Purpose in Recovery: Interpersonal Psychotherapy for Alcohol Addiction

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Well-rounded addiction treatment programs offer a wide selection of services, including therapy for alcohol use disorder, or alcohol addiction.¹ Although interpersonal psychotherapy (IPT) has strong foundations in treating depression, this approach may also help people manage other mental health disorders.²

As research in IPT grows, some experts believe that this approach may serve as a therapy for alcohol use disorder and complement addiction treatment by addressing co-occurring mental health symptoms.³

What Is Interpersonal Psychotherapy?

Interpersonal psychotherapy is a counseling approach that shares roots and themes with psychoanalytic theory.⁶ Sigmund Freud made psychoanalysis popular in the first half of the 20th century. While Freudian psychoanalysis is no longer used in clinical settings, treatment professionals used his theories to develop other therapeutic modalities, including IPT.

IPT helps you by examining experiences that develop in the early stages of life including your:⁶

• Instincts
• Motivation
• Unconscious thoughts
• Psychological defenses

Interpersonal psychotherapy techniques can help you improve how you manage moods, cope with strong emotions, and connect with others.^4,6 Therapists who offer IPT often help you explore new ways to solve problems in specific life areas.⁴

IPT takes place in phases and on a time-limited schedule.⁶ The entire course of treatment can last between 12-16 weeks.⁷ There are also abbreviated IPT programs that have been used for research purposes that took place over eight weeks.⁷

An interpersonal psychotherapy program can help you:⁶

• Identify how problems in communication and relationships connect with your mental health symptoms
• Build and practice strategies to overcome problems in different areas of your life
• Rebuild relationships while preparing to continue recovery after treatment

Treatment experts have modified IPT techniques to address a wide range of mental health disorders, though some techniques are universal regardless of an individual’s diagnosis.^2,4,8

Treatment providers may combine an interpersonal psychotherapy program or techniques with cognitive-behavioral therapy (CBT), medication-assisted treatment (MAT), and other treatment modalities.⁸

How Is Interpersonal Psychotherapy Used to Treat Alcohol Addiction?

Although research on interpersonal psychotherapy for treating addiction shows mixed results, experts continue to examine how this approach works as a therapy for alcohol addiction and other substance use disorders (SUDs).^2,5,8,9

Two pilot studies offer insight into the potential benefit of IPT for women facing mental health and alcohol-related challenges.^{5, 9} Patients in these studies exhibited some improvements in their symptoms over time.⁴ However, the results of these studies do not provide a clear picture of how well this approach worked as a therapy for alcoholism.

In 2012, researcher Kristina Brache expressed “cautious optimism” in adapting interpersonal therapy to treat people with SUDs, including alcohol use disorder (AUD).³ In describing the benefits of interpersonal psychotherapy, Brache made several suggestions on how therapists could use this approach to treat addiction.

These suggested adaptations to IPT include:³

• Creating a meaningful purpose and role in society
• Developing a sense of belonging in recovery-focused relationships
• Improving a person’s ability to achieve “personal acceptance” through therapy

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The relationship you share with a therapist may help you maintain motivation to overcome addiction.³ To help you find and maintain motivation for recovery, some addiction therapists combine motivational interviewing with other therapeutic modalities like IPT. Motivational interviewing focuses on internal motivators—or the personal things that make you want to pursue recovery—rather than external motivators—or the influences around you that encourage recovery, such as ultimatums from your doctor or family.

According to Brache, these combined techniques can also help you:³

• Examine the true positive and negative effects of alcohol or drug use in your life
• Recognize the importance of sobriety in unexpected ways
• Change the way you connect with yourself and others
• Establish a collaborative partnership with your therapist

The potential benefits of individual IPT sessions can extend beyond one-to-one sessions.³ This approach may also support alcohol and addiction recovery in group therapy sessions.^1,3

A lack of quantitative research presents a major area of concern for IPT in addiction treatment.⁴ Myrna Weissman, one of the experts who developed IPT, and her colleagues chose not to recommend this approach as a therapy for AUD or other SUDs.

When Is Interpersonal Psychotherapy Recommended?

A large body of research supports the use of IPT in treating acute major depression.⁴ People from different age groups with various mental health concerns may benefit from this therapy. Based on available research, experts found that IPT could help:⁴

• Adolescents experiencing depressive symptoms or major depression
• Older adults experiencing depressive symptoms or major depression
• People experiencing depression during pregnancy
• People experiencing depression during the postpartum stage of pregnancy
• People with bipolar I disorder
• People with eating disorders, including bulimia nervosa and binge-eating disorder

Studies also demonstrate the benefits of IPT in treating certain other mental health disorders, including anxiety disorders and post-traumatic stress disorder (PTSD).⁴ As research continues to grow, the list of disorders interpersonal therapy can effectively treat may continue to expand as well.^2,4

Co-occurring disorders, also called dual diagnosis, is common for individuals who have a substance use disorder. Surveys indicate that some of the mental health conditions with the highest rate of co-occurrence in individuals who misuse or are physically dependent on alcohol are:¹⁰

• Major depression
• Other mood disorders, such as bipolar disorder (I, II, and related disorders)
• Generalized anxiety disorder
• Other anxiety disorders, such as panic disorder
• PTSD
• Psychotic disorders and schizotypal disorders

Your therapist may use IPT to address a co-occurring mental health diagnosis, which can complement the goals of therapy for alcoholism. This may occur while you are actively seeking treatment for alcohol addiction or after you have finished an inpatient or outpatient rehab program.

What Techniques Are Used in Interpersonal Psychotherapy?

