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Bigdeli M, Khaleghipour S, Zare Neyestanak M. Neurobehavioral Rehabilitation and Mental Imagery Therapy for Mania and Cognitive Avoidance in Bipolar Disorder. Pract Clin Psychol 2026; 14 (3) :281-290
URL: http://jpcp.uswr.ac.ir/article-1-1094-fa.html

Objective: Bipolar disorder (BD) is characterized by severe mood fluctuations and maladaptive coping strategies, such as cognitive avoidance. This quasi-experimental study aimed to compare the effect of a neurobehavioral model-based psychological rehabilitation package and mental imagery-based therapy on manic symptom severity and cognitive avoidance in patients with BD.
Methods: The study was conducted during the first half of 2025. Forty-five inpatients with BD at Golestan Hospital (Ahvaz, Iran) were selected through purposive sampling and randomly assigned to three groups (n=15 each): Neurobehavioral rehabilitation, mental imagery-based therapy, and control. The experimental groups received eight 90-minute sessions. Data were collected using the mania symptom checklist (MSC) and the cognitive avoidance questionnaire (CAQ). Repeated measures ANOVA and Bonferroni post-hoc tests were used for data analysis.
Results: Both interventions were associated with significant reductions in manic symptom severity compared to the control group (P<0.001), with no significant difference between the two experimental groups. Regarding cognitive avoidance, significant differences were observed across subscales (P<0.05), with the neurobehavioral rehabilitation package showing greater improvement than mental imagery-based therapy in four out of five subscales.
Conclusion: The findings suggest that both neurobehavioral rehabilitation and mental imagery-based therapy may be beneficial as adjunctive interventions for reducing manic symptoms and cognitive avoidance in patients with BD. Larger controlled trials are needed to confirm these results.