Creating Bipolar Disorder Treatment Plan + Example

Bipolar disorder is a significant mental health condition marked by dramatic shifts in mood, energy, activity levels, and concentration. There are three types: bipolar I, bipolar II, and cyclothymic disorder. The primary distinction among these types lies in the presence and severity of manic, hypomanic, and depressive episodes.

Although the exact cause of bipolar disorder remains unknown, researchers have identified factors that may contribute to its development, such as variations in brain structure and having a first-degree relative with the disorder. Like other mental health conditions, bipolar disorder is complex and affects each person differently.

According to the National Institute of Mental Health, about 2.8% of adults in the United States experienced bipolar disorder in the past year, with rates roughly equal between men and women. Over their lifetime, 4.4% of the population will encounter bipolar disorder. The highest prevalence is among individuals aged 18 to 29, decreasing with age. More than 80% of those with bipolar disorder suffer from serious impairment due to their symptoms, while 17% experience moderate impairment. These statistics are crucial when creating a treatment plan, as individuals undergoing manic or depressive episodes may need hospitalization for crisis stabilization.

Individuals experiencing severe symptoms of bipolar disorder may find multiple areas of their lives impacted, including relationships, career or schooling, physical health, finances, self-esteem, and legal issues. Treatment for bipolar disorder typically involves a combination of psychotherapy, education, and medication.

Common therapeutic approaches for bipolar disorder include cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and interpersonal and social rhythm therapy (IPSRT). Education is a key component of treatment, as it helps individuals understand bipolar disorder, empowering them to manage their symptoms more effectively.

Medications used in the treatment of bipolar disorder include mood stabilizers, antipsychotics, antidepressants, and occasionally short-term benzodiazepines. These medications work to stabilize mood, alleviate specific symptoms of mania and depression, and reduce the recurrence of episodes, all contributing to an improved overall quality of life for the individual.

  • Sale!

    Depression Worksheets Bundle (Editable, Fillable, Printable PDFs)

    Rated 0 out of 5
    Original price was: $369.99.Current price is: $149.99. Add to cart
  • Sale! DBT Emotional Regulation Worksheets Bundle

    Emotional Regulation Worksheets Bundle (Editable, Fillable, Printable PDFs)

    Rated 0 out of 5
    Original price was: $299.99.Current price is: $149.99. Add to cart

Setting Goals and Objectives With Clients in Your Bipolar Disorder Treatment Plan

The first step in developing a treatment plan for bipolar disorder is to determine the appropriate level of care for your client. In some cases, this decision has already been made, and you are meeting with a client who has undergone some form of assessment. For example, individuals experiencing a manic episode may require hospitalization, especially if they exhibit symptoms such as psychosis, severe impulsivity, risky behaviors, extreme agitation and aggression, severe insomnia, loss of insight, and self-harm or suicidal behaviors. In these situations, crisis support services are necessary before initiating other treatments.

If you encounter a client whose diagnosis is not immediately clear, several assessment tools can help gather the necessary information. These tools include:

  • A clinical interview
  • Mood disorder questionnaires, including Mood Disorder Questionnaire (MDQ), Bipolar Spectrum Diagnostic Scale (BSDS)
  • Psychological and Neuropsychological Testing
  • Structured Clinical Interview for DSM-5 (SCID-5) or Schedule for Affective Disorders and Schizophrenia (SADS)

Your assessment will likely delve into your client’s mental health history, focusing on bipolar-related symptoms and concerns. Treatment for bipolar disorder can occur in either an inpatient or outpatient setting, depending on the severity of symptoms, functional level, and access to resources. Those with bipolar disorder may face recurring episodes of mania or depression, often already under the care of a prescribing physician or healthcare provider. This necessitates coordinated care and communication for comprehensive treatment. Once your assessment is complete and it’s determined that your treatment program aligns with your client’s needs, you can start setting goals for their bipolar disorder treatment plan.

What to Include in a Treatment Plan for Bipolar Disorder + Sample

When you are ready to begin crafting your bipolar treatment plan, it is important that you use a comprehensive and detailed treatment plan form. This is important because it can provide you with more opportunities to include client-specific information so that your treatment plan can easily be referenced for guidance. TherapyPatron is a great resource for clinicians looking for handouts, worksheets, treatment plans, and other forms that can be used in sessions. For the sake of this exercise, we will be following the TherapyPatron customizable treatment plan to walk through a step-by-step example of developing an effective treatment plan.

