Feasibility and acceptability of integrated psychological therapy versus treatment as usual for people with bipolar disorder and co-morbid alcohol use: a single blind randomised controlled trial

Research output: Contribution to journalArticle

  • External authors:
  • Steven Jones
  • Heather Robinson
  • Rosalyn Hartwell
  • Mike Fitzsimmons
  • Ian Wilson
  • Claire Hilton
  • Rita Long
  • Lucy Bateman
  • Emma Weymouth
  • Rebecca Owen
  • Christopher Roberts
  • Christine Barrowclough

Abstract

Abstract
Background
Alcohol use is a common problem in bipolar disorder (BD) and evidence indicates more promising outcomes for alcohol use than other substances. No trials have evaluated individual integrated motivational interviewing and cognitive behaviour therapy (MI-CBT) for problematic alcohol use in BD. We therefore assessed the feasibility and acceptability of a novel MI-CBT intervention for alcohol use in BD.

Methods
A single blind RCT was conducted to compare MI-CBT plus treatment as usual (TAU) with TAU only. MI-CBT was delivered over 20 sessions with participants followed up at 3, 6, 9 and 12 months post-randomisation. Primary outcomes were the feasibility and acceptability of MI-CBT (recruitment to target, retention to follow-up and therapy, acceptability of therapy and absence of adverse events). We also conducted preliminary analyses of alcohol and mood outcomes (frequency and severity of alcohol use and time to mood relapse).

Results
44 participants were recruited with 75% retention to 6 and 12 months follow-up. Therapy participants attended a mean of 17.6 (SD 4.5) sessions. Therapy alliance and treatment fidelity were acceptable. Qualitative interviews indicated the intervention was experienced as collaborative, and helpful, in addressing mood and alcohol issues, although risk of overconfidence following therapy was also identified. Clinical outcomes did not differ between arms at 12 months follow-up.

Limitations
As a feasibility and acceptability trial any secondary results should be treated with caution.

Conclusions
Integrated MI-CBT is feasible and acceptable, but lack of clinical impact, albeit in a feasibility study, suggests need for further development. Potential adaptations are discussed.

Bibliographical metadata

Original languageEnglish
JournalJ Affect Disord
Early online date22 May 2019
DOIs
Publication statusPublished - 1 Sep 2019

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