It has become clear that the benefits of cognitive therapy rests on the therapeutic relationship. The therapist has to respect the patients’ preferences and needs, even if they disagree as a trained professional. Patients, with a trust in the therapist, even when what is discussed is not what the patient wants to hear. The patient must feel comfortable telling therapists when symptoms are surfacing, and therapists must be honest when the warning signs are ignored by the patient putting them at risk of a relapse.
Effective treatment of bipolars requires a long term commitment. The therapists’ is to not only help a person overcome the symptoms of the illness and recover from the episode but also to prepare for its inevitable return. Visits include skills that are taught and reducing the symptoms. As progress is made and once the patient is stable, therapy can be reduced as the patient learns and uses the skills for bipolar living. A return of symptoms, stressful events, may indicate crisis visits. When and if therapy resumes, the therapist can help the patient pick up where they stopped. Encouraging their patients to call in when things are going well or when they have good news keeps the relationship solid. This feedback reinforces the patients trust in the therapist that they are a person not just as a disorder. This can be important when the patient is having difficulties with treatment or control of symptoms.
Psychotherapy is a stabilizing device in the lives of patients. Therapy visits are a structure utilizing time, for seeing progress, and for achieving goals helping the patient feel good about their accomplishments. Regularly scheduled sessions reporting on their progress between sessions provide opportunities for patients to take control and increasing the chance that they will complete the plans made in therapy. Most people who are not involved in psychotherapy do not regularly take the time to monitor their feelings and actions, or make time to confront personal problems and set goals for improvement.
Cognitive and affective symptoms roles in the the therapy process are important. When concentration is poor or the person is easily distracted, it is difficult to accomplish a lot in a session. If the person’s outlook is colored by depression, efforts at reviving hope must be addresses and other issues have to put aside. Mania can change a session with cognitive changes. Increased optimism especially if it comes after a depressive episode. This enthusiasm can be for the therapist who wants the patient to feel better and achieve his or her goals be overlooked as a symptom.
Cognitive therapy is a skills-oriented form of psychotherapy. Therapists use tools for helping patients to manage their moods, restructure their thinking, and cope with their problems. The people treated have managed to get along before therapy came along. They possess some skills and have learned from their experiences , they are competent, able to solve problems, and smart enough to know when to ask for help.
People who are distressed probably coped better with life at times with existing coping skills, bipolars are no different. The goal of psychotherapy is to help the patient pick up the pieces that are a result of the disorder. Once that is accomplished then the work of using daily coping skills are learned and used in leading to recovery and day by day bipolar life.
