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Psychological interventions for severe mental health problems, such as psychosis and bipolar disorder, are now established within NICE guidelines. However, there is still considerable room for improvement in relation to treatment uptake and outcomes. I aim to provide an update on recent developments in the field and to identify the important yet unresolved questions. Current clinical trials within the local area will be discussed, including the treatment of trauma within people diagnosed with psychosis and imagery based interventions for improved emotion regulation within people diagnosed with bipolar disorder.