CBT to Treat Bipolar

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  • Cognitive Behavioural Therapy to Treat Bipolar
    • AO2
      • SE: Lam et al (2003) found that when CBT was paired with meds rather than just meds the % of patients with depressive events was only 20% rather then 52% with just meds. Also, CBT reduced the % of patients with manic events from 32% to 18%.
        • Suggests that CBT does reduce the symptoms of bipolar disorder
        • HE: implies it doesn't work for everyone otherwise there wouldn't be any mania or depression but people are still experiencing symptoms
        • Study lacks rel: can't be sure it was CBT that caused the reduction in the %'s. Could of been a confounding V. Eg, CBT and meds group may of been on drugs more effective for themselves. The just meds group could still be going through the process of finding the right drugs.
      • Difficult to administer: requires a prof psych usually, long waiting lists, private = expensive though NHS = free, going every week for an hour can be quite disruptive though shorter than most psychotherapies
      • Can't be used against free will: optional whether they go and share their thoughts
      • Could take a couple of sessions before any progress is made: therapist needs to make sure it is the right therapy and gather a case history first. Only then can thought patterns be identified. But once dealt with strategies etc can be applied to real life immediately
      • LT solution: patient can continue to apply principles to everyday situations so there's less of a chance symptoms will return. All techniques and new thought patterns are present with the patient so as long as they carry on using the strategies then it should help them long term
      • Better alternative: drugs like lithium could be better as it is much quicker and easier to carry out. It's also a lot cheaper. Some people struggle to talk about their condition so drugs may be more appropriate.
      • Social control: patient is vunerable and therapist is in a position of power, they are telling the patient how to think or bahave to conform to societies norms and not necessarily to benefit the patient.
    • AO1
      • Many different forms including rational-emotive therapy and cognitive therapy
      • Takes place once a week/fortnight for between 5 and 20 sessions
      • Can be free through the NHS otherwise it can be between £40 and £100 per session
      • Talking therapy and short term psychotherapy
      • focuses on identifying negative, unhealthy beliefs/behaviours and replacing them with healthy ones
        • Because distorted/biased thoughts lead to problematic emotions, moods and behaviours
        • Diagrams to show negative patterns are often drawn
      • Therapists then work on changing the thoughts, feelings and beahviours
        • Reevaluate patterns and teach strategies to promote effective problem solving, plan pleasurable activities, reenter clients into situs they've been avoiding and teach strategies to manage extreme emotional reactions
      • Bipolar patients are taught that they can reduce the negative impact of it by correcting automatic thought distortions
        • Eg, when manic they may think they have endless energy and overexert themselves leading to fatigue and emotionally crashing. CBT can help them be more aware of situs where they are acting unusual and hence stopping them from potentially harmful behaviours.
      • Goals: improve functioning, recognise early warning signs, meds understanding, prevent relapse, mood charting
      • Several different forms...
        • Individual therapy (one on one with therapist)
        • Computer program
        • Group therapy with other bipolar patients
        • Self help book with exercises

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