An Opportunistic Qualitative Evaluation Of The Acceptability And Feasibility Of Remote Cognitive Behavioral Group Intervention for Bipolar Disorder

Elizabeth Newton^1*Alex Copello^1,2Alison Rolfe³Katie Edwards¹Sarah Moonakova¹Arielle Kaufman¹Radha Yagnik¹Olivia James⁴Anne Leadbitter⁴Gurvir Matharu¹

• ¹Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, United Kingdom
• ²University of Birmingham, Birmingham, England, United Kingdom
• ³West Midlands Institute of Psychotherapy, Birmingham, United Kingdom
• ⁴Aston University, Birmingham, West Midlands, United Kingdom

In response to the COVID-19 pandemic, many mental health services had to adapt the way in which their services were delivered. Research exploring the effectiveness of remote therapy and interventions, especially within the bipolar disorder population, is lacking. The pandemic presented a unique opportunity to conduct an opportunistic evaluation of a group intervention for bipolar disorder which began face-to-face (pre-lockdown) and transitioned to remote delivery. Service users had a unique experience of having experienced both delivery methods during the same intervention. They were interviewed about their experiences, the feasibility and acceptability of both modes of delivery and the strengths and challenges of these. A focus group was held with staff conducting the group to explore the feasibility of face-to-face and online intervention and to draw comparisons between them. As features of the intervention were adapted to the online format such as the weekly assessments, group activities and refreshment breaks for the first time, it was imperative to gain in-depth insight whether service users and staff felt their needs were met, their experience of this transition and the effectiveness of these adaptations. The intervention had not previously been adapted or investigated in terms of online delivery. This evaluation reports on both staff and service users’ experience. Collectively the analyses suggest that before embracing the use of technology for delivering psychological group interventions, we need to be cautious and consider clinical, group and practical processes that may be impacted and work towards diminishing these drawbacks. These factors and processes are discussed throughout this paper, including symptom management, accessibility, relationships and bonding, risk management and introducing a hybrid model. However, the evaluation also suggests that using video technology can be an effective way of delivering intervention to this client group and may also have some additional benefits such as easier access for some service users by reducing need to travel, easier access when struggling with mental health and aid in concentration when processing the group content. Further research, both qualitative and quantitative, is needed within the bipolar population to further explore remote delivery and help guide services when delivering online psychological group interventions.