Service Delivery

Behavioral family treatment for patients with bipolar affective disorder.

Miklowitz et al. (1990) · Behavior modification 1990
★ The Verdict

Loosen family ABA sessions for bipolar clients and openly talk about diagnosis and meds, but still add clear home practice to make skills stick.

✓ Read this if BCBAs who see adults or teens with bipolar disorder in outpatient or home settings.
✗ Skip if Clinicians looking for controlled data or step-by-step protocols.

01Research in Context

01

What this study did

Cooper et al. (1990) wrote a case report. They showed how to tweak behavioral family management for adults with bipolar disorder.

The team loosened the usual rules. They added open talks about the diagnosis and feelings about pills.

02

What they found

The paper is descriptive. It gives no numbers, graphs, or outcome data.

It only tells clinicians how to bend the program, not whether it works.

03

How this fits with other research

Coffey et al. (2021) and Boxum et al. (2018) later showed family coaching can cut problem behavior and parent stress. They used firmer, step-by-step plans and got clear gains.

Winett et al. (1991) echo the same idea: teach skills in clinic, then add a home meeting so families use them for real. Their data prove the extra step matters.

Rojahn et al. (1994) stretch the model again. They blend cognitive talk with in-the-moment shaping of social skills, showing you can stay flexible yet still track change.

04

Why it matters

If you coach families of bipolar adults, drop the rigid script. Make space to talk about mood swings, meds, and fear. Then borrow the proven pieces: brief functional check, home practice, and live feedback. You keep the heart of ABA while honoring the chaos bipolar can bring.

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→ Action — try this Monday

Start the next family session with a five-minute check on mood and meds, then pick one skill to rehearse at home tonight.

02At a glance

Intervention
caregiver coaching
Design
case study
Population
other
Finding
not reported

03Original abstract

Techniques of behavioral family management (BFM), which have been found to be highly effective in delaying relapse for schizophrenic patients when used as adjuncts to medication maintenance, are also applicable in the outpatient treatment of recently hospitalized bipolar, manic patients. The authors describe their adaptation of the educational, communication skills training, and problem-solving skills training modules of BFM to families containing a bipolar member. The observations that families of bipolar patients are often high functioning, and that these families seem to enjoy interchanges that are highly affective and spontaneous, led to certain modifications in the original BFM approach. The authors found it necessary to be (a) more flexible and less didactic, (b) more oriented toward dealing with affect and resistance to change, and (c) more focused on the patient's and family members' feelings about labeling, stigmatization, and medication usage. Research issues relevant to testing the efficacy of this approach are also discussed.

Behavior modification, 1990 · doi:10.1177/01454455900144005