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Open Access Research article

A feasibility study of expert patient and community mental health team led bipolar psychoeducation groups: implementing an evidence based practice

Katharine Coulthard1, Dipty Patel2, Clare Brizzolara3, Richard Morriss4 and Stuart Watson5*

Author Affiliations

1 Newcastle Cognitive and Behavioural Therapy Centre, Carliol Place, Newcastle Upon Tyne NE1 6UR, UK

2 Druridge Ward, St Georges Park, Morpeth, Northumberland NE61 2NU, UK

3 Faculty of Applied Sciences, University of Sunderland, Room 105, Dale Building, City Campus, Chester Road, Sunderland SR1 3SD, UK

4 Institute of Mental Health and CLAHRC NDL, University of Nottingham, Triumph Road, Nottingham NG7 2TU, UK

5 Wolfson Unit, Campus for Ageing and Vitality, Institute of Neuroscience, Newcastle University, Newcastle NE4 5PL, UK

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BMC Psychiatry 2013, 13:301  doi:10.1186/1471-244X-13-301

Published: 11 November 2013

Abstract

Background

Group psychoeducation is a cost effective intervention which reduces relapse and improves functioning in bipolar disorder but is rarely implemented. The aim of this study was to identify the acceptability and feasibility of a group psychoeducation programme delivered by community mental health teams (CMHTs) and peer specialist (PS) facilitators. Organisational learning was used to identify and address systematically barriers and enablers, at organisational, health professional and patient levels, to its implementation into a routine service.

Methods

A systematic examination of barriers and enablers to a three day training process informed the delivery of a first treatment group and a similar process informed the delivery of the second treatment group. Triangulation of research methods improved its internal validity: direct observation of training, self-rated surveys of participant experiences, group discussion, and thematically analysed individual participant and facilitator interviews were employed.

Results

Barriers and enablers were identified at organisational, educational, treatment content, facilitator and patient levels. All barriers under the control of the research team were addressed with subsequent improvements in patient knowledge about the condition and about local service. In addition, self-management, agency and altruism were enhanced. Barriers that could not be addressed required senior clinical and education leadership outside the research team’s control. PS and professional facilitators were successfully trained and worked together to deliver groups which were generally reported as being beneficial.

Conclusion

Psychoeducation groups involving CMHT and PS facilitators is acceptable and feasible but their sustainment requires senior leadership within and outside the organisation that control finance and education services.

Keywords:
Bipolar disorder; Group psychotherapy; Health plan implementation; Health services research; Professional education; Qualitative research; Psychoeducation; Peer specialist; Expert patient; Service user interventions