Introduction

The use of adjunctive psychological interventions represents an important new dimension to the treatment and management of bipolar disorder and especially Bipolar II Disorder (BP II). These interventions are gradually gaining in popularity amongst clinicians who wish to develop a comprehensive management plan once depressive or hypomanic episodes have been stabilised with medication. The impetus for this new emphasis has largely been driven by the recognition that individual differences in the severity, course and outcome of the disorder over time are not fully explained by biological factors and physical treatments alone. Furthermore, there has been increasing acceptance of stress-vulnerability models which highlight interactions between psychological, social and biological factors – which in turn play a significant role in the maintenance and recurrence of several serious psychiatric illnesses, including bipolar disorder and schizophrenia. Over the last decade, interest has also shifted to psychosocial factors which affect social and occupational functioning, treatment adherence and suicidality, and which are particularly amenable to psychological interventions (American Psychiatric Association, 2002).

Much has already been written about psychological interventions for unipolar depression and there is evidence to suggest that many of these strategies may also be useful in treating the depression that accompanies bipolar disorder. Thus, this chapter will primarily focus on addressing hypomanic symptoms and on managing the phasic nature of BP II.

Psychological interventions such as self-monitoring of symptoms and mood have usually been employed during the prodrome and/or the recovery phase of an episode (Perry et al., 1999; Lam et al., 2003).