by David J. Miklowitz Ph.D., Michael J. Goldstein,Ph.D.
This indispensable guide—now in a revised and updated second edition—describes how to implement FFT to help patients and family members understand bipolar disorder, communicate more effectively, solve practical problems related to the illness, and reduce the risk and severity of relapse.
Full Description:
Family-focused psychoeducational treatment (FFT) is among a very small number of psychosocial treatments that have been found to be effective in multiple studies to improve the course of bipolar disorder. This indispensable guide—now in a revised and updated second edition—describes how to implement FFT to help patients and family members understand bipolar disorder, communicate more effectively, solve practical problems related to the illness, and reduce the risk and severity of relapse. Revised throughout to incorporate the latest knowledge on the illness and its biological and psychosocial treatment, the second edition covers the treatment of adolescents as well as adults. It includes more than a dozen reproducible handouts. "The second edition of Bipolar Disorder is, like the first, a major contribution to the understanding of a common, complex, painful, and too often lethal illness. Miklowitz, one of the world's leaders in the study of psychotherapeutic treatments of bipolar illness, presents clinical and research findings in a way that will be invaluable to clinicians."
-Kay Redfield Jamison, PhD, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine "Among the first to embrace the idea that psychosocial interventions might be of value to those who suffer from bipolar disorder, Miklowitz continues to be a leader in the field....Miklowitz has added new evidence for the effectiveness of family-focused treatment for adults from a series of recently published studies. He has also added rich new material on childhood bipolar disorder and how it emerges over time within the family context, as well as more clinical material on applications for adolescents with bipolar disorder and their families. Essential reading for anyone interested in the treatment of bipolar disorder."
-Ellen Frank, PhD, Western Psychiatric Institute and Clinic
334 pages; 6 X 9
I. Bipolar Disorder and Families: Clinical and Research Background
- 1. Bipolar Disorder: Why Family Treatment?
- How is Bipolar Disorder a Family Problem?
- Why FFT?
- The Six Objectives of FFT
- The Core Assumptions and Structure of FFT
- Is FFT Helpful?
- The Organization of This BOOK
- For Whom Is The Book Intended
- A Work about Terminology?
- 2. The Nature of Bipolar Disorder and Its Impact on the Family
- Chapter Overview
- What is Bipolar Disorder?
- The Impact of the Disorder on Family Members
- The Topography of Manic and Depressive Episodes
- The Role of the Family in Differential Diagnosis
- The Variable Life Courses of Bipolar Disorder
- Developmental Presursors to Bipolar Disorder
- The Interface between Drug treatment and FFT
- Concluding Comments
- 3. Family and Social Factors in the Course of Bipolar Disorder
- Chapter Overview
- The Vulnerability - Stress Model
- Family Environmental Factors in Bipolar Disorder
- Life Events Stress
- The Vulnerability - Stress Model Revisited
- Concluding Comments
II. Conducting the Family-Focused Treatment
- 4. Planning the First Encounter
- Chapter Overview
- Who is Appropriate for FFT
- The Mechanics of FFT
- Getting Started: The Initial Contacts
- 5. The Functional Assessment
- Chapter Overview
- Assessing the History of the Patient's Disorder
- Assessing Family Interactions
- Concluding Comments
- 6. Family Psychoeducation: The Initial Sessions
- Overview of the Psychoeducation Section
- The Therapeutic Stance
- "Setting the Stage" for the Psychoeducation Module
- Introducing the Treatment Program
- Presenting the Didactic Material: Reviewing the Index Episode
- Events Leading up to the Episode: The Life Survey
- Discussing the Hospitalization Experience
- The Expected Course of Bipolar Disorder
- Concluding Comments
- 7. Family Psychoeducation: Etiology, Treatment, and Self-Management
- Chapter Overview
- The Etiology of Bipolar Disorder
- Treatment of the Disorder within the Vulnerability-Stress Model
- How the Family Can Help
- The Self-Management of bipolar Disorder
- The Relapse Drill
- Addressing Unanswered Questions
- Conclusing Comments
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8. Family Psychoeducation: Dealing with Resistances
- Chapter Overview
- Manifestations of Denial and Resistance
- Anticipating and Preempting Denial and Resistance
- The Maning of Bipolar Disorder within the Family Context
- Differing Perceptions of the Disorder as a Source of Family Conflict
- The Stigma of Bipolar Disorder within the Larger Society
- Medication Nonadherence: Its Management within the Family Context
- Concluding Comments
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9. Communication Enhancement Training: Rationale and Mechanics
- Chapter Overview
- Objectives of CET
- Why Introduce Communication Exercises at This Point in Treatment
- CET: Getting Started
- Teaching the Four Casic Communication Skills
- Concluding Comments
- 10. Communication Enhancement Training: Clinical Issues
- Chapter Overview
- The Clinical Handling of Communication Enhancement Exercises
- Problems in the generalization of Skills
- Using CET to Midify Family Dynamics
- Concluding Comments
- 11. Dealing with Family Problems
- Chapter Overview
- Problem Solving: Why at this Point in Treatment?
- What Kinds of Problems Do the families of Bipolar Patients Have?
- Conducting Problem Solving
- Dealing with Resistance
- The Problems of the Families of Bipolar Patients: Are There Good Solutions?
- Concluding Comment
- 12. Managing Crises in Family-Focused Treatment
- Chapter Overview
- General Principles for Managing Crises within FFT
- The CLinical Handling of Crisis Management Sessions
- Manic Relapses and Hospitalization
- Depressive Relapses
- The Suicidal Crisis
- Alcohol and Substance Abuse
- Other Psychiatric Crises
- Concluding Comments
- 13. Termination
- Chapter Overview
- Terminating FFT: Two Examples
- The Structure of Termination Sessions
- Reviewing the Course of Treatment
- Anticipating Future Problems
- Evaluating Future Treatment Needs
- Arranging for Follow-up Visits
- Concluding Comments
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