Example for John:

John Smith, a 28-year-old software engineer, arrived for his intake appointment at an inpatient clinic with escalating mood swings during his appointment. He expresses concerns about the increasing frequency and intensity of these mood fluctuations over the past year, and described periods of heightened energy, impulsivity, and irritability, followed by profound sadness, hopelessness, and fatigue. Other symptoms that he discussed were having a rapid flow of thoughts that made it challenging for him to focus and concentrate. He recognizes that these mood swings are affecting his work performance, relationships, and overall quality of life. John reports no known family history of mood disorders and denies any history of substance abuse or significant medical conditions. He recalls occasional mood fluctuations beginning in adolescence but notes nothing as severe or with the same frequency as he has had in the past year. During manic episodes, John describes feeling euphoric and invincible, engaging in impulsive behaviors such as excessive spending, risky investments, and gambling. He becomes easily agitated and exhibits signs of irritability. Despite sleeping only a few hours per night during manic phases, John reports feeling invigorated and energetic. Conversely, during depressive episodes, he feels overwhelmed by feelings of sadness, worthlessness, and despair. John experiences persistent fatigue, struggles with concentration and decision-making, and admits to occasional thoughts of death and suicide. He endorsed having changes in his appetite as well. His motivation for coming in for help was his wife voicing concern about his mood shifts, and being worried that he would experience another period of being “up” and engaging in risky behaviors.

Agencies Involved and Plans for Care Coordination

While John is in an inpatient program, he will be working with the prescribing physician on staff. This information would be explained to John during his intake. This treatment plan template identified providers working in a different agency, which John does not currently do. Upon discharge, you may need to help him find a local physician who can continue providing him with medication management services.

Example for John:

Other Agency: None at this time

Plan to Coordinate: None

Clinical Diagnoses

John’s symptoms indicate that he is living with bipolar I disorder. His specific symptoms that align with the DSM-5 criteria include:

Manic Episodes:

  • Elevated Mood: John describes feeling euphoric and invincible during manic episodes, with an exaggerated sense of confidence and optimism.
  • Increased Activity: He engages in impulsive behaviors, such as excessive spending, risky investments, and gambling.
  • Irritability: John becomes easily agitated and snaps at others over minor issues.
  • Decreased Need for Sleep: He reports sleeping only a few hours per night during manic phases, without feeling fatigued.
  • Racing Thoughts: He experiences a rapid stream of thoughts, making it difficult to concentrate or focus on tasks.
  • Impulsivity: John engages in reckless behaviors, such as driving recklessly and engaging in promiscuous sexual encounters.

Depressive Episodes:

  • Depressed Mood: John feels overwhelmed by feelings of sadness, worthlessness, and despair during depressive episodes.
  • Fatigue: John experiences persistent fatigue, even after sleeping for extended periods.
  • Cognitive Impairment: He struggles with concentration, memory, and decision-making.
  • Appetite Changes: John experiences fluctuations in appetite, ranging from overeating to having no appetite.
  • Suicidal Ideation: He admits to having fleeting thoughts of death and sometimes considers suicide as a means of escaping his emotional pain.

Example for John:

Clinical Diagnosis: Bipolar disorder, current episode manic   F31.0

Supporting Assessments: Young Mania Rating Scale (YMRS), Score of 30

Hamilton Depression Rating Scale (HAM-D), Score of 24

Current Medications and Responses

Since you are working in an inpatient program, you will likely be working closely with the prescribing doctor within your program. This can help you understand John’s current medication regimen, and what changes would occur for long-term support regarding the management of his bipolar symptoms.

Example for John:

Medications:

  • Lithium Carbonate X mg, X times per day
  • Olanzapine X mg, X times per day
  • Depakote X mg, X times per day
  • Clonazepam X mg, X times per day

Presenting Problem and Related Symptoms

The presenting problem of your treatment plan should be detailed enough to provide a reader with a glimpse into John’s concerns, diagnosis, and current needs. This can be a valuable resource for members of a clinical team within an inpatient treatment program so that multidisciplinary team members are all on the same page.

