Psychotherapy in combination with drug treatment for bipolar disorder.

There is a new movement toward delivering manualized, empirically validated psychotherapies in combination with pharmacologic maintenance in the outpatient treatment of bipolar disorder. This article describes the specific goals of psychotherapy with bipolar patients: modifying social risk factors, enhancing medication adherence, increasing the patient's and family's willingness to accept the reality of the disorder, and reducing suicidal risk. It also reviews the nature and underlying assumptions for two new psychotherapies: a family psychoeducational treatment and an individual treatment. Problems in delivering new treatments in the era of managed care, and some solutions to these problems, are also discussed.