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Table 4 Value and clinical implications of ERP reported by care coordinators (CC) and service users (SU)

From: Enhanced relapse prevention for bipolar disorder: a qualitative investigation of value perceived for service users and care coordinators

Value Implications for CC Implications for SU
Improved Understanding of Bipolar Disorder • Learns about BD • Learns about BD
  • Learns about early warning signs, triggers and coping strategies • Learns about early warning signs, triggers and coping strategies
  • Acquires new skills for working with individuals with BD – increases competence and confidence of working with individuals with BD • Increases acceptance of diagnosis and rationale for medication concordance
  • Acquires new skills and strategies that generalise to working with individuals with other disorders • Reduces feeling of isolation and fear of BD
  • Gains further understanding of SU perspective and experience of BD • Allows opportunity to reflect and make sense of lives
  • Need to manage SUs distress and anxiety talking about past illness episodes • Distress and anxiety talking about past illness episodes
Developed ways of working with and managing Bipolar Disorder • More contact with SU • More contact with CC
  • Opportunity to work with SU when well • Improves recognition of triggers, early warning signs and coping strategies
  • Added burden to workload and time • Increases monitoring of mood and behaviour
  • Increases complexity of role • Empowerment and control over BD
  • Sessions are more structured and focused • Identifying and using coping strategies to prevent relapse
  • Provides added sense of purpose • Creation of concise, individualised action plan
  • Documentation to support working • Relapses can occur too quickly to use action plan
  • Creation of concise, individualised action plan • SU not motivated to prevent mania relapse
  • Concerns that action plan not used in crisis by SU and wider team  
  • Identifying and reinforcing personalised coping strategies  
Enhanced Working Relationships • Discovers new relevant information • Shares new relevant information
  • Collaborative working • Collaborative working
  • Is considered as more trustworthy • Increases trust in CC
  • Improves contact by SU when needed • Improves contact with services when needed
  • Increased dependency on CC rather than service as a whole • Increased dependency on CC rather than service as a whole
  • Changes relationship dynamic • Changes relationship dynamic