Think Effectively About Mood Swings (TEAMS): a case series of cognitive-behavioural therapy for bipolar disorders

An integrative cognitive model for bipolar disorder proposes that multiple and extreme appraisals of changes in internal state and their reciprocal impact on behaviour, physiology and the environment provide the core mechanism in maintaining and escalating bipolar symptoms (Mansell, Morrison, Reid, Lowens, & Tai, 2007a).

A case series of cognitive-behavioural therapy (CBT) based on this model, known as the TEAMS approach (Think Effectively About Mood Swings), with seven participants was conducted. An A-B direct replication design with multiple baseline and follow-up assessments at one, three and six months was used. Treatment involved 12 sessions of CBT with an emphasis on addressing extreme positive and negative appraisals of internal state change.

Improvements were reported for symptoms, functioning, cognitions and self-critical processes with large effect sizes on a range of measures, especially depression, at end of therapy and one-month follow-up. Five participants also showed clinically significant change in depression at both time-points.

This study provides preliminary evidence for the feasibility, acceptability and efficacy of CBT based on this model which warrants further evaluation.