Therapeutic Factors Of Structural Group Therapy For Bipolar Disorder:A Qualitative Study

Objective Explore the therapeutic factors and mechanism of Intensive Outpatient Program-Bipolar Disorder(IOP-BD)to provide reference for future psychotherapy protocol development and improve treatment effectiveness.Method 22 Bipolar patients in three groups received group therapy using IOP-BD which led by different therapists and set three times a week for 90 minutes of 10 sessions.Data came from semi-structured interviews for therapists set after every session and patients set before-and after-treatment.And all interviews were permitted to be recorded.Audios were transcribed verbatim,and transcriptions were analyzed by thematic analysis based on interpretative phenomenological theory.After generating initial codes,defining and naming themes and finally drafted structured theme chart.Results 1.In perspective of therapists,there were four themes(12 sub-themes)impacted psychotherapy efficacy,including protocol content,personal factors,treatment process and role of therapists.Therapists thought all content of IOP-BD would benefit patients,especially adherence and social support,and participants benefited from content they were interested in.As for personal factors,those actively involved in the therapy,could give back something,and accepted the disease truly would benefit more.Besides duration of disease,cognition,openness and the ability to adjust of caregivers would influence the treatment.And therapists mentioned the rhythm of therapy,as important part to standard treatment,was one of therapeutic factors.Otherwise therapeutic factors of group and the guiding role of therapists and their background were also important part.2.In perspective of bipolar patients,there were two therapeutic factors: protocol content and therapeutic factors of group therapy,and they impacted on the outcomes through attitude to disease and treatment compliance.Firstly in supportive group atmosphere,knowledge in IOP-BD could change the attitude to disease,including improving the knowledge and management of disease,as well acceptance to BD,which would improve treatment compliance,and the compliance would influence the attitude to disease and the reception of protocol content conversely.Protocol content,group atmosphere,character,treatment motivation and external support would impact compliance.The themes patients thought more useful,more harmonious group atmosphere,more rational character,stronger motivation and have external support,the more complied with treatment.Conclusion After all,therapists and participants thought IOP-BD could improve knowledge,management and acknowledgement of bipolar disorder,besides therapeutic factors of group was important therapeutic factor.While therapists advised considering the duration of disease of participants in the treatment,therapists' experience occupied a major position in perspective of participants,and they also thought it would be better with more methods and practice of emotional management.