Abstract
Introduction: The delivery of psychoeducational group programmes is a National Institute for Clinical Excellence recommended treatment for Bipolar Affective Disorder for which there is good evidence for effectiveness, acceptability, and cost-effectiveness. “On the level” is a group-CBT based psychoeducational intervention for adults experiencing BPAD developed by the North Lee Adult Mental Health Service. The present study aims to evaluate the “On the level” group as implemented by the North Cork Adult Mental Health Service at Mallow Primary Healthcare Centre.
Methods: The study will employ a mixed methods approach with a quantitative and qualitative arm. The quantitative arm will employ a repeated measures design using outcome measures assessing depressive and manic symptomatology at three time points: pre-intervention, post-intervention, and 3-month follow-up. For the qualitative arm, participants will be invited to participate in a focus group which will probe for pertinent issues with regard to access, positive and negative experience of the group, and perceived effectiveness of the group.
Results: Scores on outcome measures will be transformed into standard scores and clinically meaningful changed assessed on the basis that a <0.2, 0.3, and <0.8 standard deviation change will be considered to represent a small, medium, and large change respectively. In addition, the number of individuals moving from normal to abnormal ranges will be analysed. For the qualitative analysis, the focus group audio will be transcribed verbatim. The transcript will then be analysed using thematic analysis following guidelines described by Braun and Clarke (2006).
Discussions/conclusions: Results will be discussed in relation to the overall effectiveness of the group and in relation to issues revealed surrounding access, experiences of the group, and perceived usefulness. Lessons learned: This is the first evaluation of “On the Level” which has been implemented in a rural context and so it is anticipated that this study will reveal a number of unique aspects of this context which will inform future offerings.
Limitations: The sample size used in the study will be small which will prevent the use of inferential statistics, and the creation of a control group will not be possible.
Suggestions for future research: Future studies should be prospective in nature, group allocation should be randomised, and an active control group included.