The Effectiveness of Metacognitive Therapy on Family Functioning in Parents with A Child Diagnosed with Bipolar II Disorder

Abstract

Background: Bipolar II disorder is a chronic mental health condition characterized by recurrent depressive and hypomanic episodes, significantly affecting individuals and their families. Objectives: This study aimed to evaluate the effectiveness of metacognitive therapy (MCT) in improving family functioning among parents of children diagnosed with bipolar II disorder. Methods: A quasi-experimental pre-test, post-test, and 3-month follow-up design with a control group was employed. The population included parents of children diagnosed with bipolar II disorder seeking counseling services in Isfahan, Iran, in 2023. A convenience sample of 30 parents was randomly assigned to either an MCT group (n = 15) or a control group (n = 15). The MCT group received 8 weekly 120-minute sessions, while the control group received no intervention during the study period and remained on a waiting list. Family functioning was assessed using the Family Functioning Scale at pre-test, post-test, and 3-month follow-up. Data were analyzed using descriptive statistics and repeated measures analysis of variance (ANOVA) in SPSS version 26. Results: Repeated measures ANOVA revealed a significant main effect of MCT on family functioning, F = 67.41, P < 0.001, with improvements in problem-solving, communication, roles, affective responsiveness, affective involvement, behavioral control, and general functioning at post-test (P < 0.001). These gains were maintained at follow-up (P < 0.001), indicating sustained intervention effects. Conclusions: Metacognitive therapy significantly enhances family functioning among parents of children with bipolar II disorder, offering a promising adjunct to pharmacological treatments. These findings suggest MCT could improve family resilience and coping, with implications for clinical practice by supporting family-centered interventions. Future research should explore long-term outcomes and patient-parent combined interventions to further validate and extend these results.