Personal recovery in psychological interventions for bipolar disorder : a systematic review

Objective: Psychological interventions comprise a critical aspect of treatment for bipolar disorder. However, many interventions to date have focussed on clinical recovery outcomes, such as relapse prevention, rather than preferred personal recovery outcomes of hope and a meaningful life. The aim of this review was to identify, appraise and synthesise information regarding the availability, content and efficacy of recovery-oriented psychological interventions for individuals with bipolar disorder. Methods: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Databases searched included PubMed, EMBASE, PsychINFO, CINAHL and SCOPUS. The inclusion criteria were studies that assessed a psychological intervention in participants with a diagnosis of bipolar disorder and assessed personal recovery outcomes either qualitatively or qualitatively. Results: Five articles were included from the titles assessed (N = 507). All studies (N = 5) employed recovery-focussed interventions based on principles of Cognitive Behaviour Therapy (CBT) and were quantitative designs. Two studies used online, self-paced interventions, two studies used group psychoeducation programs, and one study used individual manualised therapy. All studies found a significant improvement in personal recovery. No studies assessed personal recovery outcomes qualitatively. Conclusions: Whilst data is limited, initial evidence suggests that recovery-oriented interventions may be effective in improving personal recovery in people living with bipolar disorder. Limitation of this review include a focus on those studies that assessed personal recovery. Clinicians should consider personal recovery-orientated interventions in the treatment of bipolar disorder and further assess recovery outcomes as part of practice. KEY POINTS What is already known about this topic: Recovery-orientated programs may be helpful for people living with a mental illness. Benefits have been found in mixed psychiatric samples in a range of studies. Peer led recovery programs may also assist manage symptoms and relapse in general samples. What this topic adds: There is growing interest in developing recovery interventions for bipolar disorder specifically. This review noted that CBT studies assessing recovery outcomes found improvements. Therapists should consider the use of recovery-focussed approaches in the treatment of bipolar disorder.