Biological models and treatments have dominated the research agenda in bipolar disorder (BD) for many decades, However, there is increasing evidence that individuals with BD and their significant others would welcome the introduction of more systematic psychological interventions aimed at helping the process of adjustment to the disorder, overcoming barriers to compliance with the recommended pharmacological treatments, and enhancing coping repertoires to reduce vulnerability to future episodes. Cognitive therapy (CT) appears to be an approach that not only helps clients with BD to understand the disorder, and achieve these goals, but may also improve their self-esteem and sense of self-efficacy. Adaptations to cognitive therapy that may facilitate its use in BD are outlined.