Best Psychotherapies for Bipolar
You’ve heard about the latest study published out of STEP-BD (large-scale multi-site clinical study on bipolar disorders) revealing clear benefits of intensive psychotherapy in treating bipolar disorder. 64% of a group who had one of three types of psychotherapy recovered from an episode, compared to 52% of a control group getting case management, and they did it an average of 110 days faster.
This study is the first to compare types of therapy for bipolar. Psychoanalysis doesn’t work for bipolar; Freud concluded that decades ago and nobody’s proved him wrong. But psychotherapy that is “…manualized, reproducible, time-limited, empirically supported, and strategically target a number of critical domains, can efficiently provide additional benefits,” said Ari Zaretsky in the abstract of a 2007 review article (free PDF).
“Intensive psychotherapy, when used as an adjunctive treatment to medication, can significantly enhance a person’s chances for recovering from depression and staying healthy over the long term,” said Dr. David Miklowitz [longtime researcher of psychosocial treatments for bipolar, including for child and adolescent sufferers with family stress]. “It should be considered a vital part of the effort to treat bipolar illness.”
Family focused therapy (FFT), developed in part by Miklowitz, involving the whole family system made for the best outcomes. But, some lack family support. Cognitive behavioural therapy (CBT), effective in treating mild to moderate unipolar depression without added medications, was also beneficial here for bipolar depression. Interpersonal and Social Rhythm Therapy (IPSRT) that focuses on stabilizing daily and nightly routines while minimizing social conflict, was helpful. FFT edged out the other two in efficacy.
Here’s some useful tips on finding a therapist, to which I would add, if you’re bipolar and interested in trying IPSRT, CBT or FFT, ask if s/he is trained in one of these specific types of psychotherapy.
“There also has to be a consciousness among clinicians that bipolar people benefit most from learning skills to cope with the disorder, rather than just generic counseling,” Miklowitz said. “Teaching patients and family members how to immediately recognize and get treatment for emerging symptoms is essential.”
Kiume, S. (2009). Best Psychotherapies for Bipolar. Psych Central. Retrieved on May 29, 2015, from http://psychcentral.com/blog/archives/2007/04/05/best-psychotherapies-for-bipolar/