Psychological treatment and bipolar disorders: why psychoeducate?

The primary purpose of any treatment, whether psychological or pharmacological, should always be the curing of a disorder, or at least an improving of the symptoms. Thus, we should be very critical of those treatments that offer only improvements of secondary aspects, like quality of life, or unspecific results, like the patient's subjective evaluation of the treatment in question. The latter is especially common for psychological treatments. Thus, it can be said that most psychological treatments might be useless because, perhaps due to lack of tradition, there is a limited number of psychological treatments that are properly validated by controlled clinical trial that includes a large enough sample, a prospective design, an adequate control group, randomized assignment of groups, blind evaluation of results and a medium- to long-term follow-up of patients. To make matters worse, some studies that have a good part, if not all, of these features use very indirect measurements of effectiveness that do not make it possible to show that a specific psychological treatment significantly reduces one type of symptoms, the number of hospitalizations, etc. And in reality, strictly speaking that is really the only thing that should be important to us, at least in principle, as therapists. This does not mean that an improvement in certain non-nuclear aspects of the disorder is not important: it is, but at a level immediately below symptomatic improvement, and therefore two levels below the primary objective (“curing” the disorder, somewhat utopian for more than 90% of psychiatric disorders).