Bipolar Disorder by Robert P. Reiser

By Robert P. Reiser

The previous 10 years have noticeable a dramatic bring up of curiosity in psychosocial remedies of bipolar sickness. there's now monstrous empirical proof suggesting the effectiveness of such remedies. in spite of the fact that, this accrued details has no longer but been transferred into medical perform in lots of settings. assistance is now handy. This compact quantity brings to the practitioner a entire, evidence-based method of the therapy of bipolar affliction that's useful, simply obtainable, and will be without difficulty utilized in medical perform. This practitioner's advisor starts by means of describing the most positive aspects of bipolar disease and concerns for differential prognosis according to DSM-IV and ICD-10 standards. Following this, present theories and versions are defined, in addition to choice bushes for comparing the easiest treatments. the quantity then publications the reader via a scientific, built-in method of remedy, in response to the easiest of contemporary study. The authors describe a dependent directive treatment that also is collaborative and buyer founded. certain issues, together with dealing with suicide danger, substance misuse, and medicine non adherence, are addressed. the quantity is rounded off through the inclusion of clinically orientated instruments and pattern kinds.

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4 Need for a collaborative approach Improving adherence to treatment Use of telephone contacts Initial Phase of Treatment: Orientation and Engagement The Need for a Collaborative Approach Active engagement and collaboration with the patient is a primary key to success in treatment. Contrary to a stereotypical view of cognitive and behavioral approaches, the heart and soul of cognitive-behavioral therapy is the formation of a collaborative relationship between the therapist and patient. This overarching structure must be in place so that both the therapist and the patient can take an active role in understanding the problems that brought the individual to therapy, in defining the goals of therapy, in working to achieve those goals and in working through the termination.

Even when working within the framework of a brief therapy model oriented to skills acquisition, bipolar disorders typically require a substantial amount of clinical contact time. Presently, we recommend that at least 12–15 weekly sessions should be allotted to the skill acquisition phase, followed by four or five bimonthly sessions at a minimum. This sets the stage Typical course of therapy 38 Advances in Psychotherapy: Bipolar Disorder for the final phase, which focuses primarily on maintenance of gains and relapse prevention.

Olanzapine (Zyprexa) has proven to be effective with some treatment refractory patients. It is well tolerated, except for the problem of serious weight gain. Quetiapine (Seroquel) is a newer drug that is effective as a single medication or as an adjunct to mood stabilizers. This medication also may be an effective antidepressant. Zisprasidone (Geodon) is an atypical antipsychotic that does not result in weight gain. There is also some suggestion that Zisprasidone may have antidepressant properties, as well.

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