpersonal problem areas is essential.

This personalized approach ensures that the methods taught will have a greater impact on the patient’s overall well-being and mood stability.

Regular Evaluation and Adaptation

IPSRT requires regular evaluation and adaptation based on the patient’s progress and changing needs.

The therapist should continually assess the patient’s SRM to ensure ongoing regularity and make any necessary modifications to their routine.

The effectiveness of the coping skills and strategies taught should also be evaluated to ensure they are providing the patient with adequate support in managing daily stressors and preventing further mood episodes.

As each patient’s situation and recovery process is unique, it is imperative that therapists remain flexible in their approach and continuously adapt the therapeutic process to maximize its effectiveness in addressing the patient’s specific needs and goals.

Therapeutic Process

Interpersonal and Social Rhythm Therapy, known as IPSRT, is a specialized and evidence-based approach to managing mood disorders, particularly bipolar disorder.

This therapeutic modality encompasses a comprehensive and structured process that targets not only mood stabilization but also the cultivation of interpersonal relationships and daily routines.

Initial Stage

Interpersonal and Social Rhythm Therapy

During the initial stage of interpersonal and social rhythm therapy (IPSRT), clinicians focus on gathering information about the patient’s interpersonal relationships and their social rhythm patterns.

These patterns play a vital role in stabilizing mood and preventing the recurrence of depressive or manic episodes in bipolar disorder patients.

The therapist also conducts an interpersonal inventory to identify possible interpersonal problem areas that may contribute to mood symptoms and regularity issues.

In this stage, psychoeducation is provided to help the patient understand the importance of social rhythms and their connection to mental health.

The therapist introduces the Social Rhythm Metric (SRM) as a tool to track the patient’s social rhythms and encourage stability in their daily routines.

Intermediate Stage

During the intermediate stage of therapy, patients are encouraged to address interpersonal deficits and problems that may exacerbate their mood symptoms.

Emphasis is placed on the importance of maintaining a regular routine and improving social rhythm stability.

Alongside the in-session activities, patients are asked to continue tracking their SRM to aid the therapist in evaluating progress and identifying areas in need of improvement.

At this stage, patients may also be educated on different coping skills and strategies to manage stress, anxiety, and other mood symptoms triggered by interpersonal problems or irregular social rhythms.

Final Stage

The final stage of IPSRT involves developing a relapse prevention plan to maintain gains achieved in therapy and prevent future mood episodes.

The therapist and patient review progress made in stabilizing social rhythms, managing interpersonal difficulties, and reducing the risk of relapse.

Treating Specific Disorders Using IPSRT


Interpersonal and Social Rhythm Therapy (IPSRT) is a versatile intervention addressing various mental health disorders.

Bipolar Disorders

IPSRT is effective in treating bipolar disorder by helping patients manage episodes of mania and depression.

This therapy focuses on stabilizing social rhythms and interpersonal relationships to indirectly regulate the biological rhythms that contribute to bipolar mood episodes.

Major Depressive Disorder

Although IPSRT was initially developed for bipolar disorder, it has been found useful in addressing major depressive disorder as well.

By assisting patients with coping strategies for sleep disruption and depressive symptoms, this therapy enhances their recovery from unipolar depression.

Anxiety and Stress Disorders

Given its focus on interpersonal relationships and coping mechanisms, IPSRT is also valuable in treating anxiety and stress disorders.

Its techniques can help patients manage stressful life events and reduce anxiety symptoms.

Social and Interpersonal Problems

IPSRT addresses various interpersonal relationship issues, including role disputes and relationship conflicts.

By working with patients to improve their communication skills and understanding of their own emotional patterns, they can better navigate personal relationships, ultimately improving their mental health outcomes.



Interpersonal and Social Rhythm Therapy (IPSRT) offers several benefits for individuals with bipolar disorder, as well as those struggling with mood instability and interpersonal difficulties.

