title: Psychological therapies for bipolar disorder: the role of model-driven approaches to therapy integration.
abstract: OBJECTIVE
  The psychological and social aspects of bipolar disorder are receiving increasing recognition. Recently, there have been promising developments in psychological interventions, but there is scope for further improvement of therapeutic outcomes. This paper argues for the use of more detailed psychological models of bipolar disorder to inform the further development of therapeutic approaches.
  
  
  METHODS
  Evidence for psychological, family and social factors in bipolar disorder is reviewed. The efficacy of current individual and family interventions are discussed. A model, which has potential to synthesize group and individual approaches, is outlined.
  
  
  RESULTS
  Psychological, social and family factors have important influences on the onset, course and outcome of bipolar disorder. Interventions based on vulnerability stress models have proved effective. However, to enhance efficacy future developments need to be based on models that integrate current understandings of the multiple levels at which mood fluctuations occur. A particular recent model is discussed which leads to specific proposals for future intervention research.
  
  
  CONCLUSIONS
  Psychological and family approaches to BD have much potential. They clearly have a role in conjunction with appropriate pharmacological treatment. If this potential is to be fully realized future developments need to be based on psychological models that can accommodate the complexity of this illness.
authors.affiliation: Academic Division of Clinical Psychology, University of Manchester and Pennine Care Trust, Greater Manchester, UK. steven.jones@man.ac.uk
authors.forename: Steven H
authors.initials: SH
authors.lastname: Jones
authors.forename: William
authors.initials: W
authors.lastname: Sellwood
authors.forename: John
authors.initials: J
authors.lastname: McGovern
mesh_terms: D001714:Bipolar Disorder / Q000503:physiopathology / Q000628:therapy*; D001921:Brain / Q000503:physiopathology; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D019033:Delivery of Health Care, Integrated; D005190:Family / Q000523:psychology; D006801:Humans; D007398:Interpersonal Relations; D012931:Social Environment