. Author manuscript; available in PMC: 2019 Jun 10.

Published in final edited form as: Br J Psychiatry. 2019 Mar 22;214(5):260–268. doi: 10.1192/bjp.2019.54

Table 2. Intervention characteristics organised by proposed typology.

Study ID	Format	Facilitator	^# Sessions	Duration (wks)	Session Length (hrs)	Dose (hrs)^†	Intervention Name & Description
Illness Management and Compliance Interventions

ATKINSON 1996 ²²	Group	Clinician	20	20	1.5	30	Education group Sessions alternated between an information session (short presentation and discussion) followed by a problemsolving session. Patients were given a manual outlining the content of the sessions, which included: The meaning of schizophrenia to the individual, Current understandings and treatment for schizophrenia, identifying early signs of relapse and problem solving around managing relapse, symptoms, medication & side effects. Problem solving around relationships with friends and family, teaching social skills and stress management, and rehabilitation and linking in to community resources.
CHAN 2007 ⁵³	Group	Clinician	10	2	0.8	8	Transforming Relapse and Instilling Prosperity (TRIP) Utilizes strategies from IMR however is not a direct derivative of the program. TRIP is an intensive, ward-based illness management program aims to decrease treatment non-compliance and improve patient's insight and health through didactic teaching of information about their illness and open discussion of adaptive life and coping skills. Sessions cover two categories i) illness orientated (mental health, medication management, relapse prevention planning, symptom management) and ii) health orientated (emotion management, rehabilitation resources, healthy living, stress management).
DALUM 2018 ³²,³³	Group	Clinician	39	39	1	39	Illness Management and Recovery (IMR) Program Follows the standardized curriculum-based approach of IMR as described below in Fardig 2011 but with an additional 11th module on healthy living lifestyles.
FARDIG 2011 ³⁴	Group	Clinician	40	40	1	40	Illness Management and Recovery (IMR) Program Is a clinician led, curriculum-based program for service users with SMI. Teaches evidence-based techniques for improving illness self-management: psychoeducation, cognitive-behavioural approaches to medication adherence, relapse prevention, social skills training (e.g., to enhance social support), coping skills training (e.g., for persistent symptoms). Overall aim is to help clients learn about mental illnesses and strategies for treatment; decrease symptoms; reduce relapses and rehospitalisation; and make progress toward goals and toward recovery.
HASSON 2007 ³⁵	Group	Clinician	35	35	1	35	Illness Management and Recovery (IMR) Program Follows the standardized curriculum-based approach of IMR. Educational handouts that are a central part of the Illness Management and Recovery program were translated into Hebrew and adapted for use in Israel.
LEVITT 2009 ³⁶	Group	Clinician	40	20	1	40	Illness Management and Recovery (IMR) Program The standard IMR program was delivered to those living in supportive housing.
LIN 2013 ³⁷	Group	Clinician	6	3	1.5	9	Adapted Illness Management and Recovery (IMR) Program Adapted IMR to fit in-patient acute care setting with the primary focus on symptom and medication management, while maintaining a recovery perspective. The adapted IMR program was based on three abbreviated modules from the original IMR program: Practical Facts about Schizophrenia, Using medication Effectively, and Coping with Problems and Persistent Symptoms. The IMR sessions usually started during the third week of hospitalization. Individuals who were discharged from the hospital before completing the adapted IMR program were invited to continue with the same IMR group until they had completed it. Brief essays about recovery written by individuals who had completed the adapted IMR program were also included.
MONROE-DEVITA 2018 ³⁸	Group & individual	Clinician	52	52	1	52	Illness Management and Recovery (IMR) Program This study assessed the effectiveness of IMR when delivered to those receiving Assertive Community Treatment. Follows the standardized curriculum-based approach of IMR but with an additional 11th module on healthy living lifestyles.
SALYERS 2010 ⁴¹	Individual and group	Clinician + Peer	43	43	1	43	Illness Management and Recovery (IMR) Program This study assessed the effectiveness of IMR when delivered to those receiving Assertive Community Treatment.
SALYERS 2014 ⁶⁰	Group	Clinician	39	39	1	39	Illness Management and Recovery (IMR) Program Standard program
SHON 2002 ⁴²	Group	Clinician	12	12	1	12	Medication and Symptom Management Education program Sessions covered the following key areas: six sessions covered introduction of the psychiatric disorders; recognising symptoms and a variety of coping strategies, 3 sessions reinforcing knowledge concerning medication use and side effects, and 3 sessions covering relapse warning symptoms and coping skills and prevention strategies. Utilised a range of teaching, video vignettes, and small group discussions.
TAN 2017 ⁴⁴	Group	Clinician	26	52	1	26	Adapted Illness Management and Recovery (IMR) Program Eight of the ten IMR modules were used and adapted to the local setting. The two excluded modules covered the US mental health system and addiction and were deemed not applicable to this setting.
VREELAND 2006 ⁴⁹	Group	Clinician	96	24	1	96	Team Solutions Program Group based intervention consisting of three, eight-week modules covering the following topics and workbooks: i) Understanding Your Illness and Recovering From Schizophrenia; ii) Understanding Your Treatment and Getting the Best Results From Your Medication; and iii) Helping Yourself Prevent Relapse and Avoiding Crisis Situations. This program was developed by pharmaceutical company Elli Lily.

