Interpersonal Therapy for Social Anxiety Disorder

Interpersonal therapy (IPT) is a 12- to 16-week treatment program originally developed for depression. IPT was created by Gerald Klerman and Myrna Weissman in the 1980's. The treatment is highly structured and focuses on the social context of disorders and the improvement of interpersonal functioning.

Interpersonal therapy has also been shown effective in the treatment of eating disorders and bipolar disorder. Given that one-third of patients with social anxiety disorder (SAD) do not respond to medication or cognitive-behavioral therapy (CBT), and because of the interpersonal nature of SAD, IPT is now being considered as a potential treatment alternative.

IPT generally progresses through three distinct phases consisting of weekly treatment sessions.

• Phase 1: Sessions 1 - 3During phase 1, your therapist will identify the interpersonal areas in your life in need of attention. This includes an inventory that lists all of the key relationships in your life, and the primary areas of interpersonal difficulties, such as being socially avoidant or non-assertive.
• Phase 2: Sessions 4 - 14Your therapist will address the problems in your relationships.
• Phase 3: Sessions 15 - 16In the final phase, your therapist will discuss and review your progress and prepare you for the end of therapy.

In the IPT model of depression, four areas are typically addressed during treatment: interpersonal disputes, role transitions, grief, and interpersonal deficits. Below are the key aspects of each area.

• Interpersonal Disputes: Your therapist will identify problems with communication and teach you problem-solving strategies for your relationships.
• Role Transitions: Your therapist will help you find solutions to deal with problems in adapting to new circumstances.
• Grief: If grief over a death or another loss has played a role in your difficulties, it will be explored.
• Interpersonal Deficits: Your therapist will help you to identify problems in the way that you relate to others. If you are lacking interpersonal relationships in your life, your therapist will use the relationship between you as a basis for exploring difficulties, and will help you learn how to develop new relationships.

Many IPT techniques are adopted from other therapies, such as psychoanalytic psychotherapy and CBT. Some of the techniques used by an IPT therapist include clarification, supportive listening, role playing, communication analysis, and encouragement of effect.

Research into the use of IPT with SAD is still in its infancy. In one small study of 9 patients with SAD, 78% were rated as having much or very much improved symptoms after treatment with IPT. Patients also gave concrete examples of positive changes after therapy, such as finding a new job, returning to school, or dating. 

In a critical review, IPT was found to show better outcomes for SAD than psychodynamic psychotherapy, but lesser outcomes compared to CBT.

IPT for SAD has even been delivered through mobile devices (mIPT); however, findings show that IPT delivered in this type of self-help format is less effective compared to mCBT.

Although IPT appears promising as a treatment for SAD, much more research is needed. In particular, researchers have noted that IPT may require further modification to make it applicable to anxiety disorders.

Are you receiving IPT for social anxiety? Overall, it can't hurt and may even help. However, it seems that if offered the choice between CBT or IPT, given the present research evidence, you would be best to go the route of CBT.