The final objective of any treatment should be a reduction of symptoms or an improvement in the course of a specific illness. In the case of bipolar disorders, the objective of any maintenance treatment is a reduction in the number of episodes of both polarities and their severity, and as a result, a reduction in the number of hospitalizations. This is true both for pharmacological treatments as well as psychological treatment. The commonplace distinction in which psycho-pharmacology treats symptoms while psychotherapy treats problems is absurd. In clinical psychology, psychological treatment is useful if it improves the course of an illness.

The action mechanisms of psychoeducation can be broken down into three levels (Table 1). At the first level we find those basic mechanisms that comprise partial objectives per se, those mechanisms whose lack of fulfillment leads us to say simply that psychoeducation has not worked. They include providing the patient with an adequate awareness of disorder (and also of episode, when necessary), improving pharmacological adherence and facilitating early detection of new episodes. Taken separately, these three partial objectives have been the goal of various programs similar to ours, but we believe that it is the combination of the three that makes our program a solid approach, with high rates of efficacy, even at the cost of being a long treatment. The three basic mechanisms are probably those that are most able to explain the good results of our program, although curiously they are not the ones the patients usually mention as the most relevant ones after completing a group.