			Home About us Contact

Psychosocial Treatments (psychosocial + treatment)

Distribution by Scientific Domains

Medical Sciences	67%
Psychology	32%

Selected Abstracts

[Commentary] MATCHING CLIENTS TO PSYCHOSOCIAL TREATMENTS: AT THE CUSP OF HOPE AND EVIDENCE?

ADDICTION, Issue 2 2008
JOHN W. FINNEY
No abstract is available for this article. [source]

Retention in Psychosocial Treatment of Cocaine Dependence: Predictors and Impact on Outcome

THE AMERICAN JOURNAL ON ADDICTIONS, Issue 1 2002
Lynne Siqueland Ph.D.
This report describes retention in treatment in the National Institute on Drug Abuse Collaborative Cocaine Treatment Study (CCTS), a multi-site trial of four psychosocial treatments for 487 cocaine dependent patients. Younger, African-American, and unemployed patients were retained in treatment for fewer days than their counterparts. African-American patients who lived with a partner were retained in treatment for less time than if they lived alone. Higher psychiatric severity kept men in treatment longer but put women at risk for dropping out sooner. Patients who completed the full treatment used drugs less often than patients who dropped out, but outcome did not differ at each month. Patients in the drug counseling condition stayed in treatment for fewer days than patients in psychotherapy, but they were more likely to be abstinent after dropout. Patients with higher psychiatric severity were more at risk for continuing to use drugs after dropout. [source]

Psychosocial Treatment of Depression in Older Adults with Dementia

CLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 3 2005
Linda Teri
Depression and dementia commonly coexist and are associated with higher rates of behavioral and functional problems. Caregivers of these individuals report higher levels of physical and mental distress, as well. Effective treatment, therefore, has the potential to help both the older adult and their caregiver. This article provides an overview of the current literature on treatment of depression in demented older adults, with particular emphasis on providing guidelines for evidence-based clinical care. Eleven randomized controlled clinical trials were identified following an extensive review of the literature. These studies are reviewed with particular attention to the methodological issues of most relevance to clinicians attempting to use the findings from these studies to guide their practice. Issues of particular relevance when working with this population are also addressed, including (a) for assessment,differential and coexistent diagnosis of depression in dementia, use of collateral informants, self-report and interviewer-obtained information; and b) for treatment,the need for caregiver involvement, individualizing of goals, and planning for future deterioration of cognitive function. [source]

Psychosocial treatments for people with co-occurring severe mental illness and substance misuse: systematic review

JOURNAL OF ADVANCED NURSING, Issue 2 2009
Michelle Cleary
Abstract Title.,Psychosocial treatments for people with co-occurring severe mental illness and substance misuse: systematic review. Aim., This study is a report of a systematic review to assess current evidence for the efficacy of psychosocial interventions for reducing substance use, as well as improving mental state and encouraging treatment retention, among people with dual diagnosis. Background., Substance misuse by people with a severe mental illness is common and of concern because of its many adverse consequences and lack of evidence for effective psychosocial interventions. Data sources., Several electronic databases were searched to identify studies published between January 1990 and February 2008. Additional searches were conducted by means of reference lists and contact with authors. Review methods., Results from studies using meta-analysis, randomized and non-randomized trials assessing any psychosocial intervention for people with a severe mental illness and substance misuse were included. Results., Fifty-four studies were included: one systematic review with meta-analysis, 30 randomized controlled trials and 23 non-experimental studies. Although some inconsistencies were apparent, results showed that motivational interviewing had the most quality evidence for reducing substance use over the short term and, when combined with cognitive behavioural therapy, improvements in mental state were also apparent. Cognitive behavioural therapy alone showed little consistent support. Support was found for long-term integrated residential programmes; however, the evidence is of lesser quality. Contingency management shows promise, but there were few studies assessing this intervention. Conclusion., These results indicate the importance of motivational interviewing in psychiatric settings for the reduction of substance use, at least in the short term. Further quality research should target particular diagnoses and substance use, as some interventions may work better for some subgroups. [source]

