Interpersonal Psychotherapy (IPT) for Eating Disorder Treatment

There are many therapeutic modalities that each vary in their perspective on human behavior and the skills they teach to improve mental health. The theoretical perspectives of these modalities can alter the treatment one receives and some may be more effective than others for specific individuals. This is helpful as finding one therapeutic viewpoint ineffective does not mean all therapy will be ineffective. An individual can try other modalities to find what speaks to them and allows them to improve their mental health and daily lives.

While many are aware of Cognitive Behavioral viewpoints, as these are most evidence-based treatment modalities, there are others that prove helpful. One of these is Interpersonal Psychotherapy.

What is Interpersonal Psychotherapy (IPT)?

Interpersonal Psychotherapy, often referred to in-short as IPT, is a “diagnosis-targeted, time-limited, present-focused treatments that encourage the patient to regain control of mood and functioning [1].”

One article specifies that IPT is based on “common factors of psychotherapy: a treatment alliance in which the therapist empathically engages the patient, helps the patient to feel understood, arouses affect, presents a clear rationale and treatment ritual, and yields success experiences [1].”

The primary principles of IPT are that:

  1. Depression is a medical illness, rather than the patient’s fault or personal defect; moreover, it is a treatable condition. This definition has the effect of defining the problem and excusing the patient from symptomatic self-blame.
  2. Mood and life situation are related. Building on interpersonal theory and psychosocial research on depression, IPT makes a practical link between the patient’s mood and disturbing life events that either trigger or follow from the onset of the mood disorder [1].

IPT Techniques

According to the International Society of Interpersonal Psychotherapy (ISIPT), “IPT helps patients to understand their emotions as social signals, to use this understanding to improve interpersonal situations, and to mobilize social supports [2].”

The ISIPT further describes that IPT’s “basic principles assume that helping patients to improve problematic interpersonal relationships or circumstances that are directly associated with the current mood episode will result in symptom reduction [2].”

Therapy Session

Essentially, IPT differs from cognitive therapy in that cognitive therapies focus primarily on the individual’s beliefs and cognitions and encourage altering these to alter one’s life whereas IPT places emphasis on the life circumstances and interpersonal encounters that are contributing to or maintaining the struggle.

This does not mean one is better or more effective than the other but that they focus on different areas of one’s life for treatment.

Interpersonal Psychotherapy for Eating Disorders

IPT is useful for treating those that struggle with eating disorders as interpersonal dynamics can play a key role in mediating eating disorder behaviors.

As an article in Clinical Psychology and Psychotherapy specifies, there are several ways in which interpersonal dynamics are associated with eating disorder beliefs and behaviors:

  • “Patients often become more isolated from the normalizing influence of their peers and, as a result, their psychopathology tends to persist unchallenged [3].”
  • “Certain eating disorder features may be directly maintained by interpersonal difficulties. For example, both binge eating and dietary restraint tend to occur in the context of, or are exacerbated by, adverse interpersonal events [3].”
  • “Interpersonal difficulties often serve to worsen self-esteem, which in turn tends to increase patients’ efforts to control their eating, shape and weight to feel more in control [3].”

Including IPT principles in treatment allows these aspects that contribute to eating disorders to be explored and addressed. This can help to not only heal these dynamics but improve one’s interpersonal effectiveness skills so that their relationships are a protective factor instead of a risk factor moving forward.

IPT for Anorexia Nervosa

Anorexia Nervosa beliefs and behaviors can certainly be linked to interpersonal dynamics such as having adverse childhood experiences, toxic familial beliefs and dynamics related to food, exercise, weight, appearance, etc., going through a severe trauma, or experiencing interpersonal dynamic shifts due to one’s appearance or body. Further, anorexia is often not solely about appearance, therefore, interpersonal dynamics might also contribute to a need for feelings of control or experiencing depression or anxiety symptoms the individual is attempting to cope with using eating disorder behaviors.

There are few studies looking at the impact of IPT on anorexia nervosa behaviors, however, those that do exist indicate that, when compared to Cognitive Behavioral Therapy (CBT) and non-specific supportive clinical management, IPT was the least effective in the short-term but equally as effective long-term [3].

With no further research, researchers concluded that “IPT cannot be recommended as a treatment for anorexia nervosa [3].”

IPT for Bulimia Nervosa

Bulimia Nervosa can have various root causes and rarely has only one. Much of what contributes to bulimia nervosa is similar to that of anorexia nervosa listed above.

While Cognitive Behavioral Therapy for Bulimia Nervosa (CBT-BN) is the most commonly-used treatment, this does not mean it is the only effective treatment.

Research has found the CBT-BN does show the most effective immediate results for treatment of bulimia nervosa, however, even though IPT results were slower-acting, they were equally as effective as CBT-BN in the long-run [3].

This led researchers to the conclusion that “IPT is the leading empirically supported alternative to CBT for bulimia nervosa, but it takes longer to achieve its effects” and that “there are no empirical grounds for matching patients to CBT or IPT [3].”

The Brain working

Benefits of Interpersonal Psychotherapy Treatment

IPT is most-often used, and most effective in treating, mood disorders such as Major Depressive Disorder. Studies have found that addressing interpersonal dynamics and social and familial relationships is a key aspect in reducing depressive symptomatology. Specifically, IPT has been effective “in treating depression in medically ill patients, peripartum women, depressed adolescents, and geriatric depressed patients [1].” Mood disorders often co-occur with eating disorders, therefore, an individual struggling with both is likely to benefit from IPT.

The reason IPT is so effective is that the way we interact with others affects all of us emotionally and psychologically. Humans are, by nature, social beings, therefore, adverse social experiences or dynamics will certainly impact our mental well-being.

Exploring the relationship one’s interpersonal dynamics has to their mental health and teaching skills to improve these dynamics creates waves of benefit that go far-beyond the relationships alone.

Resources

[1] Markowitz, J. C., Weissman, M. M. (2004). Interpersonal psychotherapy: principles and applications. World Psychiatry, 3:3.

[2] Unknown (2022). Overview of IPT. The International Society of Interpersonal Psychotherapy. Retrieved from https://interpersonalpsychotherapy.org/ipt-basics/overview-of-ipt/.

[3] Champion, L. Power, M. J. (2012). Interpersonal psychotherapy for eating disorders. Clinical Psychology and Psychotherapy, 19:2.

Author: Margot Rittenhouse, MS, LPC, NCC
Page Last Reviewed on March 28, 2022, and Updated By: Jacquelyn Ekern, MS, LPC