The Effectiveness of 'In-Sight': A User-Led Lifestyle Development Group Training for People with Bipolar Disorder

Abstract

This study explores the effectiveness of “In-Sight”, a holistic recovery-based group training for people with bipolar disorder. Drawn from professional therapies and lived experience of the user-researcher who is diagnosed with having the illness, the training was delivered over 12 weekly sessions. Within a case study approach, an experimental design incorporated pilot (eight participants), main study (five) and control groups (six). Participants with a wide range of DSM-IV bipolar disorders were sought. Three non-bipolar participants experiencing severe mood swings were maintained in the pilot. One bipolar pilot participant later trained as the main study group co-facilitator in delivering the training. Self-report scales measured mood, coping, empowerment and quality of life pre-, post- and six months post-training. Semi-structured interviews noted individual change within the same time frame. Mental health professional interviews, medical note analysis and user-researcher observations also informed the study. Findings from self-report questionnaires indicated promising evidence that participants experienced improved mood stability, symptom severity, coping and quality of life and greater empowerment. A model has emerged to illustrate the various course components that appeared to benefit participants (user-led approach, self-help iii group format, illness management techniques, interpersonal skills development, healthy lifestyle, structure and planning, and intellectual change of perspective). The model illustrates how these components appeared to impact upon coping strategies, in turn leading to greater mood stability, maintaining wellness and personal development resulting in greater empowerment, improved outlook on self and the future and improved quality of life over time. The three non-bipolar pilot participants also appeared to benefit from the training compared to controls albeit to a lesser degree than the bipolar participants. The co-facilitator showed evidence of the greatest improvement. Four controls indicated evidence of continued use of poor coping and risk of further deterioration in illness, of whom two experienced major episodes with psychosis. Two controls indicated slight improvements. The “In-Sight” training is proposed as a step towards a more comprehensive approach for recovery from bipolar disorder informing the development of a new Expert Patients Programme in the UK.