Bipolar specific illness management

COLOM 2003 ⁵⁴,⁵⁵	Group	Clinician	21	21	1.5	32	Manual de Psicoeducacion en Tastornos Bipolares Aims to prevent recurrences and reduce time spent ill. Addresses four main issues: illness awareness, treatment compliance, early detection of prodromal symptoms and recurrences and life style regularity through talk on topic of session, exercise related to topic and active discussion.
TORRENT 2013 ⁴⁷	Group	Clinician	21	21	1.5	31.5	Psychoeducation based on Manual de Psicoeducacion en Tastornos Bipolares This psychoeducation intervention (based on Colom, 2003) aimed to prevent recurrences of bipolar illness by improving four main issues: illness awareness, treatment adherence, early detection of prodromal symptoms of relapse, and lifestyle regularity. Note: study has three arms-Functional remediation, psychoeducation and treatment as usual. Functional remediation arm was not included in this analysis as it does not meet inclusion criteria.
SAJATOVIC 2009 ⁴⁰	Group	Clinician	6	6	1.25	7.5	Life Goals Program The Life Goals Program (LGP) is a manualised, structured group psychotherapy program for individuals with bipolar disorder. It is based on behavioural principles from social learning and self-regulation theories and focuses on systematic education and individualized application of problem solving in the context of mental disorder to promote illness self-management. LGP is organized in two phases which cover illness education, management, and problem solving. Phase I is the core psychoeducational intervention. The optional phase II group sessions address goal setting and problem solving in an unstructured format.
SMITH 2011 ⁴³	Individual	Computer	8.5	17	NR	N/A	Beating Bipolar The key areas covered in the package are: (i) the accurate diagnosis of bipolar disorder; (ii) the causes of bipolar disorder; (iii) the role of medication; (iv) the role of lifestyle changes; (v) relapse prevention and early intervention; (vi) psychological approaches; (vii) gender-specific considerations, and (viii) advice for family and carers. Online modules were required to be completed in sequential order and throughout the trial there was an opportunity for participants in the intervention group to discuss the content of the material with each other within a secure, moderated discussion forum.
TODD 2014 ⁴⁵,⁴⁶	Individual	Computer	10	26	NR	N/A	Living with Bipolar (LWB) LWB is an online interactive recovery informed self-management intervention, broadly based on the principles of Cognitive Behavioural Therapy and psychoeducation. The intervention aims to help people to: increase their knowledge, self-esteem and self-efficacy around managing bipolar in order to pursue personally meaningful recovery goals. Ten interactive modules were developed: (1) Recovery & Me;(2) Bipolar &Me; (3) Self-management &Me; (4) Medication & Me; (5) Getting to Know Your Mood Swings; (6) Staying well with Bipolar; (7) Depression & Me; (8) Hypomania & Me; (9) Talking about my diagnosis; and (10) Crisis &Me. Worksheets were used to enhance learning and personalise the content, and could be down- loaded or printed out. Case studies and worked examples, written by service users were used extensively to reduce perceived isolation through shared experience. A mood checking tool was available for participants to help them identify major changes in their mood. Participants receive information about the most appropriate modules, given their mood symptoms. In line with the recovery agenda participants were given access to all aspects of the intervention and encouraged to use it as and when they felt appropriate.
PROUDFOOT 2012 ⁵⁸,⁵⁹	Individual	Computer and Peer email	8	8	0.5	4	Online Bipolar Education Program (BEP) + Informed Supporters (email support from expert patients) The online psychoeducation program consisted of topics covering causes of bipolar disorder, diagnosis, medications, psychological treatments, omega-3 for bipolar disorder, wellbeing plans, and the importance of support networks. It was supplemented by email-based coaching and support from ‘Informed Supporters' (i.e. peers) to answer specific questions or to provide examples of how to apply the education material to their everyday lives. Emails focused on effective self-management across three domains: medical, emotional and role management, and were linked to the content of the online psychoeducation program. Questions of a clinical nature were referred to suitable clinicians.
PERRY 1999 ³⁹	Individual	Clinician	11.97	9	0.75	9	Teaching patients with bipolar disorder to identify early symptoms of relapse and obtain treatment Treatment occurred in two stages: collaboratively exploring previous relapses and training the patient to systematically identify the idiosyncratic nature and timing of their prodromal symptoms of manic or depressive relapse. Diaries were kept to distinguish symptoms associated with normal mood variation from prodromes. Once prodromes had been recognised by the patient, an action plan was created and rehearsed (such as ways to seek early treatment from a professional). The full relapse plan of warning and action stage prodromal symptoms for manic and depressive relapse with the plan for seeking treatment was recorded on a card in laminated plastic, which was carried by the patient.

