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OBJECTIVES: Bipolar patients are at high risk for suicidal ideation and attempts. Suicidal behavior is correlated with poor family communication and/or high levels of intrafamilial conflict, particularly among adolescent bipolar patients. This article describes the application of family-focused therapy (FFT) as an adjunct to pharmacotherapy in the management of suicidal ideation and behavior among bipolar patients. METHODS: We describe the empirical basis of FFT in studies of adult and adolescent patients. We then describe the manner by which the three modules of FFT - psychoeducation, communication skills training and problem solving - are adapted to address the clinical issues presented by suicidal bipolar adults or adolescents and their families. RESULTS: Key objectives of the treatment are to help the family recognize that suicidal behavior is a part of the pathophysiology of bipolar disorder but that it is also to some extent under environmental control. Thus, the family is in a unique position to develop and help assure the success of a suicide prevention contract. A case study of an adolescent with suicidal behavior is presented. CONCLUSIONS: Future research should include a focus on: (i) cross-cultural issues in suicide and bipolar disorder; and (ii) the adaptation of interventions shown to be effective in reducing suicidal behaviors in non-bipolar populations.

Original publication




Journal article


Bipolar Disord

Publication Date





640 - 651


Bipolar Disorder, Family Therapy, Humans, Risk Factors, Suicide, Attempted