Interpersonal & Social Rhythm Therapy for People with Schizophrenia-Spectrum Disorders
Interpersonal and Social Rhythm Therapy (IPSRT), a treatment originally developed to target the mood symptoms associated with Bipolar I Disorder, may be a potent psychotherapy option for people with SSDs. There is significant evidence of overlap between bipolar disorders and SSDs in etiological processes, candidate endophenotypes, and clinical presentation, suggesting there may also be overlap in efficacious treatments between these groups. IPSRT was originally developed as an adaptation of Interpersonal Psychotherapy (IPT), an evidence-based treatment for depression. At its core, IPSRT is a hybrid treatment that combines the focus on interpersonal problems characteristic of IPT with a behavioral intervention, social rhythm therapy, to target disrupted social rhythms. Social rhythms are activities, such as the time one gets out of bed or has contact with another person, that are thought to entrain disturbances in circadian rhythms, thereby addressing key biological processes that are, at least in part, responsible for the genesis and maintenance of mood episodes.
IPSRT has potential to treat depressive symptoms seen in up to 80% of those with SSDs by intervening on potential etiologic contributors, circadian dysregulation and sleep disturbance; improvements in depression may lead to associated improvements in hopelessness and suicidality. Further, IPSRT may benefit patients with SSDs on interpersonal processes. IPSRT is an interpersonally-oriented psychotherapy, suggesting that patients with SSDs may improve in social cognition or social skills in addition to mood. In light of the potential benefits for patients with SSDs, a pilot clinical trial of IPSRT designed to extend the evidence for this intervention to SSDs is needed. We are currently conducting a small, unfunded pilot clinical trial of IPSRT for people with schizophrenia-spectrum disorders, to build upon our past theoretical work and case studies. |