Psychosocial treatments of suicidal behaviors: A practice-friendly review

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 2 2006
Katherine Anne Comtois
Worldwide, almost a million people die by suicide each year. Intentional, nonfatal, self-inflicted injury, including both suicide attempts and acts without suicide intent, also has very high prevalence. This article provides a practice-friendly review of controlled studies of psychosocial treatments aiming to prevent suicide, attempted suicide, and nonsuicidal self-inflicted injuries. Despite relatively small sample sizes for a low-base-rate outcome such as self-inflicted injury, several psychotherapies have been found effective, including cognitive therapy, dialectical behavior therapy, problem-solving therapy, and interpersonal psychotherapy, as well as outreach interventions, such as sending caring letters. The clinical implications of the review are discussed with the goal of translating the science to service,particularly the importance of outreach and treatment of non-compliance, the assessment and management of suicide risk, and competency in effective psychotherapies. These are critical steps for clinical psychology and psychotherapists to take in their role in suicide prevention. © 2005 Wiley Periodicals, Inc. J Clin Psychol: In Session 62: 161,170, 2006. [source]

Overcoming Barriers to Increase the Contribution of Clinical Psychologists to Work With Persons With Severe Mental Illness

CLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 4 2006
David Roe
Psychosocial treatments for persons with severe mental illness (SMI) have been developing rapidly over the past decade. Despite the fact that people with SMI are often in the greatest need of care, clinical psychologists are not currently playing a major role in their treatment and are underrepresented compared to other disciplines in this area such as nursing, social work, and psychiatry. In this article, we present possible reasons for clinical psychologists' underrepresentation and discuss motivators, potential opportunities, and ways for clinical psychologists to take a greater role in the provision of services for persons with SMI. Implications for the training of clinical psychologists are discussed. [source]

Technology and innovation in the psychosocial treatment of methamphetamine use, risk and dependence

DRUG AND ALCOHOL REVIEW, Issue 3 2008
FRANCES J. KAY-LAMBKIN
Abstract Issues. The dramatic increase in methamphetamine use has led to the urgent need for high-quality, effective treatments and management strategies for methamphetamine use problems to be developed and disseminated. Although some evidence exists for the use of psychological, pharmacological and other approaches to treatment for problematic methamphetamine use, other evidence suggests that many methamphetamine users do not access these treatment options due to a range of individual and service-level barriers. Approach. A review of available research literature was undertaken to identify treatment strategies for methamphetamine users, which overcome the problems associated with treatment access for this important target group and involve technological and other innovative approaches. Key Findings. Several approaches to addressing problematic methamphetamine use have been suggested, including assertive engagement strategies, flexibility in the provision of treatment and retention strategies and use of a multi-focused intervention package, such as stepped care, perhaps including new technologies as alternatives or supplements to face-to-face-delivered treatments. No research currently exists to examine the possible benefit of these strategies for people with methamphetamine use problems. Implications. The use of stepped-care intervention packages has the potential to address many of the current challenges faced by both clinicians and clients in treating methamphetamine use problems. Conclusions. Although promising, these approaches require further attention and research effort, particularly among the specific group of methamphetamine users. [source]

Reducing sex under the influence of drugs or alcohol for patients in substance abuse treatment

ADDICTION, Issue 1 2010
Donald A. Calsyn
ABSTRACT Aims In a previous report, the effectiveness of the Real Men Are Safe (REMAS) intervention in reducing the number of unprotected sexual occasions among male drug abuse treatment patients was demonstrated. A secondary aim of REMAS was to reduce the frequency with which men engage in sex under the influence (SUI) of drugs or alcohol. Design Men in methadone maintenance (n = 173) or out-patient psychosocial treatment (n = 104) completed assessments at baseline, 3 and 6 months post-intervention. Participants The participants were assigned randomly to attend either REMAS (five sessions containing information, motivational exercises and skills training, including one session specifically targeting reducing SUI) or human immunodeficiency virus (HIV) education (HIV-Ed; one session containing HIV prevention information). SUI during the most recent sexual event served as the primary outcome in a repeated measures logistic regression model. Findings Men assigned to the REMAS condition reporting SUI at the most recent sexual event decreased from 36.8% at baseline to 25.7% at 3 months compared to a increase from 36.9% to 38.3% in the HIV-Ed condition (tintervention = ,2.16, P = 0.032). No difference between the treatment groups was evident at 6-month follow-up. At each assessment time-point, sex with a casual partner versus a regular partner, and being in methadone maintenance versus psychosocial out-patient treatment, were associated with engaging in SUI. Conclusions Overall, a motivational and skills training HIV prevention intervention designed for men was associated with greater reduction in SUI than standard HIV education at the 3-month follow-up. [source]

Are differences in guidelines for the treatment of nicotine dependence and non-nicotine dependence justified?

