The feasibility of mindfulness-based cognitive therapy for people with bipolar disorder: a qualitative study

Abstract

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.

Mindfulness-based cognitive therapy v. treatment as usual in people with bipolar disorder: A multicentre, randomised controlled trial

“…This would resonate with findings in a recent network meta-analysis showing that adjunctive psychotherapy is the best option in stabilising episodes and preventing recurrences in BD, while at the same time heterogeneity in study populations was found to temper this finding (Miklowitz et al, 2021 ). Furthermore, as participants in our qualitative study indicated that they experienced the lack of follow-up sessions as a barrier to maintain their meditation practice (Hanssen et al, 2021b ), future research should investigate whether including booster sessions after MBCT increases long-term adherence and effectiveness. Moreover, the use of ecological momentarily assessments by interviews and self-report questionnaires in a highly recurrent and alternating disorders such as BD might be questionable.…”

Mindfulness‐based and mindfulness‐informed interventions in bipolar disorder: A meta‐analysis based on Becker's method

“…Random selection of participants for evaluation was not performed in any study. Two studies had a follow‐up rate of ≥80% (Ives‐Deliperi et al, 2013; Van Dijk et al, 2013), while six studies show an attrition rate of over ≥20% (Eisner et al, 2017; Hanssen et al, 2020; Painter et al, 2019; Pankowski et al, 2017; Perich et al, 2013; Weber et al, 2010).…”

“…Some differences were noted in the studies included in these reviews compared those in meta‐analysis. For example, in the Lovas and Schuman‐Olivier (2018) study, MII interventions are not included, while in Bojic and Becerra (2017) and Miziou et al (2015), due to the year of implementation, five articles are not included (Biseul et al, 2017; Eisner et al, 2017; Hanssen et al, 2020; Painter et al, 2019; Pankowski et al, 2017). Regarding the meta‐analyses published to date (Chu et al, 2018; Xuan et al, 2020), these do not include MII interventions, so for the ES calculations, our work includes 13 studies with respect to the seven by Chu et al (2018) and nine by Xuan et al (2020).…”

Mindfulness‐based cognitive therapy for chronic noncancer pain and prescription opioid use disorder: A qualitative pilot study of its feasibility and the perceived process of change

“…There were also practical barriers to participation: having other responsibilities, limited social support, too much pain, and too many mental complaints. Having limited time and practical/social support have also been identified as barriers in other studies on feasibility of MBIs in patients using opioids for chronic pain (Zgierska, Burzinski, Cox, Kloke, Singles, et al., 2016 ) as well as in different populations with somatic or psychiatric complaints (Brintz et al., 2020 ; Ewais et al., 2020 ; Hanssen et al., 2020 ; Janssen et al., 2020 ; Schoultz et al., 2016 ). To overcome these practical issues, MBCT could be offered in an individual, online format, where patients can follow the eight sessions in their own pace from home.…”