Interpersonal psychotherapy (IPT) treats emotional problems by working on the relationships around a child: with parents, siblings, friends and teachers. The idea is simple. Mood and relationships affect each other. A teen who fights constantly with a parent, has lost a grandparent or feels left out at a new school often becomes more depressed, and depression in turn makes those relationships harder. IPT breaks this loop with a short, structured course of sessions. It was first developed for adults by Gerald Klerman and Myrna Weissman and later adapted for adolescents and younger children. This guide explains how it works, who it fits and what parents can do to help.
Key points
- IPT links a child’s mood to current relationship problems and works on those problems directly.
- IPT-A, the version for depressed teens aged about 12 to 18, usually runs about 12 weekly sessions in three phases.
- Family-based IPT (FB-IPT) adapts the approach for children aged about 7 to 12 and includes parents in sessions.
- The American Academy of Pediatrics’ GLAD-PC guidelines name IPT-A and CBT as evidence-based therapies for adolescent depression.
- Regular attendance and practice at home matter as much as what happens in the therapy room.
Who interpersonal therapy is for
IPT was built to treat depression, and that is where the evidence is strongest. In children and teens it is used mainly for:
- Depression and persistent low mood in adolescents
- Depressive symptoms in younger children, through the family-based version
- Teens whose low mood is closely tied to conflict, loss, a big life change or loneliness
- Prevention in teens who have some symptoms but no full depressive disorder, through a group program called IPT-AST (Interpersonal Psychotherapy–Adolescent Skills Training), developed by Jami Young and colleagues
IPT is not the main treatment for disruptive behavior such as frequent defiance or aggression. For those problems, parent training programs have stronger evidence (see family therapy for children with behavioral disorders). Many children have more than one problem, however, and IPT can be part of a wider plan.
IPT-A: the adolescent version
Interpersonal Psychotherapy for Depressed Adolescents (IPT-A) was adapted by Laura Mufson and colleagues at Columbia University for teens aged roughly 12 to 18. Randomized trials, including studies in school-based health clinics in New York City, found that teens receiving IPT-A improved more than those receiving usual care. A typical course is about 12 weekly sessions of 45 to 60 minutes, sometimes spread over 12 to 16 weeks.
The three phases
- Initial phase (about sessions 1 to 4): The therapist explains depression as a treatable illness, assesses symptoms and safety, and builds an “interpersonal inventory” with the teen. Together they choose one or two problem areas to focus on. Parents usually join part of these sessions to learn about the plan.
- Middle phase (about sessions 5 to 8): The teen works on the chosen problem area. Sessions start with a mood rating and a review of the past week’s interactions, then move to skill practice.
- Termination phase (about sessions 9 to 12): The teen and therapist review progress, name the skills that helped, talk about warning signs of relapse and plan what to do if symptoms return. Parents often attend a final session.
The four problem areas
| Problem area | Typical situation | What therapy works on |
|---|---|---|
| Grief | Death of a parent, grandparent, friend or pet | Talking about the loss, remembering the person, finding new support |
| Role disputes | Ongoing conflict with a parent over curfew, grades or friends | Understanding both sides, negotiating, expressing feelings calmly |
| Role transitions | New school, divorce, moving, a new sibling, starting high school | Mourning what was lost, building skills and support for the new role |
| Interpersonal deficits | Few friends, social isolation, trouble starting conversations | Practicing social skills and slowly widening the social circle |
What happens in a session
IPT sessions are practical and focused on the present. Common techniques include:
- Mood rating: The teen rates mood each week, often on a scale of 1 to 10, and links changes to events. “I was a 3 on Tuesday after the argument with Dad, and a 6 on Saturday after I saw my friends.”
- Interpersonal inventory: A map of the important people in the teen’s life, what is good and difficult in each relationship, and what has changed recently.
- Communication analysis: A recent conflict is replayed step by step. What was said, what was meant, what the teen felt and how it could go differently.
- Role play: The teen rehearses a hard conversation, such as asking a parent for more freedom or telling a friend they felt hurt, before trying it in real life.
- Limited “sick role”: Parents and teen learn that depression lowers energy and concentration. The teen is expected to keep up with school and activities, but with realistic goals while recovering.
Family-based IPT for younger children
Children aged about 7 to 12 often cannot change family patterns on their own. Family-based IPT (FB-IPT), developed by Laura Dietz and colleagues, combines individual sessions for the child with joint parent-child sessions. Parents learn how depression shows up in children (irritability, withdrawal, stomachaches, loss of interest in play), how to respond to conflict without escalating it and how to support the child’s friendships. A randomized trial found that children in FB-IPT had better improvement in depressive symptoms and social functioning than children in a supportive, child-centered therapy.
IPT compared with CBT
Cognitive behavioral therapy (CBT) is the other main evidence-based talk therapy for youth depression. Both are short-term and structured. The difference is where they look for change.
| IPT-A | CBT | |
|---|---|---|
| Main focus | Relationships and life events that affect mood | Thoughts and behaviors that keep low mood going |
| Typical tools | Communication analysis, role play, interpersonal inventory | Thought records, cognitive restructuring, activity scheduling |
| Homework | Trying new ways to talk with specific people | Worksheets, planned activities, practice exercises |
| Often a good fit when | Conflict, loss or a big change triggered the depression | Negative thinking and withdrawal dominate the picture |
Neither is “better” for every teen. Availability of a trained therapist, the teen’s preference and the main problem usually decide. Learn more about the cognitive approach in cognitive therapy for children, and about how pediatricians manage teen depression in our overview of the GLAD-PC guidelines.
Choosing a therapist
A good match between child and therapist strongly affects whether therapy works. Some children open up more easily to a male therapist, others to a female therapist, and that preference is worth respecting. Practical steps:
- Ask your pediatrician or school counselor for referrals to therapists who treat children or adolescents.
- Check whether the therapist has specific training in IPT-A or FB-IPT. Many therapists use “interpersonal” loosely; formal training follows the Mufson manual.
- Contact university training clinics and community mental health centers, which often offer evidence-based therapy at lower cost.
- Ask how parents will be involved, how progress is measured and what happens if the child does not improve after several weeks.
How parents can help between sessions
- Keep appointments consistent. Missed sessions slow progress, and children may slip back into old patterns.
- Support practice. If your teen is working on a conversation with you, make time for it and listen without interrupting.
- Notice effort. Praise specific steps: “You told me calmly that you were upset. That helped.”
- Keep routines steady. Regular sleep, meals and activity help mood.
- Don’t mistake quiet for recovery. A calmer week is progress, but skills take time to become habits. Finish the planned course.
- Watch for warning signs such as talk of death, giving away belongings or self-harm, and contact the therapist right away.
If a child is in crisis, call or text 988, the Suicide and Crisis Lifeline, or call 911 in an emergency.
Frequently Asked Questions
How long does interpersonal therapy take?
IPT-A is usually about 12 weekly sessions. Some teens need booster sessions afterward, especially if new conflicts or changes arise.
Will I be part of my teen’s therapy?
Usually yes, especially at the start and end. In the middle phase most sessions are one-on-one, and the therapist may ask parents to join for specific conversations.
Can IPT be combined with medication?
Yes. For moderate to severe depression, a doctor may recommend therapy together with an antidepressant. Read more about the safety of antidepressants in childhood depression.
What if my child doesn’t want to talk?
Many children are reluctant at first. A therapist trained in IPT starts with concrete, present-day events rather than deep feelings, which often makes it easier to begin.
This article is general information and does not replace an evaluation by a pediatrician or a licensed mental health professional.
