Interpersonal therapy (IPT): what to note at each session, with a template and an example

IPT in a few lines

Interpersonal therapy was developed by Gerald Klerman and Myrna Weissman. The first randomised trial was published in 1974. It was first designed for depression in adults, then adapted to other situations (adolescents, the perinatal period, bipolar disorder, binge eating disorder, post-traumatic stress).

Its principle is that mood and relationships influence each other in both directions. A conflict, a loss or a life change can keep a depression going, and the depression in turn damages relationships. The work therefore focuses on a current relationship difficulty, within a number of sessions set from the start.

It does not matter whether the relationship difficulty caused the episode or resulted from it. The aim is for the patient to see the link between the two, and that link is what your notes follow from one session to the next.

The most widely described format for acute depression is 12 to 16 sessions, once a week, of 45 to 50 minutes. The NICE guideline on depression in adults (NG222) describes IPT as usually 8 to 16 sessions, delivered by a practitioner trained in the method.

The three phases and what the note keeps at each one

IPT runs in three stages. The initial phase lasts three sessions at most, and the final phase takes up the last two or three.

• Initial phase (sessions 1 to 3 or so)
  • What happens. Symptom assessment, depression explained as an illness that can be treated, interpersonal inventory, choice of problem area, contract.
  • What the note keeps. Baseline score, sick role explained, inventory, formulation offered and the patient's response, contract (number of sessions, frequency).
• Middle phase
  • What happens. Work on the chosen problem area, with the strategies specific to that area.
  • What the note keeps. Relationship events since the last session, change in mood, techniques used, agreed task, session number.
• Final phase (last 2 or 3 sessions)
  • What happens. Review of progress, preparing for the separation, spotting signs of relapse, deciding what comes next.
  • What the note keeps. Comparison of scores, gains named by the patient, warning signs, proposed next step (ending, maintenance, other treatment).

The session number out of the total planned (“session 6 of 14”) deserves a fixed place at the top of every note. The time limit is part of the method, and writing it down helps you prepare for the end.

The four problem areas

At the end of the initial phase, the therapist chooses one problem area that will serve as the common thread.

• Grief
  • When it is chosen. The depressive episode is linked to the death of someone close (also called complicated grief).
  • What the notes follow. What is said about the relationship with the person who died, the emotions that come back, the return to relationships and activities.
• Interpersonal disputes (or role disputes)
  • When it is chosen. The episode is linked to a relationship in which the two people do not expect the same thing from each other.
  • What the notes follow. The stage of the dispute (renegotiation, impasse or dissolution), each person's expectations, the exchanges analysed in session, what the patient has tried.
• Role transition
  • When it is chosen. The episode follows a change in life circumstances that is hard to cope with (separation, retirement, illness, a birth, a move, job loss).
  • What the notes follow. What the patient loses and gains between the old role and the new one, the skills and support they build up.
• Interpersonal deficits
  • When it is chosen. No recent event stands out, but there is a long history of sparse or strained relationships. This area is chosen when no other focus is apparent.
  • What the notes follow. Past relationships and their repeated patterns, isolation, new contacts attempted and how they went.

In the note that closes the initial phase, write in one sentence why this problem area was chosen over another. Six weeks later, that sentence will help you judge whether the focus was the right one.

The interpersonal inventory and how to write it down

The interpersonal inventory is a structured review of the relationships that matter to the patient. It looks at the important people, those who support the patient, those the patient confides in, and the patient's way of communicating. The emphasis is on the present. It is used to choose the problem area and is best kept as a separate document that you will reread at the end.

A simple grid, one line per person

• Who. First name or initial, relationship to the patient (partner, mother, colleague, friend).
• How often they are in contact. Every day, every week, rarely, not at all any more.
• What works. What the relationship brings, in plain words.
• What gets stuck. Tensions, disappointments, what goes unsaid.
• Expectations. What the patient expects from the other person and what they think the other person expects from them.
• Recent change. What shifted in this relationship in the months before the symptoms.
• What they would like to change. In the patient's own words.

This grid is a practical suggestion, not an official tool of the method. Add a short timeline underneath that sets the onset of symptoms side by side with the relationship events of the previous months. It is often the timeline that brings the problem area to light.

The formulation and the contract, kept word for word

At the end of the initial phase, the therapist offers the patient a formulation that is brief, organised and direct. It links the diagnosis to a current relationship difficulty. The patient accepts or corrects it, and this focus guides the rest of the therapy.

Write down the formulation as you said it, then the patient's response. In the same note, write the contract. Number of sessions, frequency, length, any medication alongside. Also note that the sick role was explained. The patient has an illness that can be treated, is not to blame for it, and takes an active part in their recovery.

Linking mood and events from one session to the next

In the middle phase, each session opens with a question such as “How have things been since we last met?”. The therapist then links mood to a recent event, or an event to mood, and explores the emotionally charged exchange.

In the note, this link comes down to three items. The mood or score for the week. The key relationship event. The link the patient made, or did not make, between the two. Here is that thread over three weeks, for a fictional patient seen for a dispute with her partner.

• Session 4 of 14
  • Mood and score. Low, score 25
  • Relationship event. Argument about sharing household tasks, then two days of silence.
  • Link made by the patient. “I felt even emptier afterwards.”
• Session 5 of 14
  • Mood and score. Low, score 24
  • Relationship event. No conversation with her partner.
  • Link made by the patient. Does not make the link yet.
• Session 6 of 14
  • Mood and score. Slightly better, score 20
  • Relationship event. Asked for help with the shopping, using the sentence prepared in session.
  • Link made by the patient. “When I dare to ask, I feel less crushed.”