Transition to Community from Ward

ANZAI 2002 ⁵²	Group	Clinician	18	9	1	18	SILS - Community Re-entry Module The Community Re-entry Module consists of sessions on medication management, warning signs of relapse and how to develop and implement an emergency plan to deal with relapse, how to find and secure housing and continuing psychiatric care in the community, and how to reduce stress and promote coping after discharge. The conventional program emphasizes arts and crafts, reality-orientation groups, and work assignments in the hospital.
ECKMAN 1992 ²⁰	Group	Clinician	52	26	1.5	78	SILS- Medication and Symptom management modules Utilised two modules from the UCLA Social and Independent Living Skills Program. Medication and Symptom Self-management modules
KOPELOWICZ 1998 ²¹,⁵⁷	Group	Clinician	8	1	0.75	6	SILS - Community re-entry program Based on the UCLA Social and Independent Living Skills Modules and modified for use in the rapid-turnover, “crisis” operations of a typical acute psychiatric inpatient facility. Sessions focused on preparing participants for discharge through teaching knowledge and skills to understand their disorders and the medications that control it, to develop an aftercare treatment plan by identifying problems, specifying remedial and maintenance services, and linking with service providers, teaching skills to avoid illicit drugs, cope with stress, organize a daily schedule, and make and keep appointments with service providers.
ZHOU 2014 ⁵¹	Group	Clinician	26	26	2	52	SILS- Medication and Symptom management modules The Medication Management and Symptom Management Modules of UCLA program were delivered. Additionally, at the end of the intervention, participants were given a self-management check-list journal (which monitored medication adherence, sleep, side effects, residual symptoms and signs of relapse) and the main caregiver was asked to provide guidance on the process. Participants in the intervention group attended monthly self-management group meetings (for 24 months) where community mental health workers checked and evaluated their journals.
WIRSHING 2006 ⁶²	Group	Clinician	8	1	1	8	Modified Community Re-Entry Program (CREP) Based on the UCLA Community re-entry modules modified to be administered during brief hospitalizations to address the immediate needs of a patient who is transitioning back into the community.
XIANG 2006 ⁶³	Group	Clinician	16	8	1	16	SILS - Community Re-entry Module Chinese version of the community re-entry module.
XIANG 2007 ⁶⁴	Group	Clinician	16	4	1	16	SILS-Community Re-entry Module Chinese version of the community re-entry module

