Abstract
Social rhythms are patterns of habitual daily behaviors that may impact the timing of the circadian system directly or indirectly through light exposure. According to the social rhythm hypothesis of depression, depressed individuals possess a vulnerability in the circadian timing system that inhibits natural recovery after disrupting life events. Social rhythm therapies (SRTs) support the implementation of regular, daily patterns of activity in order to facilitate recovery of circadian biological processes and also to improve mood. The majority of SRT research has examined interpersonal and social rhythm therapy (IPSRT) for bipolar disorder. Recent studies have examined IPSRT in inpatient settings, using alternative modes of delivery (group, combined individual and group, internet-based applications) and with brief timeframes. New forms of SRTs are developing that target mood in individuals who have experienced specific types of stressful life events. This manuscript reviews the theoretical and biological bases of SRTs and current literature on SRT outcomes.
Highlights
Social rhythm therapy (SRT) was first conceptualized and developed by Ellen Frank [1] for outpatients with bipolar disorder
Frank and colleagues [30] found that an anxiety disorder history was associated with worse response to interpersonal and social rhythm therapy (IPSRT); subset analyses from their sample suggested that panic spectrum symptoms were associated with longer times to remission [35]. These findings indicate that the type of anxiety is a potentially important moderator in IPSRT response
The specialist supportive care (SSC) was a control condition with equivalent therapy time and clinical attention as IPSRT. Both groups improved on outcome measures, but there were no differences between IPSRT and SSC on cumulative depression and social functioning at 1 year post-baseline assessment
Summary
Social rhythm therapy (SRT) was first conceptualized and developed by Ellen Frank [1] for outpatients with bipolar disorder. The social rhythm hypothesis is largely consistent with a conceptualization of bipolar disorder focusing on instability as proposed by Goodwin and Jamison [3]. Social rhythm therapies target daily activity routines with the explicit goal of changing circadian biological processes that are contributing to the maintenance of dysfunctional biological and behavioral patterns. While these therapies support behavioral change in general, the key target is the client’s behavioral pattern that occurs across multiple days. In contrast to behavioral activation, SRTs do not encourage increasing daily activities nor do they directly encourage engagement in activities that increase pleasure, mastery, or social engagement
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