The techniques most often cited are communication analysis (the patient replays a conversation almost word for word), clarification, role play, and analysis of options and decisions. Simply note which one you used and what it brought out.

Which depression scale to use

In the IPT tradition, depression is measured at the start with the Hamilton scale (HAM-D), completed by the clinician, then again at regular intervals to track progress. IPT studies also use self-report questionnaires such as the Beck Depression Inventory (BDI and BDI-II).

For your notes, three rules are enough.

• Keep the same scale from start to finish, otherwise the scores cannot be compared.
• Note the name of the scale, the date and the total score. The detailed answers stay on the completed questionnaire, filed in the patient file.
• Check the terms of use of the tool you choose. Some scales are protected and their content must not be copied into your documents.

IPT session note template, ready to copy

This template is for the middle phase, which makes up most sessions. For the general framework, see our article on psychologists' session notes and the same session written in SOAP, DAP and BIRP.

• Header. Date, patient's initials, session n of N, chosen problem area.
• Mood and score. Scale used, today's score, comparison with the baseline score.
• Since the last session. Main relationship event, in the patient's words where useful.
• Link between mood and event. What the patient links, what you suggested they link.
• Work on the problem area. Technique used (analysis of an exchange, role play, analysis of options), what came out of it.
• Agreed task. What the patient will try before the next session.
• Points to watch. Suicidal thoughts (present or not, action taken), medication, any other risk factor.
• Next steps. What you will pick up next week, and what remains to be done before the final phase.

A completed example of a fictional session

Everything here is invented. Mrs L., 42, comes for a depressive episode that began after her partner moved to night shifts, with repeated arguments about how the household is run. Chosen problem area, interpersonal dispute at the impasse stage. Contract of 14 weekly sessions.

• Header. 12 March, Mrs L., session 6 of 14, interpersonal disputes (partner).
• Mood and score. Usual self-report questionnaire, score 20 compared with 27 at session 1. Says she is sleeping a little better.
• Since the last session. Asked her partner to do the Saturday shopping. He agreed without argument. “I thought he was going to criticise me for being tired.”
• Link between mood and event. Links the better weekend to this request herself. Recognises that her mood drops on the days she keeps quiet.
• Work on the problem area. Analysis of the Sunday evening exchange, replayed almost word for word. She wanted to say she feels lonely in the evenings, she said “do what you like”. Role play to phrase the request differently. The dispute seems to be moving from impasse to renegotiation.
• Agreed task. Suggest to her partner a fixed time each week to talk about organisation, using the sentence prepared in session.
• Points to watch. No suicidal thoughts reported, question asked. Antidepressant unchanged, followed by her GP.
• Next steps. Review the outcome of the conversation. Start raising the end of therapy around session 11.

The end-of-treatment note

IPT presents the ending as a passage, almost a graduation, and points out that sadness about the separation is not a depressive relapse. The therapist highlights what the patient has managed to do and prepares with them how to spot and handle future symptoms. If the depression has not improved enough, the method asks the therapist to blame the treatment rather than the patient, then to consider another form of care.

The end-of-treatment note can cover these points.

• Problem area worked on, number of sessions planned and held.
• Score at the start and score at the end, on the same scale.
• What changed in the relationship or situation worked on, in concrete facts.
• The gains as the patient puts them.
• The warning signs identified together and what the patient will do if they come back.
• The next step decided. Ending, spaced-out maintenance sessions for a patient at risk of relapse, or referral to another treatment.

It also provides the material for any letter to the patient's GP. Our end-of-therapy summary template offers a complete structure.

Mistakes that make IPT notes hard to reread

• Telling the story of the week without linking it to mood. The note turns into a diary.
• Forgetting the session number. The ending then comes as a surprise.
• Changing scale along the way. The scores can no longer be compared.
• Letting the problem area drift without writing it down. If the focus changes, note why and at which session.

For adolescents, our child and adolescent session note template covers the points specific to that age.

How Delta works

Delta is an AI assistant for mental health professionals. During the session, Delta transcribes what is said, then prepares a session report that you read through and correct. You can also dictate your observations right after the session. The report takes your specialty and your therapeutic approach into account. It is added to the patient's file. If you work in IPT, the file brings out the progress specific to that approach over the sessions, for example how mood and the relationship being worked on change from one week to the next. Delta also drafts your assessment reports, letters and certificates.

Data is hosted in France by a host certified for health data (HDS). AI processing, including transcription, runs on servers located in France. The patient's name and identifying details are pseudonymised before they reach the AI, no audio file is kept, the data is never used to train models, and it is encrypted in transit and at rest. On informing patients, see our article on consent and AI note-taking.

Frequently asked questions

Sources

• International Society of Interpersonal Psychotherapy (ISIPT), Overview of IPT
• ISIPT, Key IPT Strategies (length, inventory, problem areas, techniques, termination)
• ISIPT, Adaptations of IPT: what works for whom
• The Clinical Conduct of Interpersonal Psychotherapy, Focus (American Psychiatric Association), vol. 4, no. 2
• Mello M. F., Interpersonal therapy: a brief and focal model, Revista Brasileira de Psiquiatria, 2004
• Lavigne B. et al., Thérapie interpersonnelle (TIP) en psychiatrie de l'enfant et de l'adolescent (interpersonal therapy in child and adolescent psychiatry), L'Encéphale, 2016
• Title IV-E Prevention Services Clearinghouse, Interpersonal Psychotherapy (Weissman, Markowitz and Klerman, The Guide to Interpersonal Psychotherapy, Oxford University Press, 2018)
• NICE, Depression in adults: treatment and management (NG222), Recommendations
• HAS, Épisode dépressif caractérisé de l'adulte : prise en charge en soins de premier recours (major depressive episode in adults, primary care management), summary sheet, October 2017