ADDICTION, Issue 12 2009
John R. Hughes
ABSTRACT Despite the many similarities between nicotine dependence and other drug dependences, national guidelines for their treatment differ in several respects. The recent national guideline for the treatment of nicotine dependence has (i) less emphasis on detailed assessment; (ii) less emphasis on treatment of psychiatric comorbidity; (iii) less acceptance of reduction of use as an initial treatment goal; (iv) greater emphasis on pharmacological interventions; and (v) less emphasis on psychosocial treatment than national guidelines for non-nicotine dependences. These treatment differences may occur because (i) nicotine does not cause behavioral intoxication; (ii) psychiatric comorbidity is less problematic with nicotine dependence; (iii) psychosocial problems are less severe with nicotine dependence; and (iv) available pharmacotherapies for nicotine dependence are safer, more numerous and more easily available. However, it is unclear whether these treatment differences are, in fact, justifiable because of the scarcity of empirical tests. We suggest several possible empirical tests. [source]

Principles for psychosocial treatment of personality disorder: Summary of the APA Division 12 Task Force/NASPR review

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 6 2006
Kenneth L. Critchfield
A wide variety of clinical problems and relational styles are collected under the diagnostic heading of personality disorder (PD). These disorders involve maladaptive, persistent ways of thinking, feeling, and behaving that are associated with both functional impairment and disturbed interpersonal relationships. Personality disorders are difficult to treat, and challenge a therapist's ability to intervene helpfully, in part because the maladaptive patterns can impact the therapy relationship itself. Therapeutic principles were derived by Task Force review from the small body of research conducted to date with this family of disorders and include characteristics of clients and therapists, their relationship together, and essential elements of technique. The importance of a collaborative relationship as well as a treatment that is comprehensive, empathic, patiently applied, and flexibly tailored to presenting problems are dominant themes across principles. Treatment research with PD is in its early stages and many important areas remain uncharted. The Task Force principles are here summarized in hopes of providing general guidance to clinicians working with PD, as well as to outline research needs for the area. © 2006 Wiley Periodicals, Inc. J Clin Psychol 62: 661,674, 2006. [source]

A Placebo-Controlled Randomized Clinical Trial of Naltrexone in the Context of Different Levels of Psychosocial Intervention

ALCOHOLISM, Issue 7 2008
David W. Oslin
Background:, Naltrexone is approved for the treatment of alcohol dependence when used in conjunction with a psychosocial intervention. This study was undertaken to examine the impact of 3 types of psychosocial treatment combined with either naltrexone or placebo treatment on alcohol dependency over 24 weeks of treatment: (1) Cognitive-Behavioral Therapy (CBT) + medication clinic, (2) BRENDA (an intervention promoting pharmacotherapy) + medication clinic, and (3) a medication clinic model with limited therapeutic content. Methods:, Two hundred and forty alcohol-dependent subjects were enrolled in a 24-week double-blind placebo-controlled study of naltrexone (100 mg/d). Subjects were also randomly assigned to 1 of 3 psychosocial interventions. All patients were assessed for alcohol use, medication adherence, and adverse events at regularly scheduled research visits. Results:, There was a modest main treatment effect for the psychosocial condition favoring those subjects randomized to CBT. Intent-to-treat analyses suggested that there was no overall efficacy of naltrexone and no medication by psychosocial intervention interaction. There was a relatively low level of medication adherence (50% adhered) across conditions, and this was associated with poor outcome. Conclusions:, Results from this 24-week treatment study demonstrate the importance of the psychosocial component in the treatment of alcohol dependence. Moreover, results demonstrate a substantial association between medication adherence and treatment outcomes. The findings suggest that further research is needed to determine the appropriate use of pharmacotherapy in maximizing treatment response. [source]

