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example, some people might find it helpful to try and identify what has caused their problems, whilst others might prefer to focus on how to make positive practical changes in their life (Drayton et al., 1998). Central to all therapies (and, some would argue, the most important ‘active ingredient’) is the establishment of a good, trusting and collaborative relationship between client and worker so that the person is able to talk and think about their experiences in a calm, supportive and non-judgmental atmosphere. This can, of course, also happen outside of a formal ‘talking treatment’, for example between a service user and his or her care manager in the context of a community mental health team. Both client and worker also need access to the information contained in this report in order to make an informed judgement about what is likely to be maintaining the problem and what is likely to help. 14.3.1.2 Information and choice: Medication As with talking therapies a range of medications are used in the treatment of bipolar disorder. Services users have the right to information about the pros, cons, side effect profiles and evidence base for any treatment they may commence. Particularly when individuals may be contemplating commencing prophylactic treatment, individuals should be encouraged and supported to ask questions about the medications and alternatives that are available. 14.3.1.3. Information and choice: Complementary therapies There is a high level of demand from service users for access to complementary therapies such as massage (Faulkner & Layzell, 2000), exercise therapy, meditation and acupuncture. Many of these therapies are effective in reducing the high levels of stress and arousal which appear to play a role in many episodes of extreme mood, and they can be very helpful. There is a good argument that they should be more widely available. 14.3.1.4 Information and choice: Self-help Many people report finding self-help groups very useful. Professionals and other workers should give their clients information about such groups. MDF the Bipolar Organisation (formerly the Manic Depression Fellowship – www.mdf.org.uk) runs a national network of self-help groups. Many groups also offer self-management training courses which help people learn to recognise early signs of depression or ‘mania’ and take active steps to manage the situation. 14.3.1.5. Information and choice: Crisis services Many people need help only occasionally when their problems become so extreme that they, or their family and friends, feel unable to cope. When friends or relatives are suggesting that help is needed, workers need to bear in mind that those making this suggestion may have coped with their friend or relative for some time, and try to understand why help is being sought now. What do the friends/relatives and the potential service-user actually feel would be helpful at this point? Is it possible to negotiate a contract of work with commonly agreed goals? There is a need for more creative responses to such situations, which build on what service users themselves say is helpful (Grey, 2007). In the past, often the only help available at such times has been admission to an acute psychiatric ward, and the only treatment has been medication. Sometimes the person has had little opportunity to talk about the reason for their admission and has been left feeling powerless

Part 5: Wider implications

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Understanding Bipolar Disorder  

This report was written by a working party of clinical psychologists who were chosen because of their particular expertise on the subject of...

Understanding Bipolar Disorder  

This report was written by a working party of clinical psychologists who were chosen because of their particular expertise on the subject of...