ASPOFAFF :: Journal - Volume 1 :: Issue 2 :: Vol 1 - Iss 2 - Short Communication - The life goals group psychotherapy for bipolar patients: an open study


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ASPOFAFF :: Journal - Volume 1 :: Issue 2 :: Vol 1 - Iss 2 - Short Communication - The life goals group psychotherapy for bipolar patients: an open study

Vol 1 - Iss 2 - Short Communication - The life goals group psychotherapy for bipolar patients: an open study #42

The life goals group psychotherapy for bipolar
patients: an open study

J.M. Aubry MD, M. Gex-Fabry PhD, R. Denis, MD:
Department of Psychiatry, Adult Psychiatry Service, University Hospitals, Geneva, Switzerland.

The life goals psychotherapy program is a manualized structured group psychotherapy specifically developed for bipolar patients. It provides a psycho-educational and problem-solving approach to the psychosocial treatment of bipolar disorder using cognitive, behavioural, and interpersonal group strategies. The program is structured into two sequential components. Phase 1 consists of 6 sessions, is agenda-driven and focuses on identifying early warning signs of impending episodes and developing coping skills to limit the recurrence and progression of episodes. Phase 2 aims are to improve functional outcome by assisting group members to achieve functional goals that they have not been able to attain due to illness. It also aims to reiterate and strengthen the illness management skills developed in phase 1.

In Geneva, our specialized program for bipolar disorders has been using the French version of this manual for the last five years.

In order to evaluate the impact and effectiveness of this approach, fifty patients were included in an open study. Among other variables, the level of satisfaction regarding the psycho-educational sessions, the effect on medication compliance, effectiveness in preventing relapses and level of psycho-social functioning at study entry and after 9 months of group participation were evaluated.

Nine patients dropped out during phase 1. Drop out was not correlated to comorbid personality disorder, higher MADRS or Bech-Rafaelson scores at study entry. At the end of phase 1, a majority of participants (82%) indicated that the information and the material used for the sessions were adequate and easy to understand. Half the participants (47%) acknowledged taking their treatment more easily.
Seventeen patients subsequently entered phase 2 and only 2 participants left before one year of attendance. Ninety percent estimated that they had better mood stability, 85 % were more able to prevent a new episode and 90 % to cope more efficiently with the beginning of a new depressive or manic episode. A large majority of participants also indicated that the interactions within the groups were very valuable. Finally, the MADRS score was significantly lower at the end of phase 2 compared to study entry. Half the participants (47%) achieved at least one goal such as find a job, go on holidays, practice a sport regularly or loose weight, during the one year attendance. The remaining 53% attained one objective at least partially.

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