Integrated Bipolar Parenting Intervention (IBPI) Study
The aim of this study is to assess whether providing online parenting support (IBPI) for parents with bipolar disorder leads to their children having fewer behavioural and emotional problems. Researchers also want to know whether the online support helps parents feel less stressed and more confident about their parenting and have fewer mood problems. If successful, the IBPI can be made widely available for parents with bipolar disorder.
Individuals with mental health issues are increasingly turning online for support, yet how online support works and the impact of going online for support is not well understood. The aim of this project is to improve the uptake, safety and usefulness of these communities by developing a theory as to how these online forums work, for why, why and in what contexts.
The Library of Lived Experience for Mental Health in the North
Living libraries help to facilitate conversations between people with lived experience of mental health difficulties (books) to share their expertise with others facing similar difficulties, carers and healthcare staff (readers). The aim of this study is to develop a programme theory about the likely impacts of the living library and the mechanisms by which it can help people to share their lived experiences. An implementation plan will be co-designed with individuals with lived experience of mental health issues and previous living libraries, which will lay out how to run a living library for mental health in the North.
People with severe mental illness often have problems with their teeth and gums and are more likely to have missing, filled, and decayed teeth than people without severe mental illness. Having poor oral health impacts a lot of everyday activities like eating, speaking and smiling. However, very few people with SMI attend regular dental appointments. The Mouth Matters in Mental Health feasibility trial wants to help people with severe mental illness to access dental care by involving link workers who will help people to book, plan, and attend regular dental appointments and support patients to apply for financial support.
The Right to Smile Consensus Statement – UKRI Closing the Gap
People experiencing severe mental ill health are at increased risk of problems with their teeth and gums. They also experience difficulties accessing early and effective dental care. The Right to Smile Consensus Statement outlines 11 five year targets for addressing these inequalities. It advocates that poor oral health should not be an inevitable consequence of severe mental ill health.
The Mental Imagery for Suicidality in Students Trial (MISST)
One of Spectrum's recently completed projects, the Mental Imagery for Suicidality in Students Trial (MISST) aimed to explore the feasibility of evaluating a new talking therapy for reducing suicidal thoughts in university students.
Here at Spectrum we have developed an online Relatives Education and Coping Toolkit (REACT) to support relatives of people who have had experiences of psychosis and bipolar disorder.
The toolkit was developed collaboratively with relatives, clinicians and researchers to provide information and emotional support to carers as recommended by the National Institute for Health and Care Excellence (NICE).
The aim of the project is to explore how REACT can move from being a research project, to becoming part of a clinical service that is available widely for relatives as part of their routine NHS care. This will be achieved by working in collaboration and developing networks with key stakeholders, clinicians and Commissioners to explore most viable ways of offering and implementing REACT within NHS Trusts and CCG areas. Learning from this project will be widely shared, and will provide information about best ways to narrow the research practice gap and ensure that treatment that can improve the health and wellbeing of people are implemented and accessible within NHS Trusts.
As part of this project a free knowledge exchange event was held in Manchester on the 9th July 2019 titled ‘Mental health carers: The Way Forward’.
Recovery focused CBT for older adults with bipolar disorder (RfCBT-OA)
Bipolar disorder (BD) persists into older adulthood and there is evidence that a proportion of individuals will experience late onset BD which begins after 50 years of age.
There has been very little research or service development for older adults with BD, particularly with respect to psychological therapies.
There is evidence for the effectiveness of such interventions for BD in adults of working age. A recent study from our group at the Spectrum Centre has shown a recovery focused CBT intervention (RfCBT) for individuals with BD (below 65 years) is beneficial in terms of both functional and symptomatic outcomes (Jones et al, 2014). This therapy has now been adapted through rigorous literature review and extensive service user involvement to meet the needs of an older adult population.
The aim of this study is to explore how interested people are in this new type of therapy, what aspects of the therapy are most useful, and the impact it might have on a range of outcomes including recovery, quality of life, functioning and symptoms.
