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Questions:
8.
Psychiatric comorbidity occurs in what percentage of bipolar individuals?
9.
What are the three phases of Family Focused Therapy for bipolar disorder?
10.
What is the social zeitgeber hypothesis?
11.
What are four components of the "relapse drill" technique for family-focused treatment?
12.
How can well-meaning family members inadvertently reinforce suicidal behaviors in bipolar individuals?
13.
What are three integral tasks of Family Focused Therapy for BD?
14.
What are four unique aspects to CBT that make it particularly suitable to the treatment of BD?
15.
According to Patelis-Siotis, what is an important consideration when a BD client with a comorbid anxiety disorder reports cognitive impairment, cognitive slowing, and difficulties with memory during the recovery phase?
16.
Partial or non-adherence to longterm treatment is reported in what percentage of bipolar disorder patients?
17.
What percentage of BD patients have been reported to have a history of substance abuse?
18.
What are twelve topics that psychoeducation should include?
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Answers:
A. First, the psychoeducational nature of CBT, which promotes, monitoring and self-regulation, makes it helpful for the treatment of this severe chronic recurring disorder. Second, CBT has been shown to be effective in increasing compliance to pharmacological treatment. Third, the established effectiveness of CBT in the prevention of relapse in unipolar depression suggests that it might be useful for relapse prevention in patients diagnosed with BD. Fourth, preliminary results indicate that the interaction of cognitive style and stressful life events may predict depressive symptomatology in BD.
B. Four components are, 1. Identifying signals of increasing instability; 2. Forming a prevention plan; 3. Communication Enhancement Training; and 4. Problem solving.
C. Family Focused Therapy for bipolar disorder has evolved to be delivered to families in 3 phases. The first phase involves Psychoeducation, whereas the final 2 phases focus on
communication and problem-solving skills.
D. The 3 tasks in FFT are: (1)to encourage the patient to verbally express his or her suicidal despair, hopelessness, regrets, shame, or guilt to family members; (2)for family members to respond calmly and validate the patient’s feelings without becoming punitive, anxious, or rejecting; & (3)for the family to problem-solve about ensuring the patient’s safety.
E. Substance abuse history has been reported in around 60% of BD patients
F. Partial or non-adherence to longterm treatment is reported in up to 50% of bipolar disorder patients.
G. This hypothesis posits that unstable or disrupted daily routines lead to circadian instability and affective episodes in vulnerable individuals.
H. Psychiatric comorbidity occurs with a 25% prevalence rate of personality disorder and with anxiety disorders co-occurring in 31% to 95% of bipolar individuals.
I. Suicidal behaviors can be inadvertently reinforced by well-meaning family members who ignore a bipolar, depressed patient’s persistent complaints about feeling badly but then show excessive concern when he or she mentions suicide.
J. An important consideration during the recovery phase is whether the client’s reported cognitive symptoms are true cognitive deficits related to the illness, or medications, or both; or the perception of the individual that his or her memory and concentration were much better prior to the diagnosis of the illness.
K. recognition and acceptance of illness; identifying triggers to relapse and early signs of trouble; standardizing daily routines; dealing with friends and family and minimizing stressors; learning how to cope with mood changes; medication education; potential risks of substance use; info about self-help groups; family planning; risk of sexually transmitted diseases; info regarding resources and referral to support services; and efforts should be made to make psychoeducation understandable given the individual’s language, culture, and reading level |
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