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

Imke Hanssen, Nicole van der Horst, Marieke Boele, Marc Lochmann van Bennekom, Eline Regeer, Anne Speckens, Imke Hanssen, Nicole van der Horst, Marieke Boele, Marc Lochmann van Bennekom, Eline Regeer, Anne Speckens

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://ichgcp.net/clinical-trials-registry/NCT03507647 .

Keywords: Barriers; Bipolar disorder; Facilitators; MBCT; Qualitative research.

Conflict of interest statement

IH and AS both work at the Radboudumc Centre for Mindfulness, as a PhD student and professor respectively. NH and MB were interns at the Radboudumc Centre for Mindfulness when conducting this study.

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