Variation in GABRA2 Predicts Drinking Behavior in Project MATCH Subjects

ALCOHOLISM, Issue 11 2007
Lance O. Bauer
Background:, Previous studies demonstrated, and replicated, an association between single nucleotide polymorphisms (SNPs) within the GABRA2 gene and risk for alcohol dependence. The present study examines the association of a GABRA2 SNP with another definition of alcohol involvement and with the effects of psychosocial treatment. Methods:, European-American subjects (n = 812, 73.4% male) provided DNA samples for the analysis. All were participants in Project Matching Alcoholism Treatment to Client Heterogeneity (MATCH), a multi-center randomized clinical trial evaluating the efficacy of 3 types of psychosocial treatment for alcoholism: Cognitive Behavioral Therapy (CBT), Motivational Enhancement Therapy (MET), or twelve-step facilitation (TSF). The daily probabilities of drinking and heavy drinking were estimated during the 12-week treatment and 12-month post-treatment periods. Results:, Subjects homozygous for the allele associated with low risk for alcohol dependence in previous studies had lower daily probabilities of drinking and heavy drinking in the present study. This low-risk allele was also associated with a greater difference in drinking outcomes between the treatments. In addition, it enhanced the relative superiority of TSF over CBT and MET. Population stratification was excluded as a confound using ancestry informative marker analysis. Conclusions:, The assessment of genetic vulnerability may be relevant to studies of the efficacy of psychosocial treatment: GABRA2 genotype modifies the variance in drinking and can therefore moderate power for resolving differences between treatments. [source]

Development and Validation of the Child Psychosocial Distress Screener in Burundi

AMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 3 2008
Mark J. D. Jordans MA
In non-Western countries, efficient and contextually valid methods of community screening are scarce. The present study describes the validation of a new, brief, 7-item multi-informant screener for conflict-affected children (Child Psychosocial Distress Screener; CPDS). To determine concurrent validity, the CPSD was administered to 65 children and their teachers. CPDS scores were compared with indication for psychosocial treatment based on an in-depth clinical assessment by a psychiatrist and psychologist. Construct validity was assessed by testing the measurement equivalence of the CPDS in a community sample (N = 2,240) in Burundi. The CPDS identifies indication for treatment with an accurateness of .81(sensitivity of .84; specificity of .60). Test-retest reliability of the instrument is good (.83). A robust and invariant factor structure provides evidence for the construct validity of the CPSD. The CPDS appears to be a useful multidimensional tool that measures nonspecific child psychosocial distress, detecting children with an indication for treatment. Because of brevity and the ability to be administered by nonspecialists, the CPDS can be an appropriate instrument to screen large populations of conflict-affected children. [source]

Change in post-traumatic stress symptoms following psychosocial treatment for breast cancer

PSYCHO-ONCOLOGY, Issue 8 2005
Ellen G. Levine
The diagnosis of cancer is a traumatic experience, which may result in post-traumatic stress symptoms, such as arousal, re-experiencing the diagnostic process and avoidance. Changes in post-traumatic symptoms were assessed in 181women with breast cancer who participated in either a standard support group or complementary/alternative (CAM) oriented intervention. At baseline 26 women were classified as having significant PTSD symptoms. After the 12-week sessions, significant decreases in the number of women with PTSD was seen in both interventions, however it was more evident in the Standard group where there was a 91% reduction in the number of women with PTSD versus an 80% reduction in the CAM group. For women with PTSD both groups showed significant decreases in overall PTSD symptoms and arousal. However, only the women in the Standard support group showed significant decreases in re-experiencing and avoidance symptoms. For the entire sample only women in the Standard group had significant decreases in overall PTSD, re-experiencing, and arousal. These results indicate that PTSD symptoms can be prevalent among women with breast cancer, and that while psychosocial interventions can be effective in reducing this type of distress, a support group might be more effective than a more complementary/alternative oriented intervention. Copyright © 2005 John Wiley & Sons, Ltd. [source]

Examination of Research Trends on Patient Factors in Patients with Implantable Cardioverter Defibrillators,

CLINICAL CARDIOLOGY, Issue 2 2007
Lauren A. Stutts B.S.
Abstract Background The implantable cardioverter defibrillator (ICD) is the most effective treatment available for terminating potentially life-threatening ventricular tachycardia and ventricular fibrillation and reducing the risk of mortality. Despite its established health benefits, ICD therapy is accompanied by a unique array of patient and psychological factors meriting ample research attention. The purpose of this paper is to examine research trends and results regarding patient factors in cardiac and ICD research and to discuss key areas for future research. Hypothesis: An increase in articles associated with patient factors in cardiac and ICD research will be shown over time. Methods: The Medical Subject Heading (MeSH) system in PubMed was used to index articles under a range of psychosocial headings for both cardiovascular disease and ICDs to quantify the frequency of articles published across time, the journals most frequently utilized, the most productive institutions, and the most common areas of inquiry. Results: A significant positive relationship was revealed between patient factors in cardiac research (r = 0.96, p<0.01) and ICD research (r = 0.88, p<0.01) over time. Research is limited by the small number of investigations and institutions. Of the 178 articles on patient factors in ICD research, the most frequent areas of inquiry were psychosocial treatment (70.79%), anxiety (33.15%), quality of life (32.02%), and depression (29.78%). Conclusion: Future research examining positive adjustment is warranted, especially in light of increased prophylactic ICD implantation and possible decreased treatment burden associated with decreased shocks. [source]

