Psychosocial Treatment of Bipolar Disorder: Clinician Knowledge, Common Approaches, and Barriers to Effective Treatment.
OBJECTIVE
Nonphysician mental health clinicians were surveyed to understand their knowledge about bipolar disorder, treatment approaches, and perceived barriers to optimal treatment.


METHODS
Nonphysician mental health clinicians (N=55) from five community mental health clinics reported on their therapeutic approach, knowledge, and skill related to treatment of bipolar disorder. Chi square and t tests were used to detect differences in responses by clinician characteristics.


RESULTS
Most clinicians wished to improve their treatment for bipolar disorder. They felt best prepared to provide counseling and least prepared to identify medication side effects. Among psychotherapies, CBT was the most familiar to clinicians. Although knowledgeable overall about bipolar disorder, the clinicians were less knowledgeable about pharmacotherapy. The most commonly reported treatment barrier was comorbid substance use disorders.


CONCLUSIONS
Clinicians would benefit from additional training in effective therapeutic approaches for bipolar disorder as well as information about pharmacotherapy and supporting individuals with comorbid substance use problems.
Dr. Stein, Ms. Celedonia, Ms. Burns, and Mr. Sorbero are with the RAND Corporation, Pittsburgh, Pennsylvania (e-mail: stein@rand.org ). Dr. Stein is also with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, where Dr. Swartz and Dr. Frank are affiliated. Ms. Brindley is with Northwestern Human Services, Harrisburg, Pennsylvania.
Bradley D
BD
Stein
Dr. Stein, Ms. Celedonia, Ms. Burns, and Mr. Sorbero are with the RAND Corporation, Pittsburgh, Pennsylvania (e-mail: stein@rand.org ). Dr. Stein is also with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, where Dr. Swartz and Dr. Frank are affiliated. Ms. Brindley is with Northwestern Human Services, Harrisburg, Pennsylvania.
Karen L
KL
Celedonia
Dr. Stein, Ms. Celedonia, Ms. Burns, and Mr. Sorbero are with the RAND Corporation, Pittsburgh, Pennsylvania (e-mail: stein@rand.org ). Dr. Stein is also with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, where Dr. Swartz and Dr. Frank are affiliated. Ms. Brindley is with Northwestern Human Services, Harrisburg, Pennsylvania.
Holly A
HA
Swartz
Dr. Stein, Ms. Celedonia, Ms. Burns, and Mr. Sorbero are with the RAND Corporation, Pittsburgh, Pennsylvania (e-mail: stein@rand.org ). Dr. Stein is also with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, where Dr. Swartz and Dr. Frank are affiliated. Ms. Brindley is with Northwestern Human Services, Harrisburg, Pennsylvania.
Rachel M
RM
Burns
Dr. Stein, Ms. Celedonia, Ms. Burns, and Mr. Sorbero are with the RAND Corporation, Pittsburgh, Pennsylvania (e-mail: stein@rand.org ). Dr. Stein is also with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, where Dr. Swartz and Dr. Frank are affiliated. Ms. Brindley is with Northwestern Human Services, Harrisburg, Pennsylvania.
Mark J
MJ
Sorbero
Dr. Stein, Ms. Celedonia, Ms. Burns, and Mr. Sorbero are with the RAND Corporation, Pittsburgh, Pennsylvania (e-mail: stein@rand.org ). Dr. Stein is also with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, where Dr. Swartz and Dr. Frank are affiliated. Ms. Brindley is with Northwestern Human Services, Harrisburg, Pennsylvania.
Rayni A
RA
Brindley
Dr. Stein, Ms. Celedonia, Ms. Burns, and Mr. Sorbero are with the RAND Corporation, Pittsburgh, Pennsylvania (e-mail: stein@rand.org ). Dr. Stein is also with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, where Dr. Swartz and Dr. Frank are affiliated. Ms. Brindley is with Northwestern Human Services, Harrisburg, Pennsylvania.
Ellen
E
Frank
D001714:Bipolar Disorder / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D002648:Child; D002983:Clinical Competence / Q000706:statistics & numerical data*; D015928:Cognitive Behavioral Therapy; D003155:Community Mental Health Centers; D003376:Counseling / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D019966:Substance-Related Disorders / Q000150:complications