Tele-therapy for recurrent mood disorders

Intervention: Patients will receive tele-therapy. Either 20 x 1 hour sessions of Interpersonal and Social Rhythm Therapy (IPSRT) initially weekly and then two-weekly or monthly over 30 weeks; or 5 one-hour sessions of Patient-centred Psychoeducation for Depression (PPD) over 30 weeks. Both therapies will be delivered on to one via teleconference. There are four therapists (3 nurses and one social worker) who have been trained in IPSRT and with experience of its delivery in research conditions ranging from 2 - 15 years. PPD is a newly developed therapy which follows a manualised protocol and has been designed as an equivalent to good case management in community mental health services. This has been designed specifically for this study. In addition to face to face sessions, patients will receive their own resource book. PPD will be delivered by 3 nurses with extensive experience in caring for patients with mood disorders. All therapists will attend two-weekly supervision to ensure fidelity to the treatment. We have effective processes to ensure fidelity for in-person delivery but need to evaluate whether these can be maintained via tele-conferencing. The feasibility study will, therefore, need to assess the fidelity to both therapies by evaluating recordings of the sessions.