Addressing the research to practice gap: feasibility of implementing social rhythm therapy for bipolar disorder in specialist mental health services

Introduction Despite research evidence supporting adjunctive psychological treatment for bipolar disorder, there is often a failure in translation to routine clinical care. This study aimed to determine the feasibility of implementing social rhythm therapy, a relatively straight forward behaviourally focused intervention with potential for adoption within Specialist Mental Health Services for individuals with bipolar disorder Method Case managers from two community mental health teams were trained to deliver 12 sessions of social rhythm therapy to individuals with bipolar disorder on their caseload. Feasibility outcomes were acceptability of training, acceptability of therapy for patients, ability to deliver therapy as part of a caseload, and treatment fidelity. Descriptive analyses were used for quantitative data and thematic analysis for qualitative data. Results Ten case managers were trained with eight delivering the therapy. Of 28 potential individuals, ten agreed to participate (37% uptake), with five completing therapy (50% completion). Qualitative data demonstrated acceptability of training with implementation challenges including engagement of and balancing the other demands of the case management role. Despite this, case managers did endorse the value of social rhythm therapy and the positive impact on those individuals who completed the therapy. Conclusion The implementation of social rhythm therapy in SMHS was deemed was only partially feasible with low level of uptake and significant systemic barriers, primarily related to the requirements inherent in the case manager role. Effective implementation requires addressing the systemic issues and identifying more effective strategies in engaging individuals with bipolar disorder to engage in alternative approaches.