Background Mindfulness- Based Cognitive Therapy (MBCT) could be a promising psychosocial intervention for people with bipolar disorder (BD). However, little is known about the feasibility of MBCT for people with BD. In this study we explore the facilitators and barriers people with BD experience of an adapted MBCT program. Method This qualitative study is part of a large, multicenter randomized controlled trial on MBCT for BD (trial registration number: NCT03507647). The present study included 16 participants with BD who participated in an 8-week adapted MBCT program. Semi- structured interviews exploring the feasibility, with a particular focus on the bipolar symptoms, were recorded verbatim, transcribed and analyzed. For reasons of triangulation, teachers were interviewed as well. Results Participants reported different barriers and facilitators of MBCT, both generally as well as with regard to their bipolar disorder. Four key themes arose: the training itself, psychosocial factors, personal characteristics and the bipolar disorder. Themes were further divided in subthemes. Conclusion The adapted MBCT program seemed to be feasible for people with BD. Depressive symptoms often acted as a barrier for participating in MBCT, suggesting that participants might need additional support when depressed. Manic symptoms could act both as a barrier and facilitator, suggesting that the occurrence of (hypo)mania does not necessarily have to be an exclusion criterion for participation. Further clinical and research implications are suggested. Trial registration: ClinicalTrials.gov, NCT03507647. Registered 25th of April 2018, https://clinicaltrials.gov/ct2/show/NCT03507647.
Objectives Mindfulness-based cognitive therapy (MBCT) is an emerging psychological treatment that might be beneficial for people with bipolar disorder (BD). Neurocognitive studies suggest that MBCT may have important effects on mood regulation and broad attentional and frontal-executive control in BD. In this qualitative study, the process of change of MBCT in people with BD is explored. Methods The current qualitative study was part of a multicenter randomized controlled trial (RCT) on (cost-)effectiveness of MBCT for BD. Semi-structured interviews were conducted with a purposive sample of 16 participants who participated in an 8-week MBCT. For reasons of triangulation, teachers were interviewed as well. Results Three themes arose from the data: (1) awareness of thoughts, emotions, bodily sensations, and behavior and insight into their inter-relationship; (2) behavioral change; and (3) positive consequences following MBCT. A distinction was made between general aspects and aspects related specifically to BD. Themes were divided into subthemes. Process of change took place in a non-linear, iterative fashion. Conclusions Qualitative data support the notion that several cognitive and behavioral processes in BD could be potential targets for MBCT. We suggest that future mediation, neuroimaging, and cognitive experimental studies should explore MBCT as an adjunctive treatment strategy for BD by investigating possible working mechanisms of MBCT in BD. Trial Registration ClinicalTrials.gov, NCT03507647. Registered 25th of April 2018, https://clinicaltrials.gov/ct2/show/NCT03507647
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