Psychoeducational Group Therapy Session Plans for Bipolar Disorder Patients - Coursework Example

Psychoeducational Group Therapy Session Plans for Bipolar Disorder Patients Student Name: Student Number: Unit Name: Unit Code: University: Date: Executive Summary Bipolar disorder is a disorder which affects the brain, resulting in atypical changes in the affected person’s mood, activity and energy levels, as well as their capacity to engage in daily tasks (The National Institute of Mental Health, 2014). There has been a considerable improvement in the existing Bipolar Mood Disorder (BMD) treatments in the last couple years. Nevertheless, BMD still poses several challenges for the patients, their families, friends, and the community at large (Kleinman et al., 2003). Numerous non-pharmacological therapeutic approaches have therefore been put forward for the treatment of BMD patients and one such approach is Psychoeducation. Psychoeducation is a crucial component of any psychotherapy program and refers to the education that is offered as concerns a certain circumstance or condition that leads to psychological and mental stress. It is usually implemented by a psychologist, medical doctor or specialist therapist with a background in psychotherapies. Several conditions benefit from the therapeutic effects of psychoeducation and the rationale behind psychoeducation is that a patient will become more at ease and in control of their condition if they understand the condition. There is a greater likelihood for patients who have been educated on their condition to be actively involved in their self-management. They are consequently less susceptible to relapses (Reinares, et.al, 2008). There are different formats and settings through which psycho education can be undertaken and this is dependent upon the type of disorder, the patient’s needs as well as their developmental age. It can either be individually implemented, family-based, parent-based or group-based. Group psychoeducation is very impactful since group situations tend to be less intimidating than individual sessions. In group settings, one can share their experiences with others and discuss the techniques that have worked for them. Through this, all of the group members are able to obtain an insight into the ways through which other people handle their circumstances. This bolsters the learning experience as a whole (Virtual Medical Centre, 2008). According to a study conducted by Colom et.al (2003a), psychoeducation is very effective in helping bipolar patients. 120 patients took part in this study in which 20 weekly group sessions without any Psychoeducational content were used as the control intervention. The participants, a majority of who suffered from Bipolar I disorder, had to be euthymic for a minimum of 6 months prior to the commencement of the study. Follow-up was done every month for a period of 2 years. Considerably fewer patients in the psychoeducation group experienced a relapse and those who relapsed had less recurrence. Those with a comorbid personality disorder in the psychoeducation group were less likely to relapse, took a longer time to relapse and had less relapse episodes in general (Colom, 2004). In a related trial, Colom used a smaller sample of patients who were totally compliant in taking their medication. The study findings revealed that the treatment group had considerably fewer relapses in general and experienced less depressive relapses during the 2 year follow-up time frame (Colom, 2003b). A 5-year follow-up of the 120 patients who took part in the initial controlled study found that those in the treatment group had a markedly longer time to relapse into any mood episode. They also experienced less recurrence and spent fewer days being extremely sick (Colom, 2009). These findings reveal that group psychoeducation for bipolar disorder has a positive impact on the patients. Given the evident role that group psychoeducation therapy sessions plan in Bipolar Disorder, the following report will detail 3 session plans for people suffering from bipolar disorder using group psychoeducation as the approach. The Bipolar Disorder Psychoeducation Group A small-group approach has been chosen for these 3-session therapeutic programs. As outlined in the plan, the participants will provide each other with moral and emotional support in the sessions and in the process, any feelings of isolation will decrease and this will enhance their understanding of the condition they suffer from. It is further expected that the small group approach will encourage conversation and experience sharing amongst the patients involved. Ninety minutes was selected as the duration for each session so as to ensure there is sufficient time to adequately tackle all the pertinent discussion areas. This will also ensure that the 3 sessions are maximally utilized. Outcomes: To provide psychoeducation concerning bipolar disorder to individuals afflicted by the illness who want to gain an understanding of the disorder so as to minimize symptoms. Topics: Illness Awareness; Adherence To Treatment; and Lifestyle Regularity Target Group: A group of 5 adult bipolar disorder patients who want to overcome the manic mood swings and lessen/ prevent relapses. Methods: The group psychoeducation sessions will take the form of 3 x 90 minute sessions taking place once per week over 3 consecutive weeks and comprising 10 patients per group. Materials: Venue – boardroom in a hospital Staff – 2 Registered medical practitioners— 1 therapist who will serve as the main facilitator and 1 nurse who will be the