Psychotherapeutic interventions for bipolar disorder

2017 ◽  
Author(s):  
María Reinares
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Remediation ◽  
Family Intervention ◽  
Target Population ◽  
Behavioural Therapy ◽  
High Morbidity ◽  
Behaviour Therapy ◽  
Psychological Treatments ◽  
Psychotherapeutic Interventions ◽  
Cognitive Behavioural

The recurrent nature of bipolar disorder (BD), and the high morbidity and mortality associated with the illness advocate for an integrative treatment in which medication is complemented with psychological approaches. This chapter explores the role of adjunctive psychotherapy in BD. The most commonly tested psychological treatments have been cognitive-behavioural therapy, psychoeducation, interpersonal and social rhythm therapy, and family intervention. Functional remediation represents a new option for patients with functional impairment. Most findings indicate the benefits of adjunctive psychological treatments to improve the outcomes of BD. Controversial results have also been found, highlighting the need for a better identification of treatment moderators and mediators to design interventions tailored to the target population. Recently, cognitive remediation, mindfulness-based cognitive therapy, dialectical behaviour therapy, and eye movement desensitization and reprocessing have begun to be tested, as well as Internet-based psychological interventions, but it is too early to draw conclusions about their efficacy.

Psychotherapeutic interventions for the prevention of suicide re-attempts: a systematic review

2021 ◽  
pp. 1-16
Author(s):  
Thomas Sobanski ◽  
Sebastian Josfeld ◽  
Gregor Peikert ◽  
Gerd Wagner
Keyword(s):  
Systematic Review ◽  
Suicidal Behaviour ◽  
Strong Predictor ◽  
Behavioural Therapy ◽  
Behaviour Therapy ◽  
Problem Solving Therapy ◽  
Negative Results ◽  
Psychotherapeutic Interventions ◽  
Cognitive Behavioural ◽  
History Of

Abstract A history of suicide attempt (SA) is a strong predictor of future suicide re-attempts or suicide. The aim of this systematic review is to evaluate the efficacy of psychotherapeutic interventions specifically designed for the prevention of suicide re-attempts. A systematic search from 1980 to June 2020 was performed via the databases PubMed and Google Scholar. Only randomized controlled trials were included which clearly differentiated suicidal self-harm from non-suicidal self-injury in terms of intent to die. Moreover, psychotherapeutic interventions had to be focused on suicidal behaviour and the numbers of suicide re-attempts had to be used as outcome variables. By this procedure, 18 studies were identified. Statistical comparison of all studies revealed that psychotherapeutic interventions in general were significantly more efficacious than control conditions in reducing the risk of future suicidal behaviour nearly by a third. Separate analyses revealed that cognitive-behavioural therapy as well as two different psychodynamic approaches were significantly more efficacious than control conditions. Dialectical behaviour therapy and elementary problem-solving therapy were not superior to control conditions in reducing the number of SAs. However, methodological reasons may explain to some extent these negative results. Considering the great significance of suicidal behaviour, there is unquestionably an urgent need for further development of psychotherapeutic techniques for the prevention of suicide re-attempts. Based on the encouraging results of this systematic review, it can be assumed that laying the focus on suicidal episodes might be the key intervention for preventing suicide re-attempts and suicides.

scholarly journals Integrating non-drug treatments in early schizophrenia

2005 ◽  
Vol 187 (S48) ◽  
pp. s65-s71 ◽  
Author(s):  
Shôn W. Lewis ◽  
Nicolas Tarrier ◽  
Richard James Drake
Keyword(s):  
Cognitive Remediation ◽  
Behavioural Therapy ◽  
Treatment Modalities ◽  
First Episode ◽  
Psychological Interventions ◽  
Neurocognitive Deficits ◽  
Psychological Treatments ◽  
Adherence To Medication ◽  
Cognitive Behavioural ◽  
Drug Treatments

SummaryThere is a range of psychological interventions for established schizophrenia. These include family interventions, motivational interventions for substance misuse and for non-adherence to medication, cognitive remediation for neurocognitive deficits and cognitive–behavioural therapy for symptoms. Psychological interventions may explicitly target risk factors for poor outcome, such as substance use, or protective factors, such as adherence to medication, or be directed at specific symptoms or deficits. There is emerging evidence for efficacy of psychological treatments during, following and even prior to the first episode. Important areas for further study are how different treatment modalities can interact productively and patient and carer preferences for treatment. Many trials of psychological treatments have design flaws and this tends to overestimate the treatment effect.