Recovery Oriented Self-management

BARBIC 2009 ²³	Group	Peer	12	12	2	24	The Modified Recovery Workbook program Training uses combination of teaching, group discussion and practical exercises, complemented by a workbook for use between sessions. Uses an educational process to increase awareness of recovery, increase knowledge and control of the illness, increase awareness of the importance and nature of stress, enhance personal meaning and sense of potential, build personal support, and develop goals and plans of action. *Note: does not include strategies for medication management
COOK 2013 ⁵⁶	Group	Peer	9	9	2.5	22.5	Wellness Recovery Action Planning (WRAP) Group sessions consisted of lectures, individual and group exercises, personal sharing and role modelling, and voluntary homework to practice using and refining one’s WRAP plan between groups. The content of each session is described fully elsewhere (Cook, Copeland, Jonikas et al., 2012), and consisted of: (a) the key concepts of WRAP and recovery, (b) personalized strategies to maintain well-being, (c) daily maintenance plans with simple and affordable tools to foster daily wellness, (d) advance planning to proactively respond to self-defined symptom triggers, (e) early warning signs that a crisis is impending and advance planning for additional support during these times, (f) advance crisis planning to identify preferred treatments and supporters when in acute phases of the illness, and (g) post crisis planning to resume daily activities and revise one’s WRAP plan if needed.
COOK 2011 ²⁷–²⁹	Group	Peer	8	8	2.5	20	Wellness Recovery Action Planning (WRAP) Behavioural health illness self-management intervention where participants create an individualized plan to achieve and maintain recovery by learning to utilize wellness maintenance strategies, identify and manage symptoms and crisis triggers, and cope with psychiatric crises during and following their occurrence. Instructional techniques promote peer modelling and support by using personal examples from peer facilitators’ and students’ lives to illustrate key concepts of self-management and recovery.
COOK 2012 ³⁰,³¹	Group	Peer	8	8	2.5	20	Building Recovery of Individual Dreams and Goals through Education and Support (BRIDGES) Course topics included recovery principles and stages; structured problem-solving and communication skills training; strategies for building interpersonal and community support systems; brain biology and psychiatric medications; diagnoses and related symptom complexes; traditional and non-traditional treatments for SMI; and relapse prevention and coping skills.
VAN GESTEL-TIMMERMANS 2012 ⁴⁸	Group	Peer	12	12	2	24	“Recovery Is Up to You” Course Trained peer instructors (at an advanced state of their recovery process) were employed to facilitate this group intervention, with discussion and skills practice. Participants used a standardized workbook that covered recovery-related themes: the meaning of recovery to participants, personal experiences of recovery, personal desires for the future, making choices, goal setting, participation in society, roles in daily life, personal values, how to get social support, abilities and personal resources, and empowerment and assertiveness. Important elements of the course were the presence of role models, psychoeducation and illness management, learning from other’s experiences, social support, and homework assignments.

Coping Oriented Self-Management

CHIEN 2013 ²⁴	Group	Clinician	12	24	2	24	Mindfulness-Based Psychoeducation Program (MBPP) The program is a psychoeducational program that addresses patients' awareness and knowledge of schizophrenia and builds skills for illness management. (a) phase 1: orientation and engagement, empowerment and focused awareness of experiences, bodily sensations/thoughts and guided awareness exercises and homework practices; (b) phase 2: education about schizophrenia care, intentionally exploring and dealing with difficulties regarding symptoms and problem-solving practices; and (c) phase 3: behavioural rehearsals of relapse prevention strategies, accessible community support resources and future plans.
CHIEN 2014 ²⁵	Group	Clinician	12	24	2	24	Mindfulness-Based Psychoeducation Program (MBPP) As described above in Chien, 2013
CHIEN 2017²⁶	Group	Clinician	12	24	2	24	Mindfulness-Based Psychoeducation Group Program (MBGP) As described above in Chien, 2013. Name of intervention changed to MBGP, but contents of intervention appear to be the same.
SCHAUB 2016 ⁶¹	Group	Clinician	12	7	1.25	5	Group-based Coping Oriented Program (COP) COP seeks to improve understanding of the illness and its treatment, to teach coping strategies for specific stressors and symptoms, to activate the use of internal and external resources, and to enhance self-confidence and hope. COP combines elements of illness management with cognitive behavioural therapy for psychosis. Includes psychoeducation, cognitive-behavioural teaching principles (e.g., cognitive restructuring, role playing, problem solving). COP focused on topics of greatest concern to patients, such as symptom-management (e.g., coping with anxiety and positive symptoms), managing stress (stress-management including mindfulness and problem solving), building up rewarding activities, time management, social skills (e.g., dealing with relatives, getting to know people), reintegration into the workplace, and providing information about outpatient services. In early groups, participants identified specific distressing symptoms for which coping strategies were selected and taught.
WANG 2016⁵⁰	Group	Clinician	12	24	2	24	Mindfulness-Based Psychoeducation Group Program (MBGP) As described above in Chien, 2013. Name of intervention changed to MBGP, but contents of intervention appear to be the same.

NR – Not reported

Description of intervention, with assumption that meets 4 criteria (*with exception of Barbic, 2009).

^†

Total intervention contact time