LAUSR

Bipolar Disorder (BD) optimal care involves pharmacotherapy in conjunction with psychosocial interventions. Both treatment modalities require the establishment of a therapeutic alliance (TA), a cornerstone necessary for the successful treatment of any chronic illness regardless of the psychotherapeutic model1 . In mental disorders, TA has been considered a mediator of adherence and treatment success in a number of conditions, including but not being restricted to schizophrenia spectrum disorders; major depressive disorders, personality disorders; addictions, and also BD. It is well known that there are several obstacles to the establishment of a TA with individuals with BD, including those related to patient's characteristics (e.g. history of childhood maltreatment, comorbidities with personality disorders or substance abuse), to their illness (e.g. severity of symptoms, poor insight), patient characteristics, level of expertise and experience of the health care professional, and systemic factors (e.g. time available to provide care, models of remuneration, possibility to provide both pharmacological and psychotherapeutic care)1 . However, for psychiatrists and health professionals involved in the care of individuals with BD, countertransference (CT) factors could be especially challenging.