ABSTRACT
The aims of therapy for bipolar disorder (BD) are to alleviate acute symptoms, restore psycho-social functioning, and prevent relapse and recurrence. The benefits of pharmacotherapy have dominated the literature on treatment. However, in day-to-day clinical settings, lithium prophylaxis protects only 25–50% of BD sufferers against further episodes (Dickson & Kendall, 1986) and the introduction of newer medications has not improved prognosis (Scott, 1995a). In the past two decades there has been a greater emphasis on stress diathesis models. This has led to the development of new aetiological theories of severe mental disorders that emphasise psychological aspects of vulnerability and risk and has also increased the acceptance of cognitive therapy (CT) as an adjunct to medication for individuals with treatment-resistant schizophrenia and severe and chronic depressive disorders (Scott & Wright, 1997). Research in BD has been limited, but as described later, there is evidence that CT may benefit this client group. This chapter explores current psychological models of BD. It comments on the clinical applicability of CT, and also reviews outcome research. Lastly, a case example is used to outline the basic structure of the intervention and highlight how CT may be used to address the problems typically faced by clients with BD.
