title: Feasibility and Acceptability of the 'HABIT' Group Programme for Comorbid Bipolar and Alcohol and Substance use Disorders.
abstract: OBJECTIVE
  We investigated the feasibility and acceptability of an integrated group therapy (called HABIT) for comorbid bipolar disorder (BD) and alcohol and substance use disorders (ASUD) (BD-ASUD), a disabling clinical presentation for which no specific treatment has been validated. The 14-session HABIT programme employs psychoeducation-oriented cognitive-behaviour therapy (CBT) followed by mindfulness-based relapse prevention (MBRP) therapy.
  
  
  METHODS
  Potential group participants were recruited from adult clients with a DSM-IV diagnosis of BD and an ASUD who were referred by their treating clinician. Observer-rated changes in mood symptoms and ASUD, attendance rates and subjective feedback are reported.
  
  
  RESULTS
  Eight of 12 clients referred to the programme initially agreed to join the group, six attended the first group session and five clients completed the programme. Group mean scores for mood symptoms improved over time, with slightly greater reductions in depression during the first module. About 50% of individuals showed clinically significant improvement (≥30% reduction) in alcohol and substance use. Attendance rates showed some variability between individuals and across sessions, but the average attendance rate of the group was marginally higher for the first module (86%) as compared with the second module (77%). Most clients reported high levels of general satisfaction with a group specifically targeted at individuals with BD-ASUD.
  
  
  CONCLUSIONS
  This small pilot study suggests our intensive group therapy is acceptable and feasible. If findings are replicated, we may have identified a therapy that, for the first time, leads to improvement in both mood and substance use outcomes in clients with difficult-to-treat comorbid BD-ASUD. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message Comorbidity between bipolar and alcohol and substance use disorders (BD-ASUD) is frequent and highly disabling; Therapeutic research on approaches that can simultaneously help BD and ASUD is lacking; Previous research highlights the need for integrated treatment of both conditions but showed improvements limited to either element of the comorbid disorder; This pilot study supports the feasibility and acceptability of an intensive, 14-session group therapy programme that integrates CBT and mindfulness approaches.
authors.affiliation: Assistance Publique-Hôpitaux de Paris, GH Saint-Louis-Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France.|Fondation FondaMental, Créteil, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Biseul
authors.affiliation: Assistance Publique-Hôpitaux de Paris, GH Saint-Louis-Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France.|Fondation FondaMental, Créteil, France.|Inserm, U1144, Paris, France.|Université Paris Descartes, Paris, France.|Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris, France.
authors.forename: Romain
authors.identifier: http://orcid.org/0000-0002-5078-4048
authors.initials: R
authors.lastname: Icick
authors.affiliation: Assistance Publique-Hôpitaux de Paris, GH Saint-Louis-Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France.|Fondation FondaMental, Créteil, France.
authors.forename: Perrine
authors.initials: P
authors.lastname: Seguin
authors.affiliation: Assistance Publique-Hôpitaux de Paris, GH Saint-Louis-Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France.|Fondation FondaMental, Créteil, France.|Inserm, U1144, Paris, France.|Université Paris Descartes, Paris, France.|Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris, France.
authors.forename: Frank
authors.initials: F
authors.lastname: Bellivier
authors.affiliation: Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.|Centre for Affective Disorders, IPPN, London, UK.
authors.forename: Jan
authors.initials: J
authors.lastname: Scott
mesh_terms: D000437:Alcoholism / Q000453:epidemiology / Q000628:therapy*; D001714:Bipolar Disorder / Q000453:epidemiology / Q000628:therapy*; D015897:Comorbidity; D005240:Feasibility Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010865:Pilot Projects; D015397:Program Evaluation / Q000379:methods* / Q000706:statistics & numerical data; D011615:Psychotherapy, Group / Q000379:methods*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000628:therapy*
keywords: Alcohol and Substance Use Disorders; Bipolar Disorder; Cognitive Behaviour Therapy; Comorbidity; Group; Mindfulness Based