Initially, participants will be asked about their experience of mood fluctuations, including questions about symptoms, quality of life and coping style. Participants are then be randomly allocated to either receive an individual, six month (up to 14 session), recovery focused psychological therapy with a trained clinician or to continue with treatment a usual. All participants will be followed up at 3 monthly intervals for the 12 month study period.
We are looking for approximately 50 people to take part in the study who live in the Northwest, have a diagnosis of bipolar disorder and are over the age of 60.
If you're interested in learning more about the study or taking part please contact Elizabeth Tyler: Email - e.tyler@lancaster.ac.uk | Telephone - 07967 837938
Recently Completed Research
Recently Completed Research Accordion accordion
There is varied evidence to suggest that the environment one lives in (social, economic, etc.) can affect one's health and mental health in particular. However, it is still unknown how that happens exactly or why and when. Furthermore, it remains unclear whether these mechanisms operate in the same way across different mental health difficulties.
Some studies propose that external factors affect psychological processes, which in turn can lead to mental health or illness. An example of such a process is rumination, which is a form of repetitive negative thinking but without leading to a solution to the problem and which research has shown to be linked to mental health.
The aim of the present study is to explore if patterns of rumination are linked to social and economic environment and in turn affect mental health.
To do this we are looking for participants who are over 18 years old, a UK citizen anywhere in England and have a primary diagnosis of bipolar disorder or depression or psychosis or have never had a mental health diagnosis. Once these inclusion criteria are confirmed via a short interview on the phone, participants will be asked to complete a one-off survey. If they wish to, participants may be contacted again in the future for the second phase of the study, when they will be interviewed in more depth about their experiences.
This project is being conducted as part of a PhD and it is funded by NIHR CLAHRC NWC. The study has received NHS Research Ethics Committee approval.
If you want to discuss the study, please contact Katerina Panagaki.
Here at the Spectrum Centre, we are recruiting individuals with Bipolar Disorder and Cyclothymic Disorder who struggle with frequent mood swings for research which involves a group talking therapy, called the ThrIVe-B programme. The programme is aimed at helping people to stabilise day-to-day mood and manage stress by teaching skills for responding to rapid mood shifts and the sort of everyday life events that can trigger mood changes.
This project is being run in collaboration with the University of Exeter where the Principal Investigator, Kim Wright, is based.
"We hope that the findings of this study will help us plan for a much larger study to fully test how effective this therapy approach is," said Kim Wright of the University of Exeter.
"What many people find is that having powerful shifts in mood can sometimes make it difficult to live life to the full, and can be a source of difficulties in relationships with others."
If you are interested in taking part please contact Debbie Duncan:
1 in 100 people will experience severe mental health problems. This most commonly starts in adolescence and the majority will be living at home with families. Relatives and close friends often provide their loved one with a massive amount of support through complex and challenging mental health crises. But this can have a big impact on the life of the relative/friend, especially if they have little knowledge of what is happening or how to manage it.
Here at the Spectrum Centre we are running a nationwide study to see whether an online intervention entitled Relatives Education and Coping Toolkit (REACT) is helpful for relatives or close friends of people with bipolar disorder or psychosis. The REACT intervention is supported online by peer supporters drawing on their own experiences, rather than health professionals.
The REACT toolkit contains lots of information to help relatives/close friends, ideas of strategies to manage common problems, and stories from other relatives/close friends about their experiences. Through the website you can contact a REACT Supporter who is a trained relative who can provide additional support relevant to your personal needs. The REACT Supporter will monitor the site during office hours. There is also an online forum (REACT Group) where you can talk directly with other relatives or friends using the site. As well as being totally online, the peer support model is another novel feature of the study.
All relatives/close friends supporting someone with psychosis or bipolar disorder who are 16 or over, live in the UK and have regular access to the internet can take part and they can self-refer themselves into the study through the website. Participants are randomised to receive either the full REACT toolkit, or a Resource Directory that signposts them to all currently available national support services. That way we hope everyone will have access to something useful. We are interested in comparing the effect of these two interventions on distress levels of participants.
