Half of patients with bipolar disorder don’t take their medications. This talk therapy may help.
STUDY: Budak M et al, Psychiatria Danubina 2026
STUDY TYPE: Randomized controlled trial
FUNDING: Independent
Background
Adherence therapy is a structured, manual-based intervention developed by Richard Gray that draws on motivational interviewing, cognitive behavioral techniques, and psychoeducation. It explores patients’ beliefs about treatment, addresses barriers, and builds motivation to stay on medication. This is the first trial to test it specifically in bipolar disorder outpatients.
The Study
- 61 outpatients with bipolar disorder in remission in Turkey.
- Randomized to seven sessions of adherence therapy (over three weeks) or routine outpatient follow-up.
- Adherence and self-esteem were measured at baseline and two months after the intervention.
At the start, adherence levels were similar in both groups. After the intervention, 94% of patients in the adherence therapy group had medium or high adherence, compared to 43% in the control group.
Logistic regression showed that patients who received adherence therapy were 94% less likely to have poor adherence (OR = 0.06). Self-esteem and self-efficacy scores improved but didn’t reach significance either.
Limitations
Small sample, inactive control.
Practice Implications
- Adherence therapy brings together sensible techniques. Read the manual and weave it into your practice.
—Chris Aiken, MD
Director, Psych Partners
Editor in Chief, Carlat Psychiatry Report