Psychotherapy of borderline personality disorder

ACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2009
M. C. ZanariniArticle first published online: 6 OCT 200
Objective:, Psychotherapy is considered the primary treatment for borderline personality disorder (BPD). Currently, there are four comprehensive psychosocial treatments for BPD. Two of these treatments are considered psychodynamic in nature: mentalization-based treatment and transference-focused psychotherapy. The other two are considered to be cognitive-behavioral in nature: dialectical behavioral therapy and schema-focused therapy. Method:, A review of the relevant literature was conducted. Results:, Each of these lengthy and complex psychotherapies significantly reduces the severity of borderline psychopathology or at least some aspects of it, particularly physically self-destructive acts. Conclusion:, Comprehensive, long-term psychotherapy can be a useful form of treatment for those with BPD. However, less intensive and less costly forms of treatment need to be developed. [source]

Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications

ACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2005
J. Read
Objective:, To review the research addressing the relationship of childhood trauma to psychosis and schizophrenia, and to discuss the theoretical and clinical implications. Method:, Relevant studies and previous review papers were identified via computer literature searches. Results:, Symptoms considered indicative of psychosis and schizophrenia, particularly hallucinations, are at least as strongly related to childhood abuse and neglect as many other mental health problems. Recent large-scale general population studies indicate the relationship is a causal one, with a dose-effect. Conclusion:, Several psychological and biological mechanisms by which childhood trauma increases risk for psychosis merit attention. Integration of these different levels of analysis may stimulate a more genuinely integrated bio-psycho-social model of psychosis than currently prevails. Clinical implications include the need for staff training in asking about abuse and the need to offer appropriate psychosocial treatments to patients who have been abused or neglected as children. Prevention issues are also identified. [source]

Depression and practice guidelines

HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 1 2001
John S Mcintyre
Abstract Over the past two decades there have been great advances in the understanding of depression and in the development of pharmacological agents and psychosocial treatments that have demonstrated efficacy in the treatment of this common and disabling illness. Unfortunately, this knowledge and evidence is not consistently translated into actual treatment, and depression remains undiagnosed in a large percentage of patients, and when it is accurately diagnosed, it often is suboptimally treated. The frequent failure to properly diagnose depression may be due to the continuing stigma of mental illness, the persistence of the biomedical, rather than the biopsychosocial, paradigm of illness and treatment, educational issues and the time constraints in the typical medical practice. The suboptimal treatment may be due to all of these issues plus the difficulty in changing physician behaviours even when there exists much evidence that would seem to dictate such a change. The development of a criteria-based nomenclature and the subsequent development and dissemination of evidence-based practice guidelines addresses some of these issues. Copyright © 2001 John Wiley & Sons, Ltd. [source]

Psychosocial treatments of suicidal behaviors: A practice-friendly review

Experimental analysis of specific treatment factors: Efficacy and practice implications

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 7 2005
Jeffrey M. Lohr
Interest in the empirical demonstration of the clinical efficacy of psychosocial treatments has been rekindled by societal concerns over accountability and cost effectiveness of mental health services. The result has been the identification of specific treatments for specific disorders. The prescription of treatment content should be based on the theory of therapeutic action and/or the disorder to which it is applied. The demonstration of specific treatment efficacy requires experimental evidence showing the influence of specific procedures beyond nonspecific factors of treatment. We provide an analysis of these factors and their effects in evaluating the specific efficacy of prescriptive psychosocial treatments. Experimental procedures and designs that test the validity of specific treatments are described and applied to cognitive-behavioral treatments of generalized anxiety disorder. The empirical and professional implications of specific treatment efficacy in evidence-based practice are discussed. © 2005 Wiley Periodicals, Inc. J Clin Psychol 61: 819,834, 2005. [source]

