| dc.description.abstract | Although it is still possible to encounter the view that medication is the only method of
treatment for bipolar disorder, research shows that there is a significant need for a
comprehensive and integrative approach to this complex disorder.
The current thesis firstly describes the rationale and development of a new, psychological
intervention specifically directed at bipolar disorder, and secondly reports on an
evaluation of this approach to treatment.
Using a longitudinal design with replication across 13 participants, combined with the
use of multiple case study methodology and qualitative data collection strategies, which
allowed for triangulation between multiple data sources, it is concluded that the newly
developed Therapeutic Instability Model approach to treatment had a significant and
positive impact on factors of importance when treating bipolar disorder. These factors
included hopelessness, known to be predictive of suicidal behaviour, and perceived
control over internal states, a central aspect of bipolar disorder.
As part of the evaluation, insights into which factors are important for client satisfaction
and perceived usefulness of a treatment were also gained and it is argued that these
should be borne in mind when attempting to develop interventions with high
effectiveness and low dropout from treatment.
The study further-more found positive changes occurring as a result of the intervention in
thoughts, feelings, behaviours and illness related knowledge, and began a mapping of the
participants' understanding or subjective models of their disorder's aetiology and
maintenance.
Further, two distinct patterns of change in important variables were observed during
treatment and appear to be related to the participants' general attitude to having future
episodes of mania. In relation to this, it was noted that specific interventions, such as
behavioural experiments, may be more important for outcomes of treatment for
individuals with a positive/ambivalent attitude to mania compared with individuals who
do not share this attitude to manic experiences. It was argued that these findings could
have potentially important clinical implications and a number of suggestions with regards
to further research in this, and other, areas relating to the study were finally made. | en_US |
