These themes were then interpreted in the light of the existing literature and an integrative cognitive model of bipolar disorder. Limitations and future research directions are discussed.

Thirty individuals with Bipolar I Disorder (16 individuals had relapsed within the last 2 years; 14 individuals had remained well over this period) were hypothesized to score higher on extreme positive and negative appraisals of internal state (HAPPI; Hypomanic Attitudes and Positive Predictions Inventory) than three control groups: remitted unipolar depression group (n = 22), and non-clinical controls with (n = 16) or without (n = 22) a history of hypomanic episodes. In partial support of the primary hypothesis, the relapsed bipolar group and the combined bipolar group scored significantly higher on the HAPPI than the unipolar group and non-clinical group when controlling for age, level of education and bipolar symptoms. It is concluded that self-reported cognitions characterize individuals with bipolar disorder, consistent with a cognitive behavioral approach to its treatment.

Objectives. To explore clients' experience of the therapy process in Motivational Interviewing (MI) for alcohol abuse. Design.A qualitative study using Grounded Theory. Methods.Interviews with nine clients were conducted using Interpersonal Process Recall (IPR), a methodology which utlises a video recording as a cue to aid memory recall. Clients watched a videotape of their MI session and were asked to identify and describe important moments in the therapy session. The transcribed interviews were then analysed using Grounded Theory. Results.A single session of MI is seen by the clients in this study as a complex interpersonal interaction between client and therapist, which impacts on the client's cognitive and affective intrapersonal processes. Conclusions.The themes which emerged partly confirm processes of motivational interviewing previously hypothesised to be important, but also highlight the importance of factors common to all therapeutic approaches. Practitioner points The aspects of therapy which clients in this study felt were important are similar to those hypothesised to underlie the effectiveness of MI, including a nonconfrontational approach, affirmation, and developing discrepancies between beliefs and behaviour.

ObjectiveThere has been growing interest in the use of cognitive analytic therapy (CAT) with those facing experiences of psychosis. However, there is little research on how CAT is best applied to working with psychosis. This study aimed to identify what the key aspects of CAT for psychosis are or whether this approach requires adaptation when applied to those with experiences of psychosis, drawing on expert opinion.MethodAn adapted Delphi methodology was used. Items were generated during an initial workshop (N = 24) and then rated for agreement or importance via an online survey by a sample of experts with experience of CAT and working clinically with psychosis (N = 14).ResultsFollowing two rounds of ratings, consensus was reached on most items. Additional comments emphasized the need to be flexible with regard to the varying needs of individual clients.ConclusionsResults highlight the specific relational understanding of psychosis provided by CAT as one of the key elements of this approach. Responses emphasized the need for some level of adaptation to work with psychosis, including greater flexibility with regard to the treatment frame.Practitioner Points When working with experiences of psychosis, aspects of the CAT model, such as session length, pacing, and duration of therapy, are open to change and may require modification.When working with experiences of psychosis, narrative reformulation letters and sequential diagrammatic reformulation (SDR) remain essential to the therapy.This Delphi methodology study essentially relies on opinion. Further empirical research could test assumptions about the most important or therapeutically effective components of CAT in psychosis.CAT is still not widely used in the context of psychosis limiting the pool of experts available for the current sample.

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