Example for John:

John Smith, a 28-year-old software engineer, was diagnosed with Bipolar I Disorder based on his presentation during the intake appointment. He exhibits escalating mood swings, characterized by manic episodes of heightened energy, impulsivity, and irritability, often leading to reckless behaviors such as excessive spending and gambling. During these manic phases, John experiences inflated self-esteem and a decreased need for sleep, engaging in multiple projects simultaneously with rapid speech and racing thoughts. Conversely, he also endures depressive episodes marked by profound sadness, hopelessness, and fatigue, losing interest in previously enjoyable activities and struggling with concentration and decision-making. These mood fluctuations significantly impair his occupational functioning, as John finds it challenging to maintain focus and productivity during manic phases, while depressive episodes leave him feeling overwhelmed and unmotivated.

John’s relationships also suffer as a result of his bipolar symptoms, with his mood swings causing strain and misunderstanding among family members, friends, and colleagues. Despite his efforts to manage his symptoms, John experiences substantial distress and impairment in various aspects of his life, including work performance, social interactions, and overall well-being. Consequently, a comprehensive treatment plan, including pharmacotherapy to stabilize his mood and psychotherapy to address underlying emotional issues, is warranted to help John manage his mood instability and improve his overall quality of life.

Goals and Objectives

Your goals and objectives will be unique to John and his symptoms. Objectives can be viewed as short-term, or smaller goals, that work together to achieve a larger, or long-term goal. When developing John’s goals, it is important to be mindful and realistic about his abilities and the time frame being given for his goals. You’ll want to include details in this section so that it can be used as a reference down the road.

Examples for John:

Goal 1: Stabilize Mood Swings

  • Objective 1: Reduce the frequency and severity of manic episodes by implementing early intervention strategies, such as mood tracking and relaxation techniques, to recognize and manage symptoms at the onset.
  • Objective 2: Enhance emotion regulation skills during manic episodes by incorporating mindfulness techniques and distress tolerance skills from Dialectical Behavior Therapy (DBT) to manage intense emotions effectively.
  • Objective 3: Challenge cognitive distortions associated with grandiosity and impulsivity during manic episodes through cognitive restructuring exercises aimed at promoting more balanced and realistic thinking patterns.

Goal 2: Improve Coping Skills for Depressive Episodes

  • Objective 1: Increase engagement in pleasurable activities and social support networks during depressive episodes using behavioral activation techniques, including activity scheduling and graded task assignments.
  • Objective 2: Address negative self-beliefs and feelings of worthlessness during depressive episodes through cognitive restructuring exercises aimed at replacing negative self-talk with more compassionate and realistic self-statements.
  • Objective 3: Develop problem-solving skills to address practical challenges and reduce stressors contributing to depressive symptoms using problem-solving therapy, involving a structured approach to problem-solving and stress reduction.

Goal 3: Enhance Interpersonal Functioning

  • Objective 1: Improve communication and conflict resolution skills in interpersonal relationships through communication skills training, focusing on assertiveness techniques, active listening, and empathic responding.
  • Objective 2: Address maladaptive relationship patterns and expectations contributing to relationship difficulties by exploring interpersonal issues and attachment patterns in interpersonal psychotherapy (IPT).
  • Objective 3: Develop a social support network and reduce social isolation through social skills training, including role-playing and behavior rehearsal, to improve social skills and build confidence in initiating and maintaining social connections.

Specific Interventions to Be Used

The therapeutic interventions that you use should be incorporated into your objectives to help you work towards your client’s goals. You’ll want to use evidence-based approaches to ensure that your client is receiving the best care. This treatment plan template allows you to indicate who is responsible for the specific intervention, which can be used as a reference for yourself, and for homework assignments for your client.

Example for John:

  • Intervention/Action: Complete a mood tracking sheet to begin learning signs of mood fluctuations
  • Responsible Person: John
  • Intervention/Action: Use psychoeducation to introduce the use of mindfulness techniques and distress tolerance skills to cope with emotional and psychological distress
  • Responsible Person: Counselor A
  • Intervention/Action: Use behavioral activation techniques, such as activity scheduling, to improve coping skills for depressive symptoms
  • Responsible Person: John
  • Intervention/Action: Communication skills training including assertiveness techniques, active listening, and empathetic responding to improve interpersonal relationships
  • Responsible Person: Counselor A
  • Intervention/Action: Social skills training, such as behavioral rehearsal and role-playing, to help improve interpersonal functioning
  • Responsible Person: Counselor A and John

Family Involvement

Family involvement for John could be beneficial in a few ways. One of which would be that educational sessions may help his wife gain a more in-depth insight into bipolar disorder, the signs, and symptoms associated with manic and depressive episodes, and learn how to support him with his mental health. Family therapy can be helpful as well by providing a safe place for them to come together and work through some of the challenges that they have experienced within their relationship. It is, of course, up to the client with what he is comfortable including his wife in for his treatment.

