Family, group and interpersonal therapy
- Technique
Therapies that work through relationships: with the family, with a group of peers, or on the relationships and life changes linked to depression.
What it is
Interpersonal therapy (IPT) is a time-limited treatment, developed for depression, that links mood to current relationships and focuses on grief, role disputes, role transitions or interpersonal deficits. Family therapy treats the family as a system in which each member influences the others; family-based treatment is the first-line therapy for adolescent anorexia nervosa. Group therapy uses the group itself, its support and feedback, as a vehicle of change and is economical. Couples therapy addresses the relationship between partners.
Key facts
- IPT does not interpret the past; it works on present relationships and practical communication.
- In family-based treatment the family is treated as a resource for recovery, not blamed as the cause of the illness.
- Systems ideas: boundaries, alliances, hierarchies and rules in the family; a symptom may keep a family balance in place.
- Mutual-help groups led by peers, such as twelve-step groups, are not psychotherapy but help many people with alcohol use disorder stay abstinent.
- Group therapy limits: discomfort speaking among strangers, conflicts between members and less control over confidentiality.
Relationship-based therapies and where they are used
| Modality | Focus | Best-supported use |
|---|---|---|
| Interpersonal therapy (IPT) | Grief, role disputes, role transitions, interpersonal deficits | Major depression |
| Family-based treatment | Parents restore eating, then return control to the adolescent | Adolescent anorexia nervosa |
| Parent management training | Consistent positive reinforcement, clear rules and predictable consequences | Conduct and oppositional problems in children |
| Family psychoeducation | Information, problem-solving and lowering expressed emotion | Schizophrenia (relapse prevention) |
| Group CBT | Shared skills practice and exposure in a group | Social anxiety and other anxiety disorders |
| Mutual-help and group therapy | Peer support, shared experience, accountability | Alcohol and other substance use disorders |
| Couples therapy | Communication, conflict resolution and shared problem-solving | Relationship distress, depression in a partner |
Clinical notes
- Joint couples sessions are generally avoided while there is ongoing intimate partner violence; safety assessment comes first and each partner is seen separately.
- In perinatal depression, IPT's focus on role transition fits the change to parenthood well.
Test yourself
Think of the answer, then tap the question to see it.
What are the four problem areas of interpersonal therapy?
Grief, role disputes, role transitions and interpersonal deficits.
Which psychotherapy is first line for an adolescent with anorexia nervosa?
Family-based treatment, in which parents temporarily take control of eating before gradually returning it.
Why does family psychoeducation help in schizophrenia?
It reduces high expressed emotion in the family, which is linked to relapse.
What does universality mean in group therapy?
Discovering that others share the same problem, which reduces shame and isolation.
Connections
Educational content on behavior and the clinical relationship; not a diagnostic or treatment guide and no substitute for assessment by a health professional. If you or someone near you is at risk, seek help now from an emergency service or a mental-health helpline.
Sources: Depression (National Institute of Mental Health (NIMH), 2024); Eating Disorders: What You Need to Know (National Institute of Mental Health (NIMH), 2024).
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Representative model, for educational purposes only.