Bipolar disorder is a severe mental health condition that affects a person’s mood and can cause disability, with an average wait of around six years for diagnosis and access to treatment, although longer when symptoms begin before the age of 21. Intervening in early symptoms of bipolar disorder to prevent more severe illness should be a clinical priority. The early intervention model has been successful in supporting people with first episode psychosis and those at risk of psychosis, but there is no current guidance for clinical services on the identification and treatment for people at-risk of developing bipolar disorder. 

Applying early detection and intervention approaches used for people with subthreshold psychosis experiences could be useful in this field. The Bipolar At Risk (BAR) criteria has been developed, which has shown to be reliable and valid in predicting those who are at higher risk of developing bipolar disorder. Cognitive Behavioural Therapy (CBT) is recommended for individuals with a diagnosis of bipolar disorder with research showing improvements in functioning, symptoms of mania and depression, and relapse rates in adults. A feasibility randomised controlled trial of CBTBAR was conducted to test its acceptability and found to be an acceptable and feasible treatment option.