Trauma-focused psychological interventions within bipolar disorder: an examination of effectiveness and required adaptations

Abstract

There is growing research and clinical interest in the comorbidity between posttraumatic stress disorder (PTSD) and bipolar disorder; however, the significance and effectiveness of trauma-focused psychological interventions for individuals with bipolar disorder remains insufficiently explored. The first chapter of this thesis presents a systematic review that examined the efficacy of trauma-focused psychological therapies in bipolar disorder. A narrative synthesis was conducted across 11 papers. Outcomes suggest reductions in both PTSD symptoms and secondary outcomes following treatment, predominantly for eye movement desensitisation and reprocessing (EMDR) and cognitive behavioural therapy (CBT). Findings emphasise the necessity for further large-scale controlled trials.
The second chapter presents an empirical paper that explored how EMDR can be effectively conducted and adapted for trauma-focused work in individuals with bipolar disorder, using expert consensus generated through a three-round Delphi survey. A total of 71 general, phase-specific and supervisory recommended adaptations were rated as either essential or important. Maintaining client stability during treatment was identified as crucial, and the need for additional guidance for practitioners when adapting trauma-focused EMDR for individuals with bipolar disorder was advocated. These papers make important contributions to the emerging evidence base on the effectiveness of trauma-focused psychological interventions for individuals with bipolar disorder.

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Identifiers

ORCID for Leeanne Nicholls: orcid.org/0009-0000-1759-5504

ORCID for Thomas Richardson: orcid.org/0000-0002-5357-4281

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