Psychological Therapy For Bipolar Disorder: What Really Works?

Psychological therapy for bipolar disorders is one of the more important areas of recent research related to this frequently debilitating psychological syndrome.  However, most of the research has been done within the context of psychological therapy for bipolar disorder as an adjunct to medication management rather than as a substitute for or alternative to medication treatment.  It has been found to be effective in optimizing outcomes in the illness. Psychological therapy for bipolar disorder has usually been found to provide one or more of several roles in the management of the disorder. 

Both contemporary medication treatments and the psychological therapies have been predominantly focused on improving clinical outcome for bipolar disorder.  Under this conceptualization, psychological therapies have usually been geared toward directly addressing symptoms such as are usually found in the utilization of cognitive therapy for the treatment of depressive symptoms.  On a much less frequent basis, psychological treatments for bipolar disorder have been also geared toward reducing functional deficits.  Functional outcomes have frequently been measured in trials of various forms of psychotherapy.  A third conceptualization has been to use psychological treatments in an educational format in order to help individuals to participate more effectively in treatment.  In this regard, the treatment is oriented toward improving specific "host factors," which are factors not directly due to the disease, but have an impact on its course and treatment, through education, support and problem solving.  Host factors have been frequently found to include illness management skills, which may be improved through psychoeducation and with attention also given to building therapeutic alliances to assist in effectively managing the disease process. 

A recent evidence-based review has been done for psychological treatments for bipolar disorder. The review identified five main types of psychotherapy that have been studied: couples-partners, group interpersonal or psychoeducative, cognitive-behavioral, family, and interpersonal and social rhythms.  Several of these therapy types including couples-partners, cognitive-behavioral, and family methods all have randomized clinical trials supporting their role in improving functional clinical outcome or improving illness management skills. 

It appears that an education component focusing on early warning symptoms and triggers of episodes, as well as well developed, detailed, individual-specific action plans seem to be key components in many of these research studies.  Also, the core education agenda frequently includes various approaches such as cognitive behavioral interventions. It appears that the basis of the education is to improve disease management through a focus on basic principles such as the biological basis, environmental components, course and outcomes, setting specific treatment goals and assisting with coping skills.

Information adapted from DSM-IV-TR Mental Disorders Diagnosis, Etiology & Treatment by Michael B. First and Allan Tasman

Additional information and webpage by Paul Susic MA Licensed Psychologist Ph.D Candidate (Health Psychology)

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