Behavioural therapy in adolescents and adults

2018 ◽  
Author(s):  
Alexandra Philomena Lam ◽  
Alexandra Philipsen
Keyword(s):  
Social Skills Training ◽  
Psychological Treatment ◽  
Skills Training ◽  
Behavioural Therapy ◽  
Behaviour Therapy ◽  
Training Techniques ◽  
Psychotherapeutic Interventions ◽  
Cognitive Behavioural ◽  
Adolescents And Adults ◽  
Limited Scale

Many different kinds of group or individual psychotherapeutic interventions, applied to the special needs of patients with ADHD, already exist (e.g. cognitive–behavioural therapy [CBT], coaching, problem-focused therapy, meta-cognitive training, mindfulness-based interventions, psychoeducation, and dialectical behaviour therapy [DBT]-based cognitive therapy). Most of these treatments are behaviourally orientated, and are predominantly modularly structured. CBT has been investigated most frequently and is regarded as the most effective psychological treatment option. The National Institute for Health and Care Excellence guidelines recommend CBT as appropriate for adolescents with moderate impairments and for adults, i.e. if drug treatment has proved to be only partially effective or ineffective. Interventions treating adolescents with ADHD are frequently based on CBT principles, behavioural therapy approaches, and cognitive and social skills training techniques addressing the patient, parents, or teachers. Unfortunately, interventions for adolescents have been investigated on a comparatively limited scale.

scholarly journals Ethnicity and impact on the receipt of cognitive–behavioural therapy in people with psychosis or bipolar disorder: an English cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e034913
Author(s):  
Rohan Michael Morris ◽  
William Sellwood ◽  
Dawn Edge ◽  
Craig Colling ◽  
Robert Stewart ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cohort Study ◽  
Cognitive Behavioural Therapy ◽  
Secondary Care ◽  
Behavioural Therapy ◽  
Single Session ◽  
Black African ◽  
Cognitive Behavioural ◽  
Black Caribbean ◽  
To Receive

Objectives(1) To explore the role of ethnicity in receiving cognitive–behavioural therapy (CBT) for people with psychosis or bipolar disorder while adjusting for differences in risk profiles and symptom severity. (2) To assess whether context of treatment (inpatient vs community) impacts on the relationship between ethnicity and access to CBT.DesignCohort study of case register data from one catchment area (January 2007–July 2017).SettingA large secondary care provider serving an ethnically diverse population in London.ParticipantsData extracted for 30 497 records of people who had diagnoses of bipolar disorder (International Classification of Diseases (ICD) code F30-1) or psychosis (F20–F29 excluding F21). Exclusion criteria were: <15 years old, missing data and not self-defining as belonging to one of the larger ethnic groups. The sample (n=20 010) comprised the following ethnic groups: white British: n=10 393; Black Caribbean: n=5481; Black African: n=2817; Irish: n=570; and ‘South Asian’ people (consisting of Indian, Pakistani and Bangladeshi people): n=749.Outcome assessmentsORs for receipt of CBT (single session or full course) as determined via multivariable logistic regression analyses.ResultsIn models adjusted for risk and severity variables, in comparison with White British people; Black African people were less likely to receive a single session of CBT (OR 0.73, 95% CI 0.66 to 0.82, p<0.001); Black Caribbean people were less likely to receive a minimum of 16-sessions of CBT (OR 0.83, 95% CI 0.71 to 0.98, p=0.03); Black African and Black Caribbean people were significantly less likely to receive CBT while inpatients (respectively, OR 0.76, 95% CI 0.65 to 0.89, p=0.001; OR 0.83, 95% CI 0.73 to 0.94, p=0.003).ConclusionsThis study highlights disparity in receipt of CBT from a large provider of secondary care in London for Black African and Caribbean people and that the context of therapy (inpatient vs community settings) has a relationship with disparity in access to treatment.

scholarly journals Manualised Cognitive Behaviour Therapy for Anorexia Nervosa: Use of Treatment Modules in the ANTOP Study

2018 ◽  
Vol 7 (11) ◽  
pp. 398 ◽  
Author(s):  
Gaby Resmark ◽  
Brigid Kennedy ◽  
Maria Mayer ◽  
Katrin Giel ◽  
Florian Junne ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Secondary Analysis ◽  
Self Esteem ◽  
Behavioural Therapy ◽  
Behaviour Therapy ◽  
Duration Of Illness ◽  
Cognitive Behavioural ◽  
Outpatient Intervention ◽  
Cognitive Behaviour ◽  
Pros And Cons

Standardised treatment manuals facilitate therapy planning and enhance comparability for research purposes. Within the Anorexia Nervosa Treatment of Out Patients (ANTOP) study, the largest multisite outpatient intervention trial in anorexia nervosa (AN) to date, manualised enhanced cognitive-behavioural therapy (CBT-E) was offered as one treatment modality. The manual consisted of 9 modules, of which Motivation, Nutrition, Formulation and Relapse Prevention were compulsory. Homework worksheets were provided, to ensure the transfer of therapeutic improvements to daily life. This study investigated the use of modules and worksheets in order to explore practice styles of trained therapists in the treatment of AN. This secondary analysis was based on log-sheets (n = 2604) CBT-E therapists completed after each session. Frequencies of modules and worksheets used across all sessions were calculated. Relationships, such as that between use of module and duration of illness, were examined. The most commonly used module was Motivation. In patients with longer illness duration, the module Self Esteem seemed to be particularly important. The worksheet Scales, balancing the pros and cons of AN, was prioritised by therapists. The results underline the importance of motivational work in the treatment of AN, including validating the ambivalence experienced by most AN patients. With increasing duration of illness, resource-oriented elements, such as self esteem stabilisation, should be of focus.

