Interpersonal social rhythm therapy worksheet

What is the theory behind this Interpersonal social rhythm therapy worksheet?

This worksheet is based on the Interpersonal and Social Rhythm (ISRT) approach to therapy which primarily focuses on helping people with mood disorders. It uses techniques that teach them vital skills to manage everyday stress, adhere to medication and reduce disturbances in their social rhythms. 

The therapy emphasises that any disruptions in one’s daily routines can negatively impact the body’s ‘internal clock’ or circadian rhythm which inhibits one’s ability to cope with stressors. People with mood disorders are considered to be more vulnerable to such disruptions. 

How will the worksheet help?

This worksheet uses the Social Rhythm Metric (SRM) that helps clients keep track of their timings particularly when they go to bed and wake up, eat, go to work and make social contacts. It will help in summarising their current routines, identify the potential triggers and problem areas and set achievable targets for improvement. 

The ISRT approach has shown its effectiveness in helping clients with manic, anxiety and depressive symptoms.

How to use the worksheet?

This worksheet is to be introduced after the therapist has discussed the importance of  establishing and adhering to daily routines. 

Discuss the SRM with the client and  instruct them to keep a daily record of their timings and interaction with people for the given activities. They should also rate their mood at the end of the day using the provided rating scale

Interpersonal social rhythm therapy worksheet

Write your target time to begin these daily activities. Keep a daily record of your actual time

Record the people involved in the activity: 0 = Alone; 1 = Others present; 2 = Others actively involved; 3 = Others very stimulating

Out of bed
First contact with other person
Star work/school/volunteer/family care
To bed
Rate your mood today from -5 (very depressed) to +5 (very elated)


Frank, E., Hlastala, S., Ritenour, A., Houck, P., Tu, X. M., Monk, T. H., Mallinger, A. G., & Kupfer, D. J. (1997). Inducing lifestyle regularity in recovering bipolar disorder patients: results from the maintenance therapies in bipolar disorder protocol. Biological psychiatry, 41(12), 1165–1173.

Frank, E., Swartz, H. A., & Boland, E. (2007). Interpersonal and social rhythm therapy: an intervention addressing rhythm dysregulation in bipolar disorder. Dialogues in clinical neuroscience, 9(3), 325–332.

Monk, T. H., Flaherty, J. F., Frank, E., Hoskinson, K., & Kupfer, D. J. (1990). The Social Rhythm Metric. An instrument to quantify the daily rhythms of life. The Journal of nervous and mental disease, 178(2), 120–126.

You can download this worksheet here.

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