Ms. Bauer et al., MANUAL-BASED GROUP-PSYCHOTHERAPY FOR BIPOLAR DISORDER - A FEASIBILITYSTUDY, The Journal of clinical psychiatry, 59(9), 1998, pp. 449-455
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.