scholarly journals Influence of age on outcome of psychological treatments in first-episode psychosis

2006 ◽  
Vol 188 (3) ◽  
pp. 250-254 ◽  
Author(s):  
Gillian Haddock ◽  
Shôn Lewis ◽  
Richard Bentall ◽  
Graham Dunn ◽  
Richard Drake ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Behavioural Therapy ◽  
First Episode ◽  
Treatment As Usual ◽  
Psychological Treatments ◽  
Treatment Providers ◽  
Cognitive Behavioural ◽  
Episode Psychosis ◽  
Supportive Counselling ◽  
Randomised Controlled

BackgroundPsychological treatments have been shown to be effective in patients with psychosis. However, the studies published to date have included participants across wide age ranges, so few conclusions can be reached about the effectiveness of such treatments in relation to age.AimsTo evaluate outcomes by age in a randomised controlled trial designed to evaluate the effectiveness of cognitive-behavioural therapy (CBT), supportive counselling and treatment as usual.MethodOutcomes were evaluated in terms of symptoms, social functioning, insight and therapeutic alliance according to age at 3- and 18-month follow-up.ResultsYounger participants responded better to supportive counselling than to treatment as usual and CBTover 3 months. Older participants responded better to CBT than to supportive counselling over 18 months. Younger participants showed a greater increase in insight after CBT compared with treatment as usual and supportive counselling, and were more difficult to engage in therapy.ConclusionsYoung people may have different needs with regard to engagement in psychological treatments. Treatment providers need to take age-specific factors into account.

Psychological Treatments and Prevention in Bipolar Disorder - Recent Developments

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
C. Kuehner
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Disorders ◽  
Behavioural Therapy ◽  
Psychological Interventions ◽  
Cognitive Behavioural ◽  
Recent Developments ◽  
Social Rhythm ◽  
Future Work ◽  
High Risk Children

This contribution provides a systematic review on recent developments in psychological interventions for bipolar disorder. The main focus of research to date has investigated the role of different psychotherapeutic approaches (cognitive behavioural therapy, family focused therapy, interpersonal and social rhythm therapy, psychoeducation) as an adjunct to pharmacotherapy for remission and relapse prevention. The review will assess efficacy and effectiveness of these interventions, their common ingredients, limitations and predictors of outcome. It will further explore the potential role of psychological interventions for primary prevention of bipolar disorders in high risk children and adolescents. Suggestions will be made for future work in these areas.

Psychotherapy and refugees

2021 ◽  
pp. 493-502
Author(s):  
Francesca Brady ◽  
Cornelius Katona ◽  
Eileen Walsh ◽  
Katy Robjant
Keyword(s):  
Psychological Treatment ◽  
Behavioural Therapy ◽  
Traumatic Experiences ◽  
Post Traumatic Stress ◽  
Model Of Care ◽  
Narrative Exposure Therapy ◽  
Psychotherapeutic Interventions ◽  
Appropriate Treatment ◽  
Cognitive Behavioural ◽  
Post Traumatic

This chapter explores effective psychotherapeutic interventions for treating post-traumatic stress disorder in adult vulnerable migrants, including cognitive behavioural therapy (CBT), eye movement desensitization and reprocessing, and narrative exposure therapy. An overview of the evidence for these treatments is discussed, as well as how these can be implemented effectively for vulnerable migrants who face ongoing instability and uncertainty, as well as multiple barriers to accessing appropriate treatment. The additional needs of vulnerable migrants are therefore also highlighted. The chapter proposes that to assist individuals effectively in recovering from their traumatic experiences, support must be offered to address these needs, alongside any psychological treatment. A service case example is presented to highlight how an integrated model of care can most effectively meet the needs of vulnerable migrants.

Psychotherapy

2019 ◽  
pp. 881-930
Author(s):  
David Semple ◽  
Roger Smyth
Keyword(s):  
Mental Disorders ◽  
Behavioural Therapy ◽  
Object Relations Theory ◽  
Behaviour Therapy ◽  
Cognitive Behavioural ◽  
History Of ◽  
Behavioural Therapies ◽  
The Individual ◽  
Background Context ◽  
Selection Of

This chapter covers the psychotherapies, a collection of treatments for mental disorders which employ language and communication as a means of producing change. It covers assessment and selection of an appropriate method for the individual patient, a history of Freud and other pioneers of psychotherapy to provide a background context, before examining different types of therapy. Briefly explaining the theory of psychotherapy, the phases of psychosexual development, and the object relations theory, it goes into detail on behavioural therapies such as cognitive behavioural therapy, interpersonal psychotherapy, dialectical behaviour therapy, and solution therapy. Counselling methods are described to aid the reader in developing their skills.

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