Bipolar Disorder: A Family-Focused Treatment Approach

The introduction of lithium in the early 1970s brought enormous relief to the suffering of bipolar patients and their families. Decades later, however, the illness continues to take a painful and pervasive toll: even patients receiving optimal medication are likely to endure multiple recurrences and to have trouble holding jobs and maintaining relationships. This cogent and practical manual by David J. Miklowitz and Michael J. Goldstein presents a complete 9-month outpatient program designed to help patients and families understand, accept, and manage the effects of bipolar disorder. The book builds upon both the late Dr. Goldstein's pioneering work with the families of schizophrenia patients and Dr. Miklowitz's extension of this work to bipolar disorder. Aimed to improve family functioning, facilitate patient willingness to follow a medication regimen, and reduce the risk and severity of relapse, this unique psychoeducational treatment approach maximizes limited time and resources and can be readily incorporated in a range of clinical settings. The book first reviews the research basis for family-focused psychoeducational treatment (FFT) and illuminates the interactive effects of family stress, life stress, and biological predisposition on recurrences of bipolar disorder. Chapters then present a clear and comprehensive framework for conducting FFT, from assessment, education, and communication and problem-solving training sessions, to crisis management and termination. Aided by numerous clinical case examples and session vignettes, clinicians learn to educate patients and family members about bipolar disorder and to address their core concerns in coming to terms with it. Specifically, the program helps families: Accept the existence of a major psychiatric disorder in a loved one. Accept the notion of vulnerability to future episodes. Work through emotional resistances to pharmacotherapy. Distinguish between the patient's personality and his or her disorder. Recognize and cope with stressors that may trigger the onset of episodes. Enhance family relationships with new communication and problem solving skills. Based on extensive research and clinical experience, this authoritative guide is an invaluable tool for therapists from any background - including psychologists, psychiatrists, marriage and family therapists, social workers, counselors, and nurses - and contains much information of relevance to patients and family members as well. FFT also has important implications for other serious psychiatric and medical conditions, making the book a useful resource for researchers. It serves as a supplementary text for advanced undergraduate and graduate-level courses.