Study: Child & Family Focused CBT Improves Symptoms of Pediatric Bipolar Disorder

From Psychiatric News Alert. A form of cognitive behavior therapy that involves the child with the family may be efficacious in reducing acute mood symptoms and improving long-term psychosocial functioning among children with bipolar disorder, according to a report appearing online in the Journal of the American Academy of Child and Adolescent Psychiatry.

Previous studies have found that family-based psychosocial treatments are effective adjuncts to pharmacotherapy among adults and adolescents with bipolar disorder (BD).

Amy E. West, Ph.D., of the University of Illinois-Chicago, and colleagues, randomly assigned 69 youth, aged 7 to 13 with bipolar I, II, or not otherwise specified (NOS) disorder (according to DSM-IV-TR) to either child and family focused CBT (CCF-CBT) or standard psychotherapy. CFF-CBT integrates principles of family-focused therapy with those of CBT and actively engages parents and children.

Both treatments consisted of 12 weekly sessions followed by six monthly booster sessions delivered over nine months. Independent evaluators assessed participants at baseline, week 4, week 8, week 12 (post-treatment), and week 39 (six-month follow-up).

They found that the CFF-CBT participants attended more sessions, were less likely to drop out, and reported greater satisfaction with treatment than controls. CFF-CBT demonstrated efficacy compared with standard psychotherapy in reducing parent-reported mania at post-treatment and depression symptoms at post-treatment and follow-up. Global functioning did not differ at post-treatment but was higher among CFF-CBT participants at follow-up.

For more on bipolar disorder in adolescents, see the Psychiatric News article “Link Found Between Glutamate, Adolescent Bipolar Disorder.

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What is Psychotherapy?

Psychotherapy, or “talk therapy”, is a way to treat people with a mental disorder by helping them understand their illness. It teaches people strategies and gives them tools to deal with stress and unhealthy thoughts and behaviors.

Psychotherapy helps patients manage their symptoms better and function at their best in everyday life.

Psychotherapy alone may be the best treatment for a person, depending on the illness and its severity. Other times, psychotherapy is combined with medications. Therapists work with an individual or families to devise an appropriate treatment plan.

There are many kinds of psychotherapies. There is no “one size fits all.”

What is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy (CBT) is a blend of two therapies: cognitive therapy (CT) and behavioral therapy. CT was developed by psychotherapist Aaron Beck, M.D. in the 1960’s. CT focuses on a person’s thoughts and beliefs, and how they influence a person’s mood and actions, and aims to change a person’s thinking to be more adaptive and healthy. Behavioral therapy focused on a person’s actions and aims to change unhealthy behavior patterns.

CBT helps a person focus on his or her current problems and how to solve them. Both patient and therapist need to be actively involved in this process. The therapist helps the patient learn how to identify distorted or unhelpful thinking patterns recognize and change inaccurate beliefs, related to others in more positive ways, and change behaviors accordingly.

CBT can be applied and adapted to many conditions, including depression, bipolar disorder, Anxiety disorders, eating disorders, schizophrenia and schizoaffective disorder. For instance, people with bipolar disorder usually need to take medication, such as a mood stabilizer. But CBT is often used as an added treatment. The medication can help stabilize a person’s mood so that he or she is receptive to psychotherapy and can get the most out of it. CBT can help a person cope with bipolar symptoms and learn to recognize when a mood shift is about to occur. CBT also helps a person with bipolar disorder stick with a treatment plan to reduce the chances of relapse (e.g., when symptoms return).

With schizophrenia, the disorder generally requires medication first. But research has shown that CBT, as an add-on to medication, can help a patient cope with schizophrenia, helping patients learn more adaptive and realistic interpretations of events. Patients are also taught various coping techniques for dealing with “voices” or other hallucinations. They learn how to identify what triggers episodes of the illness, which can prevent or reduce the chances of relapse. CBT for schizophrenia also stresses skill-oriented therapies. Patients learn skills to cope with life’s challenges. The therapist teaches social, daily functioning, and problem-solving skills. This can help patients with schizophrenia minimize the types of stress that can lead to outbursts and hospitalizations.

CBT for schizoaffective treatment shares elements of each of the foregoing. Over the past two decades, CBT for schizophrenia and schizoaffective disorder has received considerable attention in the United Kingdom and elsewhere abroad. While this treatment continues to develop in the United States, the results from studies in the United Kingdom and other countries have encouraged therapists in the U.S. to incorporate this treatment into their own practices. In this treatment, often referred to as cognitive behavioral therapy for psychosis (CBT-P).

For more information, see the National Institute for Mental Health Site and NAMI.

From: National Institute of Mental Health and NAMI National.