Comparison of the Effectiveness of Family-Focused Therapy and Social Cognition and Interaction Training in Preventing Relapse in Bipolar Disorder and Enhancing Patients' Social Functioning and Interpersonal Relationships

Abstract

Background: Bipolar disorder type I (BD-I) is marked by periodic mood swings, including episodes of mania and depression. Factors such as family stress and cognitive impairments are crucial in the relapse of this disorder. Objectives: This study aims to evaluate the effectiveness of family-focused therapy (FFT) and social cognition and interaction training (SCIT) in preventing relapses of BD-I and enhancing patients' interpersonal relationships and social functioning. Methods: This experimental study featured a controlled, pretest-posttest design with a three-month follow-up, conducted from 2019 to 2020. Sixty primary caregivers of patients with BD-I in Zahedan, Iran, were purposively selected and randomly assigned to three groups. The SCIT group (only patients) and the FFT group (patients with primary caregivers) each underwent 15 sessions of group interventions. Research tools were administered before and after the intervention, as well as in the follow-up. Baseline differences in outcomes were assessed using independent samples t-tests for completers vs. non-completers and analysis of variance (ANOVA) for the three intervention groups. Results: Results indicate that both SCIT and FFT significantly improved relapse prevention and enhanced social functioning, except in the domain of interpersonal relationships. Here, SCIT proved more effective than FFT in post-tests (β = 3, P = 0.034) and follow-up (β = 5.043, P = 0.001). Conclusions: Given that FFT is an evidence-based treatment for BD-I, integrating SCIT can further enhance intervention effectiveness, particularly in improving interpersonal relationships and social functioning by addressing environmental factors and social cognitive deficits.