Multimodal Analgesia for Chronic Pain: Rationale and Future Directions

PAIN MEDICINE, Issue S2 2009
Charles E. Argoff MD
ABSTRACT Chronic pain is a multifaceted disease requiring multimodal treatment. Clinicians routinely employ various combinations of pharmacologic, interventional, cognitive,behavioral, rehabilitative, and other nonmedical therapies despite the paucity of robust evidence in support of such an approach. Therapies are selected consistent with the biopsychosocial model of chronic pain, reflecting the subjective nature of the pain complaint, and the myriad stressors that shape it. Elucidating mechanisms that govern normal sensation in the periphery has provided insights into the biochemical, molecular, and neuroanatomic correlates of chronic pain, an understanding of which is leading increasingly to mechanism-specific multidrug therapies. Peripheral and central neuroplastic reorganization underlying the disease of chronic pain is influenced by patient-specific emotions, cognition, and memories, further impairing function and idiosyncratically defining the illness of chronic pain. Clinical perceptions of these and related subjective elements associated with the suffering of chronic pain drive psychosocial treatments, including, among other options, relaxation therapies, coping skills development, and cognitive,behavioral therapy. Treatment selection is thus guided by comprehensive assessment of the phenomenology and inferred pathophysiology of the pain syndrome; patient goals, preferences, and expectations; behavioral, cognitive, and physical function; and level of risk. Experiential, practice-based evidence may be necessary for improving patient care, but it is insufficient; certainly, well-designed studies are needed to support therapeutic decision making. This review will discuss the biochemical basis of pain, factors that govern its severity and chronicity, and foundational elements for current and emerging multimodal treatment strategies. [source]

Research Findings on Psychotherapy of Addictive Disorders

THE AMERICAN JOURNAL ON ADDICTIONS, Issue 2003
George E. Woody M.D.
Psychoanalytically trained physicians working in methadone programs in the 1980s theorized that adding psychotherapy to addiction treatment would improve outcomes. Since then, a number of clinical studies have evaluated the effect of psychotherapy, drug counseling, and twelve-step intervention on treatment outcomes in methadone maintenance or cocaine and alcohol addiction programs. These studies have shown consistently that psychosocial treatments are helpful for patients with addictive disorders, with an effect size that ranges from mild to moderate. Major studies of psychotherapy in the treatment of addictive disorders are reviewed, and background information on psychotherapy and drug counseling is presented. [source]

Retention in Psychosocial Treatment of Cocaine Dependence: Predictors and Impact on Outcome

Practitioner Review: Psychological Management of Anxiety Disorders in Childhood

THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 8 2001
Mark R. Dadds
Many anxiety problems begin in childhood and are a common form of psychological problem that can be highly distressing and associated with a range of social impairments. Thus, skills for conceptualising, assessing, and treating childhood anxiety problems should be in the repertoire of all child mental health specialists. This paper reviews psychosocial treatments for the most common anxiety disorders in children and adolescents. Developmental models of anxiety disorders emphasise maximum risk in children with shy or inhibited temperaments who are exposed to high family anxiety and avoidance, and/or acutely distressing experiences. As children mature these temperamental and environmental experiences are internalised to low self-competence and high threat expectancy. Both individual or group-based interventions utilising cognitive-behavioural strategies to address multiple risk factors are highly efficacious and family involvement can contribute to positive outcomes. Guidelines for assessment and treatment are presented, and suggestions are made for effectively managing clinical process. [source]

Psychosocial interventions for bipolar disorder

ACTA NEUROPSYCHIATRICA, Issue 6 2009
David J. Castle
Aim: To provide a selected overview of the literature on psychosocial treatments for bipolar disorder Method: Selective literature review Results: Randomised controlled trials of psychosocial interventions in bipolar disorder fall largely into five categories, namely: psychoeducation, integrated treatments, family based therapy, cognitive behavioural therapy and interpersonal social rhythm therapy. Most studies have shown some benefit in terms of relapse prevention, but have tended to be effective for either the depressed or the manic pole, and not both. Broader outcome parameters such as quality of life have not been reported consistently. The mechanisms whereby treatments might exert their effects have not been clearly delineated. Many studies have excluded patients with bipolar II and other variants, and those with psychiatric and substance use comorbidities, reducing their generalisability. Discussion: Whilst psychosocial treatments show promise in the area of bipolar disorder, more work is required to delineate the effective elements of such interventions, and to ensure generalisability to individuals with bipolar II and other forms of bipolar disorder, as well as those with psychiatric and substance use comorbidities. Other forms of delivery, such as via the internet, deserve further exploration. [source]