Example for John:

Psychoeducational and joint therapy sessions with his wife to promote social support

Additional Services and Interventions

In John’s case, an example of an additional service would be continued medication management services with his prescribing physician. Medications used to treat bipolar disorder are used on a long-term basis, to reduce the severity of and decrease the frequency of recurrent mood episodes. Support groups may also be a good recommendation for him because they can provide a sense of validation and support regarding his mental health concerns and related experiences. 

Example for John:

Additional Services:

  • Continued medication management services
  • Support Group for those living with bipolar disorder

Estimation for Completion

In this scenario, John is being treated in an inpatient psychiatric setting for a manic episode. The focus of his treatment is clinical stabilization so that he can reach a place where his symptoms are stable, and he can participate in outpatient treatment options. Inpatient programs for mania are dependent on the severity of his symptoms, and his response to medications, which can last anywhere from one to two weeks.

Example for John:

Two weeks of inpatient psychiatric care including medication management, psychoeducation, and supportive counseling services to help him achieve stabilization. Adjust as needed to ensure safety and low risk at the time of discharge.

Aftercare Plans

The aftercare plans for John are important because he will need to have continued support to maintain optimal wellness at home. This should include medication management and psychotherapy on an outpatient treatment basis. To promote engagement, the location of the treatment provider should be thoughtful, ensuring that distance does not become a barrier to treatment. Additionally, providing him with direct referrals, and even scheduling his intake appointments can be an added layer of security knowing that he is already linked up with appropriate treatment providers.

Example for John:

  • Medication management with Dr. X, at the [insert name of practice]
  • Outpatient counseling and therapy services with Clinician X at [insert practice or facility]
  • Continued engagement in bipolar disorder support group
  • Continued engagement in family counseling services

Final Thoughts On Creating a Treatment Plan for Bipolar Disorder

Thank you for reading our resource on creating a treatment plan for bipolar disorder clients. A carefully designed treatment plan for bipolar disorder is essential in navigating its complexities. It serves as a guide for clinicians and clients alike, aiming to stabilize mood swings, prevent relapses, and enhance overall quality of life. Successful treatment plans often integrate medication, therapy, lifestyle adjustments, and support networks to address both manic and depressive episodes. Through following such a holistic plan, individuals can attain improved mood control, enhanced functioning, and a more balanced and satisfying life.

TherapyPatron is a valuable resource for mental health professionals that offers various mental health therapy worksheets that can be incorporated into your sessions. Examples of worksheets that may be helpful with clients who are living with bipolar disorder include:

TherapyPatron.com helps mental health professionals better serve their clients. Our (editable, fillable, printable PDF) therapy worksheets can help you streamline your practice, effectively deliver different types of therapy, and support your clients be the best version of themselves.

  • Sale!

    Depression Worksheets Bundle (Editable, Fillable, Printable PDFs)

    Rated 0 out of 5
    Original price was: $369.99.Current price is: $149.99. Add to cart
  • Sale! DBT Emotional Regulation Worksheets Bundle

    Emotional Regulation Worksheets Bundle (Editable, Fillable, Printable PDFs)

    Rated 0 out of 5
    Original price was: $299.99.Current price is: $149.99. Add to cart

Resources:

Kayla VanGuilder, MA, LCMHC
Author: Kayla VanGuilder, MA, LCMHC

Kayla is a Mental Health Counselor who earned her degree from Niagara University in Lewiston, New York. She has provided psychotherapy in a residential treatment program and an outpatient addiction treatment facility in New York as well as an inpatient addiction rehab in Ontario, Canada. She has experience working with individuals living with a variety of mental health concerns including depression, anxiety, bipolar disorder, borderline personality disorder, and trauma.

Scroll to Top