Priority 9 from the Bipolar PSP

UNCERTAINTY: How effective are talking therapies such as counselling, dynamic psychotherapy and CBT? (JLA PSP Priority 9)
Overall ranking	9
JLA question ID	0041/9
Explanatory note	Not available for this PSP
Evidence	Beynon S, Soares-Weiser K, Woolacott N, Duffy S, Geddes J. Psychosocial interventions for the prevention of relapse in bipolar disorder: systematic review of controlled trials. Br J Psychiatry 2008; 192: 5–11. [Comment: 8 years old] Soares-Weiser K, Bravo Vergel Y, Beynon S et al. A systematic review and economic model of the clinical effectiveness and cost-effectiveness of interventions for preventing relapse in people with bipolar disorder. Health Technol Assess 2007; 11: iii–iv, ix–206. [Comment: 9 years old] Justo LP, Soares BG, Calil HM. Family interventions for bipolar disorder. Cochrane Database Syst Rev 2007; CD005167. [Comment: 9 years old] Gregory VL Jr. Cognitive-behavioral therapy for depression in bipolar disorder: a meta-analysis. J Evid Based Soc Work 2010;7: 269–279. [Comment: 6 years old] Szentagotai A, David D. The efficacy of cognitive-behavioral therapy in bipolar disorder: a quantitative meta-analysis. J Clin Psychiatry 2010; 71: 66–72. [Comment: 6 years old] Lynch D, Laws KR, McKenna PJ. Cognitive behavioural therapy for major psychiatric disorder: does it really work? A meta-analytical review of well-controlled trials. Psychol Med 2010; 40: 9–24. [Comment: 6 years old]
Health Research Classification System category	Mental Health

Extra information provided by this PSP
Original uncertainty examples	For full examples, see Category ID T11 on spreadsheet. Can CBT help with recovery from bipolar disorder? ~ Are there any other psychological therapies which might help people with bipolar disorder prevent relapses, move towards recovery and manage symptoms e.g. third wave psychological therapies such as schema therapy (focused more on unmet needs, role of early beliefs and using more experiential techniques such as imagery rescripting and chair work)? ~ Can any treatments (preferably psychosocial) be developed to help prevent the ascent into hypomanic or manic episodes? This would seem an urgent priority, linked to significant distress, relapse and significant costs of inpatient hospitalisation associated with such manic episodes. Interventions which could be used "in the moment" to prevent such a ascent would be of enormous value to service users/patients, family, friends and all those involved in their care. ~ How can family interventions help and do they? ~ Why do they offer CBT when bipolar sufferers have no control over how their brain works? ~ is dialectical behavioural therapy an effective treatment for bipolar? ~ How can talking therapy's work as when I'm in a eposide it's to late to talk.
Submitted by	Patients x 152 ~ Carers x 65 ~ Health Professionals x 34 ~ Others x 8

Extra information provided by this PSP

Original uncertainty examples

For full examples, see Category ID T11 on spreadsheet. Can CBT help with recovery from bipolar disorder? ~ Are there any other psychological therapies which might help people with bipolar disorder prevent relapses, move towards recovery and manage symptoms e.g. third wave psychological therapies such as schema therapy (focused more on unmet needs, role of early beliefs and using more experiential techniques such as imagery rescripting and chair work)? ~ Can any treatments (preferably psychosocial) be developed to help prevent the ascent into hypomanic or manic episodes? This would seem an urgent priority, linked to significant distress, relapse and significant costs of inpatient hospitalisation associated with such manic episodes. Interventions which could be used "in the moment" to prevent such a ascent would be of enormous value to service users/patients, family, friends and all those involved in their care. ~ How can family interventions help and do they? ~ Why do they offer CBT when bipolar sufferers have no control over how their brain works? ~ is dialectical behavioural therapy an effective treatment for bipolar? ~ How can talking therapy's work as when I'm in a eposide it's to late to talk.

Submitted by

Patients x 152 ~ Carers x 65 ~ Health Professionals x 34 ~ Others x 8

PSP information
PSP unique ID	0041
PSP name	Bipolar
Total number of uncertainties identified by this PSP.	363 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	14 June 2016