title: Recovery-focused cognitive-behavioural therapy for recent-onset bipolar disorder: randomised controlled pilot trial.
abstract: BACKGROUND
  Despite evidence for the effectiveness of structured psychological therapies for bipolar disorder no psychological interventions have been specifically designed to enhance personal recovery for individuals with recent-onset bipolar disorder.
  
  
  OBJECTIVE
  A pilot study to assess the feasibility and effectiveness of a new intervention, recovery-focused cognitive-behavioural therapy (CBT), designed in collaboration with individuals with recent-onset bipolar disorder intended to improve clinical and personal recovery outcomes.
  
  
  METHODS
  A single, blind randomised controlled trial compared treatment as usual (TAU) with recovery-focused CBT plus TAU (n = 67).
  
  
  RESULTS
  Recruitment and follow-up rates within 10% of pre-planned targets to 12-month follow-up were achieved. An average of 14.15 h (s.d. = 4.21) of recovery-focused CBT were attended out of a potential maximum of 18 h. Compared with TAU, recovery-focused CBT significantly improved personal recovery up to 12-month follow-up (Bipolar Recovery Questionnaire mean score 310.87, 95% CI 75.00-546.74 (s.e. = 120.34), P = 0.010, d = 0.62) and increased time to any mood relapse during up to 15 months follow-up (χ2 = 7.64, P<0.006, estimated hazard ratio (HR) = 0.38, 95% CI 0.18-0.78). Groups did not differ with respect to medication adherence.
  
  
  CONCLUSIONS
  Recovery-focused CBT seems promising with respect to feasibility and potential clinical effectiveness. Clinical- and cost-effectiveness now need to be reliably estimated in a definitive trial.
authors.affiliation: Steven H. Jones, MSc (Clin Psychol), PhD, Spectrum Centre for Mental Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster; Gina Smith, PGDipPsych, DClinPsych, 5 Boroughs Partnership NHS Foundation Trust, Warrington; Lee D. Mulligan, MSc, Manchester Mental Health and Social Care Trust, Manchester; Fiona Lobban, DClinPsy, PhD, Lancaster University, Lancaster; Heather Law, PhD, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust, Manchester; Graham Dunn, MA, MSc, PhD, Institute of Population Health, University of Manchester; Mary Welford, DClinPsy, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust; James Kelly, MSc, ClinPsyD, Lancashire Care NHS Foundation Trust, Lancaster; John Mulligan, MSc, ClinPsyD, The Beaco Service HMP Garth, Mersey Care NHS Trust, Liverpool; Anthony P. Morrison, ClinPsyD, Department of Clinical Psychology, University of Manchester, Manchester, UK.
authors.forename: Steven H
authors.initials: SH
authors.lastname: Jones
authors.affiliation: Steven H. Jones, MSc (Clin Psychol), PhD, Spectrum Centre for Mental Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster; Gina Smith, PGDipPsych, DClinPsych, 5 Boroughs Partnership NHS Foundation Trust, Warrington; Lee D. Mulligan, MSc, Manchester Mental Health and Social Care Trust, Manchester; Fiona Lobban, DClinPsy, PhD, Lancaster University, Lancaster; Heather Law, PhD, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust, Manchester; Graham Dunn, MA, MSc, PhD, Institute of Population Health, University of Manchester; Mary Welford, DClinPsy, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust; James Kelly, MSc, ClinPsyD, Lancashire Care NHS Foundation Trust, Lancaster; John Mulligan, MSc, ClinPsyD, The Beaco Service HMP Garth, Mersey Care NHS Trust, Liverpool; Anthony P. Morrison, ClinPsyD, Department of Clinical Psychology, University of Manchester, Manchester, UK.
