The TEAMS trial has been developed from years of research studies, clinical practice, and talking to people with bipolar disorder. Follow the links below to find out more about bipolar disorder and cognitive behaviour therapy (CBT).
HOW TEAMS DEVELOPED
Traditionally, CBT for bipolar disorder has helped people to identify the signs of a mood episode and employ coping strategies to manage these signs to reduce the chance of a mood relapse. CBT is typically provided alongside medication. CBT has successfully reduced relapses; however there is a consensus that the effects are quite modest, leaving many people with problems unresolved.
Over the past few years, our research group has been involved in developing and testing a new cognitive model of bipolar disorder to guide our CBT. It is a unique model because it specifically tries to understand problematic swings in mood. It brings together information from patients with bipolar disorder from interviews and clinical practice, and integrates earlier theories about bipolar disorder within psychology.
Central to our model is the view that people have extreme and conflicting (both positive and negative) beliefs about their moods and energy levels which come from earlier experiences. This means that they are in ‘two minds’ about their moods. For example, someone with bipolar disorder may believe that “I need to be extremely active to solve all my problems and overcome my depression” which may lead them to do many things to drive their mood upwards such as being active all the time so that they sleep very little. Yet the same person may also believe that “When I am very active I make a fool of myself and get criticised” and so they then try to suppress their mood and its effects to avoid being rejected by other people for example through social withdrawal or overmedication.
Our therapy helps people to challenge how much these extreme beliefs apply to them, and see their moods as normal reactions that they can accept, tolerate and manage rather than to continue to strive hard to enhance or avoid them. Instead of putting all their efforts into the meanings of their mood, we help people to see their longer term goals in life and the balanced place that moods have in achieving them. TEAMS focuses on present problems and life goals rather than focusing on relapse prevention. The name of our CBT reflects our focus – TEAMS ñ standing for Think Effectively About Mood Swings.
We have now published over 20 academic papers testing, and generally supporting the model, so we are quite confident that it is valid. Although our work is very promising, we need to carry out further research to show that the techniques based on our model are the reason why we find improvements, and that they can last longer. Therefore, we are running a controlled trial to compare TEAMS with the usual treatment in services to see if it has significantly better outcomes, and we will be testing whether the active ingredients of our therapy are what make it effective. We are working with a patron of MDF: The Bipolar Organisation to design the study and we will also be interviewing the people who receive the therapy to get feedback on what helps and where it could be improved. In three years time, we should find out the results of our work.
At present, bipolar disorder is seen as a severe, lifelong illness. Although this may unfortunately be the case for many people with the diagnosis, our research has shown that some people can manage their moods in ways which lets them get on with a relatively normal life. Our research challenges the view that bipolar disorder is considered untreatable by talking therapy. This scientific evidence coming directly from service users themselves builds hope for others and confirms that CBT, and related talking therapies, have a valid and increasingly important role in services and in the community. Our team recognises that this theme chimes with the mission of the Charlie Waller Institute and its supporters.
Click this link to find out more about How to get involved with TEAMS.