Cbt is a great form of therapy I had it for psychosis and it really helped...it helped me deal with the oddity I was experiencing but also helped reduce the anxiety I had in dealing with the world so less stress is less triggering of my illness. Yeah so if he's paranoid about his friends he might be edging into psychosis that would qualify. So people with bipolar can become psychotic and it doesn't mean they have schizophrenia so much as bipolar 1. Usually it's associated with manic states which can be triggered by everything from stress to sunlight to seemingly nothing at all. Do you know if he takes an antipsychotic? They are very commonly used as mood stabilizers in bipolar but can also help get rid of paranoia etc. So in the US the pdocs are pretty much meds only as well but they will refer you to a psychologist if they think it will help....in my opinion it's always helpful but for anything above a personality disorder I think the meds are a first line of defense. Bipolar is one of the hardest things to treat...often people are on a cocktail of five or so meds and it helps to see a pdoc who specializes in bipolar because it's so complex. It might help if you were to read some of the posts on the bipolar forum and see it from their eyes...