Abstract
BackgroundWith the advent of the recovery movement in mental health, a humanistic paradigm shift has occurred, placing the focus on personal recovery (i.e., hope, identity, and life meaning) instead of functional or clinical recovery only (i.e., symptom reduction or increases in physical function). Along the journey of recovery, people with bipolar disorder (BD) struggle to cope with recurring mood fluctuations between depression and mania. Mindfulness-based interventions (MBIs) have the potential to result in improvements in personal recovery outcomes. Thus, this protocol will evaluate the efficacy and mechanisms of a brief MBI for helping individuals with BD with their personal recovery. It is hypothesized that adults with BD randomly assigned to a brief MBI intervention will report greater improvements in personal recovery than those in a waiting list control condition. In addition, it is hypothesized that such benefits will be mediated by improvements in emotion awareness, emotion regulation, and illness acceptance. Moreover, the specific stage of BD is hypothesized to moderate the beneficial effects of the brief MBI, such that those in the early stage of BD will report more benefits regarding emotion awareness and emotion regulation, whereas those in the late stage of BD will report more advantages concerning illness acceptance.MethodOne hundred and fifty-four adults with BD will be recruited from hospitals and community settings for this research project. This study will use a mixed methods design. A randomized-controlled trial will be conducted to compare a brief MBI (four sessions in total) group and a waiting list control group. Assessments will be made at baseline, after intervention, and at six-month follow-up. In addition, a qualitative and participatory research method called Photovoice will be employed to further understand the experiences of the participants who receive the brief MBI along their personal recovery journey.DiscussionIf the study hypotheses are supported, the findings from this research project will provide empirical support for an alternative treatment. Moreover, by identifying the mechanisms of the beneficial effects of the brief MBI, the findings will highlight process variables that could be specifically targeted to make MBI treatment even more effective in this population.Trial registrationThis study is registered with the Chinese Clinical Trial Registry (ChiCTR- 1900024658). Registered 20th July 2019.
Highlights
With the advent of the recovery movement in mental health, a humanistic paradigm shift has occurred, placing the focus on personal recovery instead of functional or clinical recovery only
The essences of awareness and acceptance that are central to an Mindfulness-based intervention (MBI) could directly help individuals with bipolar disorder (BD) to address the need for more emotion awareness and emotion regulation as well as illness acceptance
The long-time commitment in standard MBI programmes limit the number of individuals willing to participate in such treatment
Summary
To facilitate the personal recovery process for individuals with BD, an appropriate personal recovery-oriented treatment is needed. Considering the stage of the participant’s BD would be useful for better understanding how (and for which individuals with BD) a brief MBI would be most effective during the recovery process. It is hoped that this study can firstly address extant research and intervention gaps by evaluating the efficacy and mechanisms of a psychosocial intervention to facilitate the process of personal recovery in adults living with BD. It can provide a novel insight into the landscape in which the brief MBI is applied to a new research area of personal recovery among people with BD.
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