Mood Stabilization

IPSRT helps individuals with bipolar disorder regulate their mood by focusing on stabilizing social rhythms, such as sleep-wake cycles and daily routines.

By promoting consistency and predictability in daily activities, IPSRT can help reduce mood fluctuations and prevent mood episodes.

Improved Sleep Patterns

Sleep disturbance is common in bipolar disorder and can exacerbate mood symptoms. IPSRT includes strategies to regulate sleep patterns, such as setting consistent sleep and wake times, practicing good sleep hygiene, and avoiding disruptions to sleep routines.

Enhanced Interpersonal Relationships

IPSRT addresses interpersonal difficulties and conflicts that may contribute to mood instability in individuals with bipolar disorder.

By improving communication skills, problem-solving abilities, and conflict-resolution strategies, IPSRT helps individuals navigate interpersonal relationships more effectively and strengthen social support networks.

Reduced Risk of Relapse

IPSRT incorporates relapse prevention strategies to help individuals maintain stability and prevent future mood episodes.

By identifying early warning signs of relapse, developing coping strategies, and promoting adherence to treatment recommendations, IPSRT can reduce the risk of recurrence and promote long-term recovery.

Increased Self-Awareness

IPSRT encourages individuals to reflect on the connection between their mood symptoms, social rhythms, and interpersonal interactions.

Through self-monitoring and awareness-building exercises, individuals gain insight into the factors that influence their mood and behavior, empowering them to make positive changes and take proactive steps to manage their condition.

    Frequently Asked Questions

    Frequently Asked Questions

    What is the role of social rhythms in this therapy?

    Interpersonal and Social Rhythm Therapy (IPSRT) is a treatment approach for individuals with bipolar and other mood disorders.

    One key element of this therapy is focusing on social rhythms, the daily routines, and patterns that regulate an individual’s biological rhythms.

    When social rhythms are disrupted, it can trigger the onset of mood episodes in those with bipolar disorder.

    Therefore, this therapy aims to help patients establish and maintain stable social rhythms, ultimately reducing the frequency and severity of mood episodes.

    What type of training is required for therapists?

    To deliver Interpersonal and Social Rhythm Therapy effectively, therapists must have a strong background in mental health and typically hold a master’s or doctoral degree in a relevant field, such as psychology, social work, or counseling.

    They should also have experience in interpersonal psychotherapy and receive specialized training in IPSRT.

    This training includes learning about bipolar disorder, the principles of interpersonal therapy, and methods for identifying and managing social rhythm disruptions.

    What is the evidence supporting its effectiveness?

    There is a growing body of research that supports the effectiveness of Interpersonal and Social Rhythm Therapy for individuals with bipolar disorder.

    Studies have shown that IPSRT can help reduce the severity and frequency of mood episodes, improve overall functioning, and increase adherence to medication regimens.

    Moreover, findings suggest that this therapy can be beneficial for adolescents with bipolar disorder, making it a promising treatment option for this age group as well.


    Frank, E., Swartz, H. A., & Boland, E. (2007). Interpersonal and social rhythm therapy: an intervention addressing rhythm dysregulation in bipolar disorder. Dialogues in clinical neuroscience9(3), 325-332. Link.

    Frank, E., Swartz, H. A., & Kupfer, D. J. (2019). Interpersonal and social rhythm therapy: managing the chaos of bipolar disorder. Bipolar Disorder, 257-268. Link.

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    About the author

    Eliana Galindo
    Eliana is a dedicated psychologist from Colombia who has gained extensive experience and made significant contributions in child development, clinical psychology, and rehabilitation psychology.Her work as a rehabilitation psychologist with disabled children has been transformative and compassionate. In the child development field, she creates nurturing environments through assessments, interventions, and collaboration with families.In clinical psychology, she supports individuals overcoming mental health challenges with empathy and evidence-based approaches. Inspired by her experiences, Eliana is motivated to write about mental health, aiming to raise awareness and advocate for a compassionate and inclusive approach to well-being.

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