"There are probably several dozen places in the country where you can get these treatments," said Dr. Holly Swartz, an assistant professor of psychiatry at the University of Pittsburgh. "It's not available in the majority of the country."
Much of the problem is lack of training in the specialized techniques for psychologists, psychiatrists and social workers, said David Miklowitz, a professor of psychology and psychiatry at the University of Colorado at Boulder. The techniques should become part of the regular curriculum for them, he said.
And just as drug companies trumpet the effectiveness of their drugs, advocates for talk therapy have to advertise the impact of their techniques, Miklowitz said.
"There's a lot of work that needs to be done to get these treatments into day-to-day use in community practice," he said.
Basically, the talk therapies work by helping patients deal with stress, function socially and stick with their medications, he said.
They come in three styles:
Miklowitz is studying whether family-focused therapy can delay the first appearance of bipolar disorder or reduce its severity in children at risk. Those children have suggestive symptoms and a family history of bipolar disorder but do not yet have the full-blown condition.