MANUAL-BASED GROUP-PSYCHOTHERAPY FOR BIPOLAR DISORDER - A FEASIBILITYSTUDY

Background: The Lift: coals Program is a structured, manual-based grou p psychotherapy program for biopolar disorder that seeks to improve pa tient participation in medical model treatment (phase 1) and assist pa tients in meeting functional status gears (phase 2). The goals of this initial study were (a) to determine whether the procedures could be e xported from the authors to other therapists and ro) to quantify toler ability 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 trai ned, and subsequent compliance with manual procedures was quantified. Several process indices measuring tolerability and impact an patients were analyzed. Results: Therapists covered 90% to 96% of phase 1 psych oeducational content, indicating excellent fidelity to manual procedur es. Sixty-nine percent of patients completed phase I, and participatio n scores were in the good to excellent range for 56%. Completion of ph ase 1 was associated with significant increase in knowledge about bipo lar disorder. Fourteen (70%) of 20 patients enrolled in phase 2 reache d their self-identified, behaviorally based goal (48% of the total sam ple who began phase 1 of the program). Mean +/- SD time to goal comple tion was 8.7 +/- 5.3 months (median [95% confidence interval] = 7 [5.1 -12.3 months]; range, 2-17 months). Conclusion: The manual-based inter vention can be exported viith fidelity to other therapists and sites ( for phase I). Data indicate reasonable tolerability and goad achieveme nt of process (for phases 1 and 2) for those who accept this group mod ality. Comparison with other manual-based psychotherapies indicates re markable consistency regarding content for psychotherapy for bipolar d isorder; major differences among the psychotherapies include mode of d elivery and relative emphasis of specific components.