Family‐Focused Therapy for Bipolar Disorder: Reflections on 30 Years of Research
Open accessAbstract
Family‐focused therapy ( FFT ) is an evidence‐based intervention for adults and children with bipolar disorder ( BD ) and their caregivers, usually given in conjunction with pharmacotherapy after an illness episode. The treatment consists of conjoint sessions of psychoeducation regarding bipolar illness, communication enhancement training, and problem‐solving skills training. This paper summarizes over 30 years of research on FFT and family processes in BD . Across eight randomized controlled trials with adults and adolescents with BD , FFT and mood‐stabilizing medications have been found to hasten recovery from mood episodes, reduce recurrences, and reduce levels of symptom severity compared to briefer forms of psychoeducation and medications over 1–2 years. Several studies indicate that the effects of FFT on symptom improvement are greater among patients with high‐expressed emotion relatives. New research focuses on FFT as an early intervention for youth at risk for BD , neuroimaging as a means of evaluating treatment mechanisms, and progress in implementing FFT in community mental health settings.
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In four RCTs, FFT demonstrated efficacy in reducing recurrence of new episodes of depression, but not mania.
“For relapse prevention, four significant RCTs of varying sizes have been conducted, delivered to a mixed audience of young adults and adolescents.95 In these studies, FFT demonstrated efficacy in reducing recurrence of new episodes of depression, but not mania.”
From Canadian Network for Mood and Anxiety Treatments ( <scp>CANMAT</scp> ) and International Society for Bipolar Disorders ( <scp>ISBD</scp> ) 2018 guidelines for the management of patients with bipolar disorder (2018) · cites this paper as [95]
The Empirical Studies of FFT section (page unavailable) reports lower relapse rates with FFT plus pharmacotherapy, supporting a general relapse-prevention benefit. It does not establish that four RCTs found reduced recurrence of depression but not mania; it also describes an adolescent trial with no difference in time to recurrence. (LLM, conf=0.84)
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- Authors
- Miklowitz, D. J., & Chung, B.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Miklowitz, David J.
- Venue
- Family Process
- Publisher
- Wiley
- Published
- 2016-07-29
- Volume
- 55
- Issue
- 3
- Pages
- 483-499
- ISSN
- 0014-7370 (ISSN-L)
- 1545-5300
- PMC
- PMC5922774
- OpenAlex
- W2482154376
- Cited by
- 243
- References
- 49
- Citations by year
- 2026: 14 · 2025: 18 · 2024: 17 · 2023: 37 · 2022: 22 · 2021: 20 · 2020: 79 · 2019: 9 · 2018: 14 · 2017: 9 · 2016: 3
- FWCI
- 1.67
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Family Process (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Mental Health
- American Foundation for Suicide Prevention
- National Institute on Minority Health and Health Disparities
- Centers for Medicare and Medicaid Services
- Patient-Centered Outcomes Research Institute
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
- Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
- Keywords
- family-focused therapy, bipolar disorder, family processes, psychoeducation, problem-solving training, relapse prevention, expressed emotion, early intervention, at-risk youth
- MeSH terms
- Adolescent, Adult, Bipolar Disorder, Child, Combined Modality Therapy, Family, Family Therapy, Female, Humans, Male, Psychotropic Drugs, Treatment Outcome, Caregivers, Young Adult
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