Bipolar Disorder: A Family-focused Treatment Approach
| Manual Title |
Bipolar Disorder: A Family-focused Treatment Approach |
| Creator |
David Miklowitz, Ph.D. |
| Reference |
Miklowitz, D. J., & Goldstein, M. J. (1997). Bipolar Disorder:
A family-focused treatment approach. New York: Guilford.
|
| Price |
$38.00 |
| Contact Information: |
David Miklowitz, Ph.D.
University of Colorado
Department of Psychology
CB 345
Boulder, CO 80309
Phone: (303)492-8575
Email: miklow@psych.colorado.edu
|
Program Overview:
Theoretical Orientation:
Miklowitz's program is an adaptation and extension of Falloon's behavioral
family therapy (originally focused on schizophrenia - see Falloon's
1984 book) to bipolar disorder.
Goals:
- Assist the patient & family to integrate experiences associated with bipolar episodes
- Accept the awareness of vulnerability to future episodes
- Accept dependency on psychotropic medications to control symptoms
- Distinguish between the patient's personality & his/her bipolar symptoms
- Recognize and learn to cope with stressful life events that may rigger recurrences of the disorder
- Help the family to re-establish functional relationships after a manic or depressive episode
Phases of Treatment:
- Initial functional assessment
- Psychoeducation for patient & family (disease symptoms, etiology, treatment, relapse planning, etc.) [~7 sessions]
- Communication skills training [7-10 sessions]
- Problem-solving training [4-5 sessions]
Setting:
Research has been conducted in clinic-based as well as home-based family sessions. Patients are included.
Frequency / Duration:
Decreasing frequency of sessions (21 sessions in all)
9-month duration
Research:
Miklowitz, Simoneau et al. (2000) and Miklowitz, George et al
(2003):
- Method: Randomly assigned 101 bipolar I patients (outpatients
from several sites in Colorado) to either 21 sessions of in-home
FFT or comparison treatment (2 family education sessions & follow-up
crisis management); both treatments were 9 months long
- Results: 2-year effects: FFT patients had fewer relapses (35%
relapsed in FFT vs 54% in control group) & longer delays before
relapses during the 2 study years than control group. Also, FFT patients
had greater improvement in depressive symptoms, lower mean levels
of manic symptoms, and better medication adherence.
Simoneau, Miklowitz et al. (1999):
- Method:Randomly assigned patients with bipolar I disorder
to 9-months of family-focused therapy (FFT) or crisis management
with natural follow up
- Results: 1-year effects: Patients & relatives who had
FFT showed more positive nonverbal (not verbal) interactional
behavior than patients in control group; however, no decrease in
negative communication behaviors in either group. Patients who showed
improvements in positive nonverbal interactional behavior showed
the greatest reductions in symptoms over a 1-year pre/post-treatment
interval.
Rea et al. (in press):
- Method: Randomly assigned 53 outpatient bipolar I patients
to 21 sessions of clinic-based FFT and medication or 21 sessions
of an educational, supportive individual therapy for bipolar disorder,
also with medication. Patients were followed over a 1-year period
of active treatment and at 1-year post-treatment interval.
- Results: Patients in FFT had longer delays prior to re-hospitalization
or relapse than patients in individual therapy. Rates of re-hospitalization
during a 1-year post-treatment were 12% in FFT and 60% in the individual
therapy condition.
Note: Above description reviewed and approved by Dr. Miklowitz, 12-18-02
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