Interpersonal Reconstructive Therapy (IRT) is an innovative and integrative approach that connects scientific knowledge from a wide range of fields, providing an in-depth explanation of the factors that give rise to mental health and mental illness.
The guidelines are founded on an attachment-based natural biological model of psychopathology enriched by Primatology, Developmental Psychology, Neuroanatomy and Chemistry. At the same time, it encompasses and integrates theory and fundamental ideas from the main schools of psychotherapy such as the humanistic, cognitive behavioural, psychodynamic and systemic.
IRT includes a case formulation model that specifically addresses each of an individual’s presenting symptoms even in complex cases (e.g. comorbid anger, anxiety, depression, disordered personality patterns). It identifies psychosocial mechanisms for an individual’s symptoms by using an attachment-based theory of affective psychopathology.
The case formulation model is used to select interventions from any known therapy approach to activate mechanisms of change to optimize outcome. This method is reliable, specific and sensitive (Critchfield and Benjamin, 2007, 2010; Critchfield, Benjamin & Levenick, 2015). Clinical observations suggest the IRT treatment model is effective with standard outpatients, while formal data from a small sample of very challenging cases (CORDS: Comorbid, Often Re-hospitalized, Dysfunctional and Suicidal) suggest that patients with IRT trainee therapists who focused more consistently on mechanisms of change in an adherent way had better outcomes.
 This strategy of testing effectiveness by relating activation of mechanisms of symptom to symptom- change presently is favoured at National Institutes of Mental Health (NIMH, 2016). One advantage of this strategy compared to Randomize Control Trial tests of effectiveness is that it provides direct rather than indirect evidence that use of the theory of change actually does relate to outcome and it also can account every individual in the sample.
Structural Analysis of Social Behaviour (SASB) is a tool that assesses interpersonal and intrapsychic behaviour
in three different dimensions, providing a lens which helps sharpen the clinician’s perception of content and
process in psychotherapy (Benjamin et al., 2006).
Interpersonal Reconstructive Therapy (IRT) uses this powerful resource to identify and clarify interactive
patterns, enhancing therapists’ ability to choose the most appropriate intervention.