Table 4.

Value and barriers of involving a relative in relapse prevention for relatives, service users and care coordinators

	For relatives	For Service Users	For care coordinators
Value	• Increases understanding of bipolar disorder, triggers and EWS • Gives relatives a role - empowering • Recognize need to seek help earlier - important in a crisis • Improves relationship with service users • Improves relationship with mental health services	• Provide insight into triggers and EWS • Another 'pair of eyes' to recognize EWS and triggers • Increased support during a crisis • Improves relationship with relative	• Provide insight into triggers and EWS • Another 'pair of eyes' to monitor service user • Improves contact during a crisis • Improves relationship with relative
Barriers	• Conflict with work and other commitments • No suitable relative to take part • Not wanting to intrude on relationship between Service User and Care coordinator	• Want to keep illness and issues private from family • Want to keep family issues private from CC • Did not want to burden family members • Fear increased monitoring will lead to increase misattribution of normal emotions and behaviors • Concern over placing relatives in position of power • Families were a source of stress and trigger to relapse • Relationship with CC is exclusive from relatives	• Takes longer • Informal increase of caseload • Have to maintain confidentiality of service user • Difficulty dealing with family dynamic within sessions • Unconfident as therapists