ABSTRACT
This chapter focuses on practicalities of providing psychological input to individuals with bipolar disorders (BP) in day-to-day clinical practice. The first and most obvious thing to state is that it is impossible for clinicians not to be psychologically important to clients with BP. There are however, three key models of psychological input-general clinical management, supportive therapy, and specific therapies (now commonly referred to as empirically supported psychotherapies). The latter are usually delivered in a course of about 20–25 sessions by trained therapists and these therapies have been the focus of a number of recent randomized controlled treatment trials (RCTs)—details of the outcomes and implications of the findings of these RCTs are discussed in Chapter 17. As such, this chapter will not review these therapies any further, but will discuss simple, basic interventions that can and should form part of a clinical management package for the many individuals with BP who are not receiving a formal course of individual, family or group psychotherapy. The approaches we describe are usually integrated within the care and treatment program in general clinical settings and are most likely to be delivered clinically by general psychiatrists or professionals working in a mental health team. The interventions are derived from the core elements of the systematic therapies. However, these brief, selected techniques are not currently the subject of formal direct empirical evaluations specifically in BP (although there is indirect evidence to support the use of these approaches), but are selected from the perspective that they represent an appropriate set of skills for all clinicians working in the field.
