Performance Optimization-Focused Family Behavior Therapy to Address Verbal and Physical Aggression in an Adolescent Diagnosed With Bipolar I Disorder: A Case Report

Bipolar disorder is chronic and debilitating; characterized by fluctuations in mood that significantly interfere with day-to-day functioning. While symptom onset typically occurs in early adulthood, manifestations can occur at earlier developmental stages. Existing research has shown that Coordinated Specialty Care Early Treatment Programs (CSC ETPs) are effective in reducing both short- and long-term negative outcomes in individuals with serious mental illness, including schizophrenia. However, detailed descriptions of how these programs are implemented and evaluated in practice remain limited. This is a case report of an adolescent client, Blake, diagnosed with DSM-5-TR bipolar I disorder, who presented with marked irritability, aggression, mild delusions, depression, suicidal ideation, and diminished interpersonal and academic functioning. He participated in Performance Optimization-Focused Family Behavior Therapy (POFFBT) within the context of an evidence based interdisciplinary CSC ETP designed to treat early bipolar disorder. Blake completed a comprehensive standardized test battery to establish diagnosis, evaluate symptoms, and assess cognition at baseline, and regularly scheduled post-intervention assessments to determine changes in symptoms and functioning over 13.5 months. Results indicated significant improvement in functioning across all domains; supporting the utilization of POFFBT within CSC ETP to optimize functioning in early bipolar disorder.