Troubled relationships put psychiatric patients at high risk of relapse, even when they are fully compliant with medication regimens. However, cognitive interpersonal therapy (CIT) can reduce anxiety and possibly improve social skills. Tamra Rasberry, PhD, MSN, RN, Liberty University, Lynchburg, Virginia, USA, presented results of a pilot study to assess the efficacy of intensive cognitive interpersonal therapy (ICIT) in an inpatient setting.

CIT is specifically designed to address relationship conflicts and to help individuals learn how to deal with the negative emotions generated by relationship distress. Key components of CIT include assessing the client's motivation for change and addressing emotion regulation by teaching strategies to develop empathy, assertiveness, and respect. By providing motivated individuals with tools and insights to improve relationships, it reduces interpersonal anxiety and fosters self-regulation of negative emotion—an essential skill to achieve and maintain emotional health. Evidence suggests that ICIT has the potential to accrue similar benefits for inpatients.

The pseudo-experimental, pre- to posttest, non-blinded trial used a short-term ICIT approach with relationship conflict (a largely overlooked area of research) as its sole focus. Targeting known contributors to relapse (ie, criticism, hostility, and emotional overinvolvement), its primary aim was to examine whether a brief ICIT intervention could improve patients' ability to handle close relationships, increase their satisfaction with them, and decrease emotion dysregulation and destructive thought processes. A secondary aim was to provide preliminary evidence for a brief intervention for psychiatric inpatients.

Inclusion criteria included hospitalization with a psychiatric diagnosis, in-hospital availability on Saturday and Sunday, willingness to participate in ICIT or treatment as usual (TAU) groups, and agreement to be contacted after discharge for follow-up. Patients also had to be aged ≤ 64 years, with an identified and acknowledged relationship problem. Exclusion criteria were psychosis, organic brain disease, intellectual disability, and acute medical conditions.

Two groups of 20 patients were assigned to either ICIT or TAU. Data were collected through a series of tests (eg, Burns Relationship Satisfaction Scale and the Firestone Assessment of Self-Destructive Thoughts) on relationship satisfaction, emotional regulation, destructive thought processes, and relapse. One-way analysis of variance was used to perform statistical analyses. A P value < .05 was considered statistically significant.

CIT therapy sessions consisted of 6 hour-long modules presented over 2 days. A follow-up appointment took place 6 weeks after discharge. Except for one Latino patient, the ICIT group was all white, as were the TAU patients. The average age range of the ICIT group was 40 to 49 years, compared with 30 to 39 years in the TAU group.

The data showed no statistically significant differences in relationship satisfaction or emotion regulation (depression and anger scales) between the groups. The only significant difference was on the Burns Brief Mood Survey, Anxiety Scale (P=.047), indicating that the therapy may be particularly helpful for patients experiencing anxiety. Although the majority of patients in both groups had a reduction in symptoms, those in the ICIT group showed greater improvement than their peers in the TAU group.