This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment (HTA), 14/49/34 and has full NHS ethical approval.
The IMPART study is a study funded by the NIHR (National Institute for Health Research) to explore the implementation of support for relatives across several Mental Health Trusts across the country.
Recovery experience is a unique and diverse experience and rarely focuses only on symptom reduction. This study aims to examine what other aspects of recovery are important to people with bipolar disorder and discover psychological, social and environmental factors that influence such aspects and fluctuations in recovery experiences, in both everyday life and in longer term.
We are exploring relationships between thinking style, responses to mood, positive experiences of mood swings, inspiration, mood and recovery using a set of online questionnaires. We will also be investigating the reliability and validity of several measures of these processes. For more information on the project, see the Thinking Style study page.
This project is designed to assess the acceptability of a 6 month family-focused psychological intervention, providing up to 18 sessions with participants. It will provide a detailed exploration of the relationship between the intervention, the characteristics of the participant (such as thoughts, mood and activity) and outcomes as defined by both the service user and clinician.
This is a study exploring the impact of a recovery-focused intervention on the mood and other factors of interest for people with a diagnosis of bipolar disorder. Considerable evidence points to the beneficial impact of psychological interventions on outcomes such as symptoms and relapse. However, such outcomes may not accurately capture what the service user considers to be meaningful change. Little is known about the interaction between service user definitions of recovery, participant characteristics and therapeutic components. An improved understanding of these factors represents an important step in developing more suitable and effective psychological interventions.
Academics at the Spectrum Centre led by Professor Steven Jones have been awarded a prestigious £2m programme grant by National Institute for Health Research. The PARADES programme will run over 5 years in collaboration with Manchester Mental Health and Social Care Trust, Nottingham and Manchester Universities.
This is the first major award for research into bipolar disorder funded by NIHR and will focus on the development, evaluation and implementation of psychological approaches to bipolar disorder and comorbid problems.
There are five studies contained within it as follows:
A definitive randomised controlled trial (RCT) comparing group psychoeducation with group peer support, both delivered by a service user and 2 clinicians.
A treatment development study concerning anxiety in bipolar disorder. This will have three phases. Phase 1 is a qualitative study of people's experience of anxiety in bipolar disorder. Phase 2 is a consultative phase in which individuals with bipolar experience indicate ways in which anxiety intervention protocols might be made relevant to individuals with bipolar. The final phase is a pilot RCT testing the feasibility and acceptability of the chosen approach and also providing provisional information on effectiveness all of which will inform a future definitive trial.
This study will follow the same model as the Anxiety stream (see above) but for people with bipolar and comorbid substance/alcohol problems and will be informed by pilot work already conducted by our team.
This study will look at factors associated with suicide and severe self-harm in bipolar disorder using both the Manchester University National Confidential database and associated data sources in the first instance.
The final element is designed to evaluate the extent to which the mental capacity act is impacting on the treatment experiences of individuals with bipolar disorder. This will include surveys of court records and Responsible Medical Officers to indicate application of advance directives as well as interviews with individuals with a bipolar diagnosis to study whether advance directives are used in relation to admission and whether this is more or less likely in individuals in receipt of the psychoeducation intervention.
The Recovery project involves the development and evaluation of a recovery-focussed psychosocial intervention for individuals with a diagnosis of bipolar disorder. For more information on the Recovery project, visit the Recovery page.
How do people with a bipolar diagnosis talk about personal recovery outside of research contexts? This is what this PhD project set out to investigate from 2019-2023. Based on a systematic review of previous qualitative research and using the well-known CHIME recovery framework, the team developed the POETIC framework to describe personal recovery experiences in bipolar disorder. POETIC comprises the dimensions Purpose & meaning, Optimism & hope, Empowerment, Tensions, Identity, and Connectedness. We then applied this framework to a large amount of public online support forum posts by people with a bipolar disorder diagnosis. This showed that the POETIC categories also very well capture personal recovery experiences voiced naturally online.