co-facilitator. Audio recording equipment. Stationery- pens, notepads, white outs, laptops, iPads and communication books. Whiteboard and whiteboard pens Copies of forms: ‘My Bipolar Disorder Management Plan,’ ‘What lifestyle changes will help alleviate my symptoms,’ ‘How to Prevent Relapses of Mood Swings,’ ‘Symptoms of Bipolar Disorder,’ Foods that Alleviate Bipolar Disorder,’ etc Therapeutic music, a CD player and a variety of musical instruments Art therapy resources e.g. paint, brushes, canvases, etc Environmental Adjustments: Ensure that the room is quite, de-cluttered, painted in warm colors and that there are no external distractions. Ensure that the seats are comfortable Ensure that there is proper air conditioning The therapists should monitor their own speech especially with respect to their speech rate, their tone of voice, language use and sentence length. Moderate speech is required to ensure that the patients understand and follow what they are saying. Assessment: Participants are to fill in a “Bipolar Disorder Comprehension Plan.” The facilitators are to discuss the process and effectiveness of the plan with all the group members, both individually with each patient and generally as a group. Evaluation: Ever session shall be evaluated by the therapists. There will be two levels of the evaluation. The first level is a descriptive evaluation of every patient’s reaction and participation during a session describing among other areas, the prompts used, their verbal and non verbal cues, their activity and energy levels, the emotions displayed, their cognition levels with regard to whether or not they have understood directions, and so on. Further to that, a response evaluation scale shall be filled out by the patients so as to facilitate the seamless comparison of patient responses from one week to another. The comparison of these weekly patient response scales will allow the therapists to ascertain the progress (or lack thereof) the patients are making with respect to achieving their goals. If the progress is good, then the sessions will continue as planned but if a gradual decline is discovered over three weeks of consecutive sessions, a re-evaluation will be done whereby new goals and objectives will be developed. A revised therapy plan will thereafter be created. The second level will be an evaluation of the session plan itself and implementation. This will enable the therapists to appraise the effectiveness of the session plan in adequately meeting the needs of the patients. This level will focus on analyzing how the therapists relate with the patients, the effectiveness of the activities, music and art used in the session, and all the other relevant factors. Session 1: Increasing Illness Awareness Date: The second day of week 1 of the programme (Tuesday) Educational Outcomes: At the conclusion of this session, the patients involved will have an increased understanding of what Bipolar Disorder is as a whole Introduction: Introduce and discuss the topic of what Bipolar Disorder is, what Bipolar Disorder is not, the cause of the disorder and the symptoms as well. Content Overview: This first session will discuss what Bipolar is and a comparison with other mental illnesses will be provided to distinguish it from other psychological disorders. The symptoms and characteristics will be highlighted and the causes will also be identified and explained e.g. manic/depressive episodes Assessment: Participants are able to describe the various characteristics and symptoms of Bipolar Disorder Main Points Educational Methods Group introduction, pace setting and rules Small Group Discussion (20 Min) Whiteboard Provide a definition of Bipolar Disorder Small Group Discussion (10 Min) Whiteboard Identify the differences between the various forms of Bipolar Disorder Small Group Discussion (10 Min) Whiteboard Identify the symptoms and characteristics of Bipolar Disorder Small Group Discussion (10 Min) Whiteboard Share personal experiences about living with Bipolar Disorder Small Group Discussion (10 Min) Whiteboard Encourage the decision to accept the fact that one has Bipolar Disorder Small Group Discussion (10 Min) Reframe any relapse in mood swings as a learning opportunity Small Group Discussion (10 Min) Discuss and have participants complete the form “what I dislike about Bipolar Disorder and what the challenges are.” Small Group Discussion (10 Min) Conclusion: Have participants outline some of the definitions of Bipolar Disorder as well as the symptoms/ characteristics Resources/Educational Aids: whiteboard and whiteboard pens, notepads, pens, copies of form “What is Bipolar Disorder?” Session 2: Encouraging Adherence to Treatment Date: The second day of week 2 of the programme (Tuesday) Educational Outcomes: At the conclusion of this session, the participants will have an in depth awareness on the importance of Bipolar Disorder medication, why it is critical to strictly adhere to their medication and the adverse effects they will experience if they fail to adhere to them. Introduction: Introduce and discuss the topic of what Bipolar Disorder medication is and the various types of medication that exist in the market. Content Overview: This second session of the therapeutic plan will delve into the existing medication that alleviates the symptoms of Bipolar Disorder. It will outline how exactly this medication helps alleviate symptoms and the side effects. It shall also highlight the disadvantages of not adhering to bipolar medication. In addition, patients will be guided on how to ensure they take their medicine even when they are