Manual-Based Group Psychotherapy for Bipolar Disorder: A Feasibility Study
J Clin Psychiatry 1998;59(9):449-455
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: The Life Goals Program is a structured, manual-based group
psychotherapy program for bipolar disorder that seeks to improve patient participation in
medical model treatment (phase 1) and assist patients in meeting functional status goals
(phase 2). The goals of this initial study were (a) to determine whether the procedures
could be exported from the authors to other therapists and (b) to quantify tolerability
and impact of procedures on patients.
Method: Four therapists across 2 sites and 29 patients from the Veterans
Affairs (VA) Medical Center were studied in an open feasibility study. Therapists were
trained, and subsequent compliance with manual procedures was quantified. Several process
indices measuring tolerability and impact on patients were analyzed.
Results: Therapists covered 90% to 96% of phase 1 psychoeducational
content, indicating excellent fidelity to manual procedures. Sixty-nine percent of
patients completed phase 1, and participation scores were in the good to excellent range
for 56%. Completion of phase 1 was associated with significant increase in knowledge about
bipolar disorder. Fourteen (70%) of 20 patients enrolled in phase 2 reached their
self-identified, behaviorally based goal (48% of the total sample who began phase 1 of the
program). Mean±SD time to goal completion was 8.7±5.3 months (median [95% confidence
interval] =7 [5.1-12.3 months]; range, 2-17 months).
Conclusion: The manual-based intervention can be exported with fidelity
to other therapists and sites (for phase 1). Data indicate reasonable tolerability and
good achievement of process (for phases 1 and 2) for those who accept this group modality.
Comparison with other manual-based psychotherapies indicates remarkable consistency
regarding content for psychotherapy for bipolar disorder; major differences among the
psychotherapies include mode of delivery and relative emphasis of specific components.