{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T15:37:56Z","timestamp":1772984276209,"version":"3.50.1"},"reference-count":48,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":32,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Psychology and Psychoth"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>BD is a chronic, cyclical condition marked by severe mood instability and significant impairment. Although pharmacological and psychotherapeutic interventions have demonstrated efficacy, challenges remain in preventing relapse and sustaining long\u2010term euthymia. This study evaluates a CBT\u2010based intervention designed to reduce symptom severity and recurrence by targeting three core maintenance factors: intolerance of anergic states, addiction to mania, and meta\u2010emotional problems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Four individuals diagnosed with BD participated in a one\u2010year CBT intervention tailored to address these key vulnerabilities. Assessments were conducted at baseline, post\u2010treatment, and at 18\u2010 and 24\u2010month follow\u2010ups, measuring depression, mania, quality of life, and personality functioning. Changes were evaluated with RCI and repeated measures ANOVA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All four patients showed a marked reduction in depressive symptoms at the end of treatment and at the 24\u2010month follow\u2010up, with a large effect size (\u03b7\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.83). Improvements were also observed in the quality of life and maladaptive personality traits over time. Notably, euthymia was maintained throughout the follow\u2010up period, with no recurrence of manic episodes or new affective cycles.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite limitations, these preliminary findings suggest that this three\u2010goal CBT intervention targeting core maintenance factors in bipolar disorder may promote sustained clinical improvements, increase long\u2010term stability, and reduce reliance on medication.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cpp.70224","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T07:20:53Z","timestamp":1770103253000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Goal Pursuit\u2010Focused CBT for Bipolar Disorder: A Four\u2010Case Series"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9129-8794","authenticated-orcid":false,"given":"Andrea","family":"Gragnani","sequence":"first","affiliation":[{"name":"School of Cognitive Psychotherapy (SPC)  Grosseto Italy"},{"name":"Network Scuole di Psicoterapia Cognitiva (APC\u2010SPC\u2010IGB\u2010AIPC\u2010SICC)  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1050-3133","authenticated-orcid":false,"given":"Allison","family":"Uvelli","sequence":"additional","affiliation":[{"name":"School of Cognitive Psychotherapy (SPC)  Grosseto Italy"},{"name":"Department of Medical Science, Surgery, and Neurosciences University of Siena  Siena Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Saettoni","sequence":"additional","affiliation":[{"name":"School of Cognitive Psychotherapy (SPC)  Grosseto Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165\u20100327(02)00320\u20108"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0193\u2010953x(05)70093\u20109"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0005\u20107967(98)00173\u20109"},{"key":"e_1_2_12_6_1","volume-title":"Cognitive Therapy of Depression","author":"Beck A. 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