Eastern Region Mental Health Educators Network 15th February 2007 “In-Sight”: user research Heather Straughan Research Fellow University of Hertfordshire.

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Presentation transcript:

Eastern Region Mental Health Educators Network 15th February 2007 “In-Sight”: user research Heather Straughan Research Fellow University of Hertfordshire

”In-Sight” a user-led recovery group training for people with bipolar disorder  Background to the research  “In-Sight”: The group training  Study design and methodology  Research outcomes  Your feedback and questions

Background to the Research - - Extent of mood disorders - - Theoretical approaches - - Professionally-led therapies - - Government policy: The Expert Patient, user-centred care, whole life, recovery - - User-led self-management programmes - - Cost-effectiveness - + personal experience of the illness - => Towards a holistic approach for recovery

“In-Sight” - a holistic recovery BIPOLAR DISORDER PSYCHO- EDUCATION COGNITIVE- BEHAVIOURAL THERAPY GROUP THERAPIES SERVICE-USER ILLNESS MANAGEMENT INTERPERSONAL THERAPY SOCIAL RHYTHM THERAPY FAMILY THERAPY MEDICATION + LIFESTYLE COMPONENTS

Past, present, future: moving forward Examining the Present & Life skills Development Looking Back Moving Forward

k Looking Back Mood chart Mood recognition & monitoring Stressors & Warning Signs Mood-Thinking-Behaviour Psychosis & Life Stress Examining the Present General coping strategies (highs & lows) Personal coping strategies Medication Lifestyle: sleep, exercise, diet, social, activity, family. Developing skills Moving forward Communication Assertiveness Negative thoughts Positive thinking Relaxation Anger Best lifestyle choices Selecting a goal for change Well-being action plan Weekly activity diary Relapse agreement Self-help group Substance use

Research Methodology - Case study approach - experimental design - 2 training groups (13) + control group (6) - Stages - pilot + main study - Setting - a day centre & church hall, Herts. - Sample - primary bipolar disorder & non-bipolars - Multi-method data collection (questionnaires for mood, coping, empowerment & qol, participant & mh professional interviews, medical notes, researcher observations) - Measurement: pre-, post- & 6 months post-training.

“In-Sight” multi-method data collection CASE STUDY CLIENT INTERVIEWS CLIENT QUESTIONNAIRES LINK WORKER INTERVIEWS RESEARCHER OBSERVATIONS CONSULTANT INTERVIEWS CPN & SW INTERVIEWS MEDICAL NOTES

Training delivery - 10 => 12 week training - 3 hours/session + 1 session follow-up - Seasonal considerations - Co-facilitator - main study

Outcomes at 6 months 13 participant questionnaires - Greater mood stability - less symptom severity - Improved coping - Greater empowerment - Improved & improving quality of life - 10 Bipolar participants : greater improvements & sustainable for longer compared to 3 non-bipolars

Outcomes at 6 months 6 control questionnaires - Unstable mood, symptoms worsened - Poorer coping - Unstable empowerment (linked to mood) - Quality of life slight improvement - Of 6 controls: - 2 gradually improved, although greater time needed - 2 gradual worsening of health with risk of relapse - 2 major relapse

Recovery & Development Maintaining Wellness Mood Stability Coping Intellectual Challenge & Change of Perspective/Responsibility User Led - Group - Mood Management Lifestyle Change & Structure Empowerment, QOL & Self and Future Over Time Skills Development Themes emerging from qualitative data

Summary - Outcomes * Formal evaluation - effectiveness for people with bipolar disorder & some evidence for non-bipolars * Larger sample/funding needed to test effectiveness further * Adaptation of training => ‘generic’ need Inform benefits of user-led training,wider self- help initiatives and recovery-oriented practice. * PhD from a user-researcher!

Points to note * Holistic recovery skills training is needed * Para-professional trainers just as effective as professional trainers (Bright, Baker & Neimayer, 1999) * Help people to help themselves => capacity build towards group of paraprofessional-trainers * Recovery measure * Beware of ‘colonising’ recovery & doing ‘for’ not doing ‘with’

Your feedback and questions “In-Sight” Heather Straughan Research Fellow, University of Hertfordshire Tel: