Psychosocial treatment of bipolar disorders in adolescents: A proposed cognitive-behavioral intervention

Abstract

Despite the severity of bipolar disorder (BP) and the amount of attention the psychosocial treatment of BP among adults has been given (e.g., Basco & Rush, 1996 ; Miklowitz, Frank, & George, 1996 ), no published outcome study or psychosocial treatment manual to date exists for children with this disorder. Based upon what is known about the phenomenology of BP in adolescents and what has been published with regard to existing treatments and their efficacy for adults with BP and adolescents with unipolar depression, the purpose of this article is to describe a model for an empirically driven cognitive behavioral treatment for BP in adolescents. The manualized intervention described herein includes the following intervention components: psychoeducation, medication compliance, mood monitoring, anticipating stressors and problem solving, identifying and modifying unhelpful thinking, sleep regulation and relaxation, and family communication. In addition, optional modules devoted to substance abuse, social skills, anger management, and contingency management are offered. The treatment includes a 12-session acute phase of treatment, followed by a maintenance phase and biyearly “booster” sessions. The rationale for and format of each session is presented. Currently, a pilot study is under way to evaluate the preliminary efficacy of this treatment for adolescents with BP. To illustrate the treatment, we present a case study including outcome data for a 13-year-old boy with bipolar I.