An Acceptance-Based Psychoeducation Intervention to Reduce Expressed Emotion in Relatives of Bipolar Patients

• Published in: Behavior therapy 2008-12, Vol.39 (4), p.375-385
• Main Authors: Eisner, Lori R, Johnson, Sheri L
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Aged; Anger; Anger - physiology; Attitude Change; Behavior modification; Behavior therapy. Cognitive therapy; Biological and medical sciences; Bipolar affective disorder; Bipolar disorder; Bipolar Disorder - prevention & control; Bipolar Disorder - psychology; Bipolar disorders; Correlation; Depression (Psychology); Emotional Response; Emotions; Expressed Emotion - physiology; Expressed emotions; Family - psychology; Family Environment; Family Relationship; Female; Follow-Up Studies; Health Knowledge, Attitudes, Practice; Humans; Internal-External Control; Intervention; Knowledge Level; Male; Medical sciences; Mental Disorders; Middle Aged; Mood disorders; Outcome Assessment (Health Care); Patient Education as Topic - methods; Patients; Personality Assessment; Predictor Variables; Problem Solving - physiology; Psychiatric Status Rating Scales; Psychiatry; Psychoeducational Methods; Psychoeducational treatment; Psychological Patterns; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Relatives; Risk Factors; Secondary Prevention; Studies; Treatments; Workshops; Young Adult
• ISSN: 0005-7894; 1878-1888
• DOI: 10.1016/j.beth.2007.11.001

Abstract Expressed emotion (EE) is a robust predictor of outcome in bipolar disorder. Despite decades of research, interventions to reduce EE levels have had only modest effects. This study used an expanded model of EE to develop an intervention. Research has demonstrated a strong link between attributions and EE in families of patients with psychiatric disorders. There is also substantial research to suggest that anger can drive blaming attributions. Combining these ideas, this study built on previous psychoeducation interventions through the addition of an acceptance component designed to decrease anger and blaming attributions among family members of those with bipolar disorder. Twenty-eight family members attended a 1-day or 2-evening multifamily group workshop and completed a follow-up assessment 1 week later. At follow-up, participants demonstrated more knowledge about bipolar disorder. Anger, blaming attributions, and number of criticisms remained unchanged. Results of this study are consistent with others in that it is difficult to change EE. Implications for future clinical research in this area are addressed.