Therapies

Psychosocial therapies for bipolar disorder include cognitive behavioural therapy (CBT), family therapy, and educational therapies, and combination therapies.

Cognitive behavioural therapy

What is cognitive behavioural therapy (CBT)? Psychosocial therapies such as CBT can provide a clinical adjunct to pharmacological therapy. CBT aims to generate links between patterns of thoughts, feelings and behaviours using cognitive restructuring to facilitate the understanding and management of these patterns. A variety of interventions can be labelled as CBT, but the primary approaches focus on coping strategies and problem solving skills. What is the evidence for CBT? Moderate quality evidence suggests CBT improves depression and functioning. Moderate to low quality evidence suggests CBT also improves mania and reduces relapse. April 2019

Crisis intervention

We have not found any systematic reviews on this topic that meet the Library’s inclusion criteria. Pending enough primary studies, we invite reviews on this topic to be conducted. Alternatively we will endeavour to conduct our own review to fill this gap in the Library. April 2019

Educational therapies

What are educational therapies? Educational therapies for psychiatric illnesses (psychoeducation) are targeted towards increasing a person’s knowledge about their disorder. Educational therapies aim to improve insight and understanding, promote coping and reduce stigma, increase medication adherence, enable behavioural change, and ultimately prevent relapse. Educational sessions can take place individually or in groups, with other patients or with family, and are usually incorporated into an ongoing treatment regimen in both hospital and community settings. What is the evidence for educational therapies? Moderate to low quality evidence suggests a medium-sized effect of fewer relapses to mania or depression with group psychoeducation, but…

Family intervention

What is family intervention? Family intervention involves the introduction of a patient’s immediate family into a psychosocial treatment setting. Its goals involve preventing relapse, improving the family’s relationships and understanding of the disorder as well as improving their own mental health, should that be compromised. Family interventions have a focus on psychoeducation which provides information on the disorder, medication, and treatment adherence. They can also employ cognitive and behavioural strategies to improve problem solving, communication skills, and coping, and to reduce high expressed emotion in the family unit. What is the evidence for family intervention? Moderate quality evidence suggests family…

Group therapy

What is group therapy? Group therapy refers to any psychosocial therapy that is administered in a group setting. It can include specific cognitive or behavioural therapies and is often utilised in inpatient settings. The usefulness of group therapy has been examined in the context of improving illness outcomes such as symptom severity and quality of life, medication compliance, and particularly social interaction and anxiety. What is the evidence for group therapy? Moderate to high quality evidence suggests a medium to large effect of reduced risk of any relapse with group therapies. Group therapies consisted of psychoeducation, cognitive behavioural therapy, family-focused…

Integrated care

What is integrated care? Integrated care refers to the association of multiple treatment paradigms to produce a single unified program. The idea is to deliver seamless care to the patient to ensure high treatment continuity and improve patient satisfaction. Integrated programs typically involve multi-element psychosocial therapies for mental illness. For example, integrated psychological therapy may involve a combination of cognitive training, social skills training, problem-solving training and cognitive remediation. Integrated care can also refer to the formal liaison of typically distinct services such as medical practitioners and dedicated mental health teams, or the incorporation of mental health and substance use…

Mindfulness

What is mindfulness? Mindfulness involves intentional and non-judgmental focus of one’s attention on emotions, thoughts and sensations that are occurring in the present moment. The aim is to open awareness to present experiences, whether positive or negative, allowing thoughts to come and go without reacting, and accepting oneself and the experience. What is the evidence for mindfulness? Moderate quality evidence suggests small to medium-sized improvements in depression and anxiety, but not mania, with mindfulness-based interventions in pre-post treatment assessments. However, moderate to low quality evidence suggests no differences in any symptom when mindfulness-based interventions are compared with usual treatment. April…

Peer support

We have not found any systematic reviews on this topic that meet the Library’s inclusion criteria. Pending enough primary studies, we invite reviews on this topic to be conducted. Alternatively we will endeavour to conduct our own review to fill this gap in the Library. April 2019

Shared decision making

What is shared decision making? Shared decision making aims to support people during specialist mental health treatment, encouraging them to be active in the decision making process regarding their pharmacological and psychoeducational treatment options, by keeping them informed and involved. Shared decision making interventions often utilise a decision-making tool, involving the person in the decision making process in conjunction with nursing support, ensuring that they understand the clinical problem, exploring their worries, fears and expectations, discussing potential treatment options, and ensuring the implications of these options are understood. There is also provision for opportunities to review decisions. What is the…

Social rhythms interventions

What are social rhythms interventions? The social environment can exert influence on synchronisation of circadian rhythms by entraining neurohormonal events such as cortisol and melatonin secretion. These are key components of circadian physiology, and disruptions to them can affect mood. Some people with bipolar disorder are particularly sensitive to social rhythm disruption. Circadian and sleep/wake processes can be manipulated through behavioural interventions because of their responsiveness to external cues. These behavioural interventions identify a person’s social patterns and how they affect their mood. People are then supported to establish more regular social rhythms. What is the evidence for social rhythms…

Telemental health

What is telemental health? There is a growing need to deliver low-cost treatments tailored to individual needs and delivered in a continuous way (e.g. all year long) from any location. Telemental health has the potential to meet this need. Telemental health refers to any mental health treatment that is provided electronically, either by telephone or internet such as via online health programs, or video conferencing. This type of intervention involves structured counselling and generally aims to increase medication adherence and prevent relapse. Importantly, it also removes geographic barriers to care. What is the evidence for telemental health? Moderate to low…

User-held records

We have not found any systematic reviews on this topic that meet the Library’s inclusion criteria. Pending enough primary studies, we invite reviews on this topic to be conducted. Alternatively we will endeavour to conduct our own review to fill this gap in the Library. April 2019

Vocational therapies

We have not found any systematic reviews on this topic that meet the Library’s inclusion criteria. Pending enough primary studies, we invite reviews on this topic to be conducted. Alternatively we will endeavour to conduct our own review to fill this gap in the Library. April 2019

NeuRA Libraries

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Orange - Topic summary is being compiled.
Red - Topic summary has no current systematic review available.