authors.forename: Gina
authors.initials: G
authors.lastname: Smith
authors.affiliation: Steven H. Jones, MSc (Clin Psychol), PhD, Spectrum Centre for Mental Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster; Gina Smith, PGDipPsych, DClinPsych, 5 Boroughs Partnership NHS Foundation Trust, Warrington; Lee D. Mulligan, MSc, Manchester Mental Health and Social Care Trust, Manchester; Fiona Lobban, DClinPsy, PhD, Lancaster University, Lancaster; Heather Law, PhD, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust, Manchester; Graham Dunn, MA, MSc, PhD, Institute of Population Health, University of Manchester; Mary Welford, DClinPsy, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust; James Kelly, MSc, ClinPsyD, Lancashire Care NHS Foundation Trust, Lancaster; John Mulligan, MSc, ClinPsyD, The Beaco Service HMP Garth, Mersey Care NHS Trust, Liverpool; Anthony P. Morrison, ClinPsyD, Department of Clinical Psychology, University of Manchester, Manchester, UK.
authors.forename: Lee D
authors.initials: LD
authors.lastname: Mulligan
authors.affiliation: Steven H. Jones, MSc (Clin Psychol), PhD, Spectrum Centre for Mental Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster; Gina Smith, PGDipPsych, DClinPsych, 5 Boroughs Partnership NHS Foundation Trust, Warrington; Lee D. Mulligan, MSc, Manchester Mental Health and Social Care Trust, Manchester; Fiona Lobban, DClinPsy, PhD, Lancaster University, Lancaster; Heather Law, PhD, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust, Manchester; Graham Dunn, MA, MSc, PhD, Institute of Population Health, University of Manchester; Mary Welford, DClinPsy, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust; James Kelly, MSc, ClinPsyD, Lancashire Care NHS Foundation Trust, Lancaster; John Mulligan, MSc, ClinPsyD, The Beaco Service HMP Garth, Mersey Care NHS Trust, Liverpool; Anthony P. Morrison, ClinPsyD, Department of Clinical Psychology, University of Manchester, Manchester, UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: Lobban
authors.affiliation: Steven H. Jones, MSc (Clin Psychol), PhD, Spectrum Centre for Mental Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster; Gina Smith, PGDipPsych, DClinPsych, 5 Boroughs Partnership NHS Foundation Trust, Warrington; Lee D. Mulligan, MSc, Manchester Mental Health and Social Care Trust, Manchester; Fiona Lobban, DClinPsy, PhD, Lancaster University, Lancaster; Heather Law, PhD, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust, Manchester; Graham Dunn, MA, MSc, PhD, Institute of Population Health, University of Manchester; Mary Welford, DClinPsy, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust; James Kelly, MSc, ClinPsyD, Lancashire Care NHS Foundation Trust, Lancaster; John Mulligan, MSc, ClinPsyD, The Beaco Service HMP Garth, Mersey Care NHS Trust, Liverpool; Anthony P. Morrison, ClinPsyD, Department of Clinical Psychology, University of Manchester, Manchester, UK.
authors.forename: Heather
authors.initials: H
authors.lastname: Law
authors.affiliation: Steven H. Jones, MSc (Clin Psychol), PhD, Spectrum Centre for Mental Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster; Gina Smith, PGDipPsych, DClinPsych, 5 Boroughs Partnership NHS Foundation Trust, Warrington; Lee D. Mulligan, MSc, Manchester Mental Health and Social Care Trust, Manchester; Fiona Lobban, DClinPsy, PhD, Lancaster University, Lancaster; Heather Law, PhD, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust, Manchester; Graham Dunn, MA, MSc, PhD, Institute of Population Health, University of Manchester; Mary Welford, DClinPsy, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust; James Kelly, MSc, ClinPsyD, Lancashire Care NHS Foundation Trust, Lancaster; John Mulligan, MSc, ClinPsyD, The Beaco Service HMP Garth, Mersey Care NHS Trust, Liverpool; Anthony P. Morrison, ClinPsyD, Department of Clinical Psychology, University of Manchester, Manchester, UK.
