Research into the psychology of bipolar disorder has, until recently, been neglected, in spite of it being a severe, chronic psychiatric illness. It is associated with high rates of self-harm and suicide; a recent study of 648 bipolar patients identified 34% as having a history of suicide attempts (Leverich et al. 2003). Co-morbid substance abuse (Strakowski et al. 2000) and personality disorder (George et al. 2003) are also significant features of bipolar presentation; both of these factors are associated with greater morbidity and risk of self-harm (Leverich et al. 2003). In contrast to the large number of studies of psychological treatment in schizophrenia (reviewed recently by Pilling et al. 2002), such studies in bipolar disorder have been less common.