Technology is increasingly being used to support the delivery of treatments for mental health problems. We are interested in speaking to people that have used a technology-based treatment for their mental health in the past six months. This means a mental health treatment that has been provided via a computer, the internet, or perhaps a mobile phone. This research aims to find out more about people's experiences of using this type of treatment.
To do this, we would like to interview people about their experiences of using technology-based treatment. We are offering a £10 voucher for taking part, as a way of thanking participants for their time. Involvement in this study is entirely voluntary, and participants can withdraw at any time.
This project is part of a PhD project by researchers at the Spectrum Centre for Mental Health Research, at Lancaster University. The Chief Investigator of the project is Laura Hillier, a PhD student. The project is being supervised by Professor Fiona Lobban and Professor Steven Jones.
If you have any questions, please feel free to contact us.
ERP Online is an interactive website which provides access to the Enhanced Relapse Prevention approach for bipolar disorder.
Why are we doing this?
Many people continue to experience relapses and our approach is effective in reducing relapse. We want to increase access to it.
For more information on the ERP Online project, see the ERP Online page.
The Spectrum Centre assessed the usefulness of a web-based parenting programme that is tailored to meet the needs of parents with a diagnosis of bipolar disorder. People with Bipolar Disorder may find that their changes in mood make the delivery of consistent parenting more difficult than for parents without mental health problems.
The Integrated Bipolar Parenting Intervention (IBPI) developed by the Spectrum Centre combines a parenting programme (Triple P) that consists of positive parenting techniques with strategies that are helpful for managing bipolar. For more information on the IBPI project, see the IBPI page.
Committed to the continuous improvement of the care provided, the Central North West London NHS Foundation Trust (CNWL) is keen to support a research project that aims to evaluate how carers experience the services they receive.
The study focused on the triangle of care in mental health, consisting of service users, relatives, and health professionals. The study explored how relatives of people with mental health problems experience the support they receive, whether they are satisfied, and how this can be improved.
For more information on the MRN project, see the MRN page.
Funded by the Violet and Milo Cripps Charitable Trust in memory of Lord Milo Douglas who had bipolar disorder and died by suicide in 2009, aged 34, this study aimed to enhance our understanding of the inter- and intrapersonal barriers and facilitators to involving relatives in mental healthcare, and the impact that communication in mental healthcare settings may have on the course of BD and the family's overall wellbeing. For more information, visit our involving relatives page.
This project was an analogue study exploring the associations between personality style and academic achievement in undergraduate students, and what factors are specifically related to positive and negative outcomes for these students.
Faye Banks, Heather Robinson, and Kay Hampshire jointly ran the EMOTE study, which aimed to explore the relationships between mood changes and anxiety, mood management and circadian rhythms.
This project was supervised by Steve Jones and Fiona Lobban.
Faye Banks investigated the associations between circadian instability, appraisals, and mood, among individuals with bipolar disorder and fybromyalgia, as well as non-clinical populations.
This project was supervised by Steve Jones and Fiona Lobban.
Heather Robinson investigated how individuals with and without a diagnosis of bipolar disorder detect and respond to changes in mood. Mood management: An eight stage process will examine whether there are differences between individuals with and without a diagnosis of bipolar disorder with regard to how they manage their moods at different stages of self-regulation, which could have important implications for psychosocial interventions for bipolar disorder.
This project was supervised by Fiona Lobban and Steve Jones.
Anxiety is common among individuals with bipolar disorder and is associated with poorer outcomes. Kay Hampshire investigated the experience of anxiety among individuals with a diagnosis of bipolar disorder, and the relationship between the two.
This project was supervised by Steve Jones and Fiona Lobban.
Laura Wainwright investigated self-management of relatives of people experiencing early psychosis. The aim was to investigate their experiences and how they may be supported to use resources to facilitate their experiences.
This project was supervised by Fiona Lobban and Steve Jones.
Background
Bipolar Disorder (BD) can have highly detrimental effects on the lives of people with the diagnosis and those who care about them. However, growing evidence suggests that aspects of bipolar experiences are also highly valued by some people.
Method
We aimed to understand how participants with a diagnosis of BD made sