An exploratory randomised controlled trial of a web-based integrated bipolar parenting intervention (IBPI) for bipolar parents of young children (aged 3–10)

Steven Jones,Matthew Sanders,Rita Long,Fiona Lobban,Rob Parker,Debbie Mayes,Rachel Calam,Jelena Jovanoska,Helen Vincent,Peter J Diggle,Laura D Wainwright

doi:10.1186/s12888-015-0505-y

Abstract

BackgroundCommunication, impulse control and motivation can all be affected by Bipolar Disorder (BD) making consistent parenting more difficult than for parents without mental health problems. Children of parents with BD (CPB) are at significantly increased risk of a range of mental health issues including Attention Deficit Hyperactivity Disorder (ADHD), anxiety, depression, substance use, and sleep disorders. Furthermore, CPB are also at elevated risk for BD compared to the general population. This paper describes the rationale and protocol for a pilot randomised controlled trial (RCT) designed to assess the feasibility and acceptability of a new online intervention providing interactive psychoeducational information and parenting support for parents with BD.Methods and designThis article describes a single-blind randomised controlled trial comparing an Integrated Bipolar Parenting Intervention (IBPI) in addition to treatment as usual (TAU) with TAU alone. Participants will be recruited from across the UK from mental health services and through self-referral. The primary outcome of the study is the feasibility and acceptability of IBPI as indicated by recruitment to target, use of the intervention site, and retention to follow-up. Parents with BD allocated to the IBPI condition will have access to the intervention for 16 weeks. Effect size estimates will be obtained with respect to child behaviour, parenting skills and measures of parental mental health using measures taken at baseline (0), and at 16, 24, 36, and 48 weeks post randomization.DiscussionThis is the first randomised controlled trial of an integrated bipolar disorder parenting intervention. The benefits and challenges of delivering this online intervention, and evaluation using online RCT methodology are discussed.Trial registrationCurrent Controlled Trials ISRCTN75279027 Registered 12 August 2013

Highlights

Communication, impulse control and motivation can all be affected by Bipolar Disorder (BD) making consistent parenting more difficult than for parents without mental health problems
Parenting can be a particular challenge for parents who are living with bipolar disorder, as there can be difficulties with sleep/wake cycles, impulse control, motivation and communication [7,8] which can impact on their ability to consistently engage in adaptive parenting
A pilot study by our team has shown that providing simple psychoeducational information on BD along with an early online version of the Triple P Positive Parenting Program led to significant improvements in child behaviour and parenting [23]

Summary

Methods and design

This article describes a single-blind randomised controlled trial comparing an Integrated Bipolar Parenting Intervention (IBPI) in addition to treatment as usual (TAU) with TAU alone. Participants will be recruited from across the UK from mental health services and through self-referral. The primary outcome of the study is the feasibility and acceptability of IBPI as indicated by recruitment to target, use of the intervention site, and retention to follow-up. Parents with BD allocated to the IBPI condition will have access to the intervention for 16 weeks. Effect size estimates will be obtained with respect to child behaviour, parenting skills and measures of parental mental health using measures taken at baseline (0), and at 16, 24, 36, and 48 weeks post randomization

Discussion

Background

Objective

Clinician Referral Route

Self-Referral Routes

Findings