not in a position to do it themselves by assigning the task of administering the medication to a trusted, close person such as a relative. In a nutshell, the session will answer several questions concerning the medication such as: What does it do? How does it work? What are the side effects of the medication? What are the benefits of the medication? When should it be taken? How often should it be taken? Why it is critical that its taken at specific intervals? What occurs following the failure of taking the medication? What is the cost of medication? What types of psychotherapies are available and appropriate in assisting patients to cope with the psychological effects of Biolar Disorder? Assessment: Participants are able to explain the importance of medication. Main Points Educational Methods Group introduction, pace setting and rules Small Group Discussion (20 Min) Whiteboard Provide an explanation on what Bipolar Disorder medication is and the examples in the market Small Group Discussion (10 Min) Whiteboard Identify the importance of taking Bipolar Disorder medication and its effectiveness Small Group Discussion (10 Min) Whiteboard Identify the side effects of Bipolar Disorder medication Small Group Discussion (10 Min) Whiteboard Share personal experiences in using Bipolar Disorder medication Small Group Discussion (10 Min) Whiteboard Encourage the decision to consistently take Bipolar Disorder medication Small Group Discussion (10 Min) Highlight the adverse effects of not taking medication Small Group Discussion (10 Min) Discuss and have participants complete the form “what I like and dislike about Bipolar Disorder medication.” Small Group Discussion (10 Min) Conclusion: Have participants identify some of the Bipolar Disorder medications and also explain the benefits of medication from personal experience Resources/Educational Aids: whiteboard and whiteboard pens, notepads, pens, copies of form “Why is Adhering to Bipolar Disorder medication important?” Session 3: Enhancing Lifestyle Regularity Date: The second day of week 3 of the programme (Tuesday) Educational Outcomes: At the conclusion of this session, the participants will have an increased knowledge on the role that lifestyle plays in managing Bipolar Disorder. Introduction: Introduce and discuss the topic of how lifestyle has an impact on Bipolar Disorder symptoms. Content Overview: This third and final session of the plan will focus on the importance of lifestyle regularity. Lifestyle habits such as sleep patterns, diet and exercise/ fitness levels have a major impact on the severity of Bipolar Disorder. Regular habits and stress management comprise the main aspects of the Interpersonal and Social Rhythm Therapy (IPSRT) whereby patients are educated on ways of regulating their sleep hours, their daily functions, diet and nutrition in addition to stress management. These measures help to dramatically decrease the relapse triggers (Colom et.al, 2009). Assessment: Participants are able to explain the importance of regulating their day to day lifestyle and habits such as diet, exercise, sleep and so on. Main Points Educational Methods Group introduction, pace setting and rules Small Group Discussion (20 Min) Whiteboard Provide a definition of ‘Lifestyle Regularity’ as pertains to Bipolar Disorder Small Group Discussion (10 Min) Whiteboard Identify the importance of regulating one’s lifestyle Small Group Discussion (10 Min) Whiteboard Identify the specific measures that compromise healthy lifestyle measures for a Bipolar person Small Group Discussion (10 Min) Whiteboard Share personal experiences in enhancing one’s personal lifestyle e.g. specific changes in diet Small Group Discussion (10 Min) Whiteboard Encourage the decision to completely turn one’s lifestyle around Small Group Discussion (10 Min) Highlight the negative effects of failing to engage in lifestyle regularity Small Group Discussion (10 Min) Discuss and have participants complete the form “What activities I engage in as part of my personal form of Lifestyle Regularity.” Small Group Discussion (10 Min) Conclusion: Have participants identify some of the habits and activities they should engage in that will alleviate symptoms of Bipolar Disorder Resources/Educational Aids: whiteboard and whiteboard pens, notepads, pens, copies of form “Why is Lifestyle Regularity important?” References Colom F, et. al. (2003a). A randomized trial on the efficacy of Group psychoeducation in the Prophylaxis of recurrences in bipolar patients whose disease is in remission. Archives of General Psychiatry, 60: 402–7 Colom F, et. Al. (2003b). Psychoeducation efficacy in bipolar disorders. Beyond compliance Enhancement. Journal of Clinical Psychiatry, 64: 1101–5 Colom, F, et. al. (2004). Psychoeducation in bipolar patients with comorbid personality Disorders. Bipolar Disorders, 6:294–8. Colom, F, et. al. (2009). Group psycho education for stabilized bipolar disorders: 5-year Outcome of a randomized clinical trial. British Journal of Psychiatry, 194: 260–5. Kleinman, L. et.al. (2003). Costs of bipolar disorder. Pharmacoeconomics, Vol. 21, No. 9, pp. 601-622 Reinares M, et al. (2008) Impact of caregiver group psycho education on the course and Outcome of bipolar patients in remission. A randomized controlled trial. Bipolar Disorders 10: 511–9. The National Institute of Mental Health. (2014). What Is Bipolar Disorder? Retrieved online From http://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml Virtual Medical Centre. (2008). Psychoeducation. Retrieved online from http://www.myvmc.com/treatments/psychoeducation/ Read More