authors.forename: Graham
authors.initials: G
authors.lastname: Dunn
authors.affiliation: Steven H. Jones, MSc (Clin Psychol), PhD, Spectrum Centre for Mental Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster; Gina Smith, PGDipPsych, DClinPsych, 5 Boroughs Partnership NHS Foundation Trust, Warrington; Lee D. Mulligan, MSc, Manchester Mental Health and Social Care Trust, Manchester; Fiona Lobban, DClinPsy, PhD, Lancaster University, Lancaster; Heather Law, PhD, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust, Manchester; Graham Dunn, MA, MSc, PhD, Institute of Population Health, University of Manchester; Mary Welford, DClinPsy, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust; James Kelly, MSc, ClinPsyD, Lancashire Care NHS Foundation Trust, Lancaster; John Mulligan, MSc, ClinPsyD, The Beaco Service HMP Garth, Mersey Care NHS Trust, Liverpool; Anthony P. Morrison, ClinPsyD, Department of Clinical Psychology, University of Manchester, Manchester, UK.
authors.forename: Mary
authors.initials: M
authors.lastname: Welford
authors.affiliation: Steven H. Jones, MSc (Clin Psychol), PhD, Spectrum Centre for Mental Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster; Gina Smith, PGDipPsych, DClinPsych, 5 Boroughs Partnership NHS Foundation Trust, Warrington; Lee D. Mulligan, MSc, Manchester Mental Health and Social Care Trust, Manchester; Fiona Lobban, DClinPsy, PhD, Lancaster University, Lancaster; Heather Law, PhD, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust, Manchester; Graham Dunn, MA, MSc, PhD, Institute of Population Health, University of Manchester; Mary Welford, DClinPsy, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust; James Kelly, MSc, ClinPsyD, Lancashire Care NHS Foundation Trust, Lancaster; John Mulligan, MSc, ClinPsyD, The Beaco Service HMP Garth, Mersey Care NHS Trust, Liverpool; Anthony P. Morrison, ClinPsyD, Department of Clinical Psychology, University of Manchester, Manchester, UK.
authors.forename: James
authors.initials: J
authors.lastname: Kelly
authors.affiliation: Steven H. Jones, MSc (Clin Psychol), PhD, Spectrum Centre for Mental Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster; Gina Smith, PGDipPsych, DClinPsych, 5 Boroughs Partnership NHS Foundation Trust, Warrington; Lee D. Mulligan, MSc, Manchester Mental Health and Social Care Trust, Manchester; Fiona Lobban, DClinPsy, PhD, Lancaster University, Lancaster; Heather Law, PhD, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust, Manchester; Graham Dunn, MA, MSc, PhD, Institute of Population Health, University of Manchester; Mary Welford, DClinPsy, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust; James Kelly, MSc, ClinPsyD, Lancashire Care NHS Foundation Trust, Lancaster; John Mulligan, MSc, ClinPsyD, The Beaco Service HMP Garth, Mersey Care NHS Trust, Liverpool; Anthony P. Morrison, ClinPsyD, Department of Clinical Psychology, University of Manchester, Manchester, UK.
authors.forename: John
authors.initials: J
authors.lastname: Mulligan
authors.affiliation: Steven H. Jones, MSc (Clin Psychol), PhD, Spectrum Centre for Mental Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster; Gina Smith, PGDipPsych, DClinPsych, 5 Boroughs Partnership NHS Foundation Trust, Warrington; Lee D. Mulligan, MSc, Manchester Mental Health and Social Care Trust, Manchester; Fiona Lobban, DClinPsy, PhD, Lancaster University, Lancaster; Heather Law, PhD, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust, Manchester; Graham Dunn, MA, MSc, PhD, Institute of Population Health, University of Manchester; Mary Welford, DClinPsy, Psychosis Research Unit, Greater Manchester West NHS Foundation Trust; James Kelly, MSc, ClinPsyD, Lancashire Care NHS Foundation Trust, Lancaster; John Mulligan, MSc, ClinPsyD, The Beaco Service HMP Garth, Mersey Care NHS Trust, Liverpool; Anthony P. Morrison, ClinPsyD, Department of Clinical Psychology, University of Manchester, Manchester, UK.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Morrison
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D061345:Early Medical Intervention; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010865:Pilot Projects; D011369:Professional-Patient Relations; D016037:Single-Blind Method; D016896:Treatment Outcome; D055815:Young Adult