Therapists use a variety of techniques to guide people through the interpersonal psychotherapy process.⁴ You may encounter some of these techniques in other types of therapy.^4,6

Therapists may use open-ended questions to help a person freely explore themselves and the problems they face.⁴ These questions can help you build a trusting relationship with your therapist. Sometimes, a therapist practicing IPT may take a more direct approach.⁴ This can help establish a specific direction for therapy. It can also help uncover critical information and feelings a person may need to acknowledge in recovery.

Therapists using this treatment approach can also help you to clarify different themes in your life.⁴ This can help you to reflect on your emotions and responses in different situations. This information can guide you into action as you pursue recovery beyond therapy.

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These and the following techniques will ideally strengthen the relationship between you and your therapist.⁴ The therapeutic relationship serves as an essential component to helping people improve their lives through therapy. Confidence in your relationship with a therapist can help you talk about any challenges you encounter in treatment. Clinicians who practice IPT may encourage open conversations about what works and what does not.

Working With Feelings in Interpersonal Psychotherapy

Your IPT provider may encourage you to intentionally feel your emotions during your time together.⁴ The process of expressing and exploring your emotions can help you to better manage what you feel.

Sometimes, painful experiences can contribute to intense or overwhelming emotions.⁴ A therapist guiding you through the IPT process will help you recognize that powerful feelings do not have “good” or “bad” qualities. Your therapist can help you understand how emotions, especially the powerful ones, enrich the human experience.

Therapists using this treatment approach can help you describe your feelings and find new ways to work through them.⁴ This approach also may help you identify and express emotions like thankfulness, appreciation, and affection.

Communication and Decision Analysis in Interpersonal Psychotherapy

Interpersonal psychotherapy can help people better understand the way that they connect with others.⁴ By exploring difficult conversations, IPT allows people to recognize how they handle challenges in communication.

Communication analysis can also help you:⁴

• Improve direct communication
• Manage feelings when communicating with others
• Understand your role in conversations
• Identify new approaches to communication

Decision analysis focuses on your actions and their consequences.⁴ This intervention can help you take a closer look at how you approach different problems. It can also help you make informed choices about how to handle those problems. This technique can help you:⁴

• Examine pros and cons to identified solutions
• Look for alternative solutions
• Reflect on what you hope to see come out of different situations

Roleplay in Interpersonal Psychotherapy

This intervention allows you to put the skills and information you obtain in therapy into practice.⁴ By engaging in roleplay with your IPT practitioner, you get the chance to look at how an interaction could turn out. Roleplay can help you:⁴

• Assert yourself
• Practice confrontation
• Share more about yourself with others
• Rehearse for challenging situations
• Express your feelings with clarity

With this technique, your IPT practitioner can help you brainstorm challenges and develop solutions when communicating with others.⁴

How Effective Is Interpersonal Psychotherapy?

Interpersonal psychotherapy can be beneficial for individuals facing many different mental health challenges.⁴ As many people as this treatment can serve, it is a cure-all for every diagnosis. Evidence regarding how well this approach works as a therapy for alcoholism remains limited.^2,4

Substance use disorder treatment programs work best when they offer a flexible, individual approach to care.¹ Licensed addiction specialists and providers can help you identify the types of therapy that may match your needs. These trained clinicians can help you discover the benefits of a supportive, professional, and therapeutic relationship.

If you have questions about therapy for alcoholism or which treatment approach may work best for you, consider getting an assessment from an addiction treatment professional.¹ An initial evaluation can help you identify how you would like to approach recovery. It can also help you start a program of long-term recovery.

For more information on accessing therapy for alcoholism, contact 800-948-8417 Calls are forwarded to these paid advertisers to speak with a specialist who can help connect you with an addiction treatment program.

Resources

1. Miller, W. R., Forcehimes, A. A., & Zweben, A. (2019). Treating addiction: A guide for professionals, 2nd ed. The Guilford Press.
2. Rajhans, P., Hans, G., Kumar, V., & Chadda, R. (2020). Interpersonal psychotherapy for patients with mental disorders. Indian Journal of Psychiatry, 62(8),
3. Brache, K. (2012). Advancing interpersonal therapy for substance use disorders. American Journal of Drug & Alcohol Abuse, 38(4), 293–298.
4. Weissman, M. M., Markowitz, J. C., & Klerman, G. L. (2018). The Guide to Interpersonal Psychotherapy. New York: Oxford University Press.
5. Markowitz, J. C., Kocsis, J. H., Christos, P., Bleiberg, K., & Carlin, A. (2008). Pilot study of interpersonal psychotherapy versus supportive psychotherapy for dysthymic patients with secondary alcohol abuse or dependence. The Journal of nervous and mental disease, 196(6), 468–474.
6. Capuzzi, D., & Stauffer, M. D. (2016). Counseling and Psychotherapy : Theories and Interventions: Vol. Sixth edition. American Counseling Association.
7. Swartz, H. A., Grote, N. K., & Graham, P. (2014). Brief interpersonal psychotherapy (IPT-B): Overview and review of evidence. American Journal of Psychotherapy, 68(4), 443–462.
8. Frank, E., Ritchey, F. C., & Levenson, J. C. (2014). Is interpersonal psychotherapy infinitely adaptable? A compendium of the multiple modifications of IPT. American journal of psychotherapy, 68(4), 385–416.
9. Gamble, S. A., Talbot, N. L., Cashman-Brown, S. M., He, H., Poleshuck, E. L., Connors, G. J., & Conner, K. R. (2013). A pilot study of interpersonal psychotherapy for alcohol-dependent women with co-occurring major depression. Substance Abuse, 34(3), 233–241.
10. Gonzalez, G., Krystal, J. H., Petrakis, I. L., & Rosenheck, R. (2002). Comorbidity of Alcoholism and Psychiatric Disorders. National Institute on Alcohol Abuse and Alcoholism.