According to a study conducted by Colom et.al (2003a), psychoeducation is very effective in helping bipolar patients. 120 patients took part in this study in which 20 weekly group sessions without any Psychoeducational content were used as the control intervention. The participants, a majority of who suffered from Bipolar I disorder, had to be euthymic for a minimum of 6 months prior to the commencement of the study. Follow-up was done every month for a period of 2 years. Considerably fewer patients in the psychoeducation group experienced a relapse and those who relapsed had less recurrence.

Those with a comorbid personality disorder in the psychoeducation group were less likely to relapse, took a longer time to relapse and had less relapse episodes in general (Colom, 2004). In a related trial, Colom used a smaller sample of patients who were totally compliant in taking their medication. The study findings revealed that the treatment group had considerably fewer relapses in general and experienced less depressive relapses during the 2 year follow-up time frame (Colom, 2003b). A 5-year follow-up of the 120 patients who took part in the initial controlled study found that those in the treatment group had a markedly longer time to relapse into any mood episode.

They also experienced less recurrence and spent fewer days being extremely sick (Colom, 2009). These findings reveal that group psychoeducation for bipolar disorder has a positive impact on the patients. Given the evident role that group psychoeducation therapy sessions plan in Bipolar Disorder, the following report will detail 3 session plans for people suffering from bipolar disorder using group psychoeducation as the approach. The Bipolar Disorder Psychoeducation Group A small-group approach has been chosen for these 3-session therapeutic programs.

As outlined in the plan, the participants will provide each other with moral and emotional support in the sessions and in the process, any feelings of isolation will decrease and this will enhance their understanding of the condition they suffer from. It is further expected that the small group approach will encourage conversation and experience sharing amongst the patients involved. Ninety minutes was selected as the duration for each session so as to ensure there is sufficient time to adequately tackle all the pertinent discussion areas.

This will also ensure that the 3 sessions are maximally utilized. Outcomes: To provide psychoeducation concerning bipolar disorder to individuals afflicted by the illness who want to gain an understanding of the disorder so as to minimize symptoms. Topics: Illness Awareness; Adherence To Treatment; and Lifestyle Regularity Target Group: A group of 5 adult bipolar disorder patients who want to overcome the manic mood swings and lessen/ prevent relapses. Methods: The group psychoeducation sessions will take the form of 3 x 90 minute sessions taking place once per week over 3 consecutive weeks and comprising 10 patients per group.

Materials: Venue – boardroom in a hospital Staff – 2 Registered medical practitioners— 1 therapist who will serve as the main facilitator and 1 nurse who will be the co-facilitator. Audio recording equipment. Stationery- pens, notepads, white outs, laptops, iPads and communication books. Whiteboard and whiteboard pens Copies of forms: ‘My Bipolar Disorder Management Plan,’ ‘What lifestyle changes will help alleviate my symptoms,’ ‘How to Prevent Relapses of Mood Swings,’ ‘Symptoms of Bipolar Disorder,’ Foods that Alleviate Bipolar Disorder,’ etc Therapeutic music, a CD player and a variety of musical instruments Art therapy resources e.g. paint, brushes, canvases, etc Environmental Adjustments: Ensure that the room is quite, de-cluttered, painted in warm colors and that there are no external distractions.

Ensure that the seats are comfortable Ensure that there is proper air conditioning The therapists should monitor their own speech especially with respect to their speech rate, their tone of voice, language use and sentence length.

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