title: Family-focused treatment of the suicidal bipolar patient.
abstract: OBJECTIVE
  Bipolar patients are at high risk for suicidal ideation and attempts. Suicidal behavior is correlated with poor family communication and/or high levels of intrafamilial conflict, particularly among adolescent bipolar patients. This article describes the application of family-focused therapy (FFT) as an adjunct to pharmacotherapy in the management of suicidal ideation and behavior among bipolar patients.
  
  
  METHODS
  We describe the empirical basis of FFT in studies of adult and adolescent patients. We then describe the manner by which the three modules of FFT - psychoeducation, communication skills training and problem solving - are adapted to address the clinical issues presented by suicidal bipolar adults or adolescents and their families.
  
  
  RESULTS
  Key objectives of the treatment are to help the family recognize that suicidal behavior is a part of the pathophysiology of bipolar disorder but that it is also to some extent under environmental control. Thus, the family is in a unique position to develop and help assure the success of a suicide prevention contract. A case study of an adolescent with suicidal behavior is presented.
  
  
  CONCLUSIONS
  Future research should include a focus on: (i) cross-cultural issues in suicide and bipolar disorder; and (ii) the adaptation of interventions shown to be effective in reducing suicidal behaviors in non-bipolar populations.
authors.affiliation: Department of Psychology, University of Colorado, Boulder, CO 80309-0345, USA. miklow@psych.colorado.edu
authors.forename: David J
authors.initials: DJ
authors.lastname: Miklowitz
authors.forename: Dawn O
authors.initials: DO
authors.lastname: Taylor
mesh_terms: D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology; D005196:Family Therapy / Q000379:methods*; D006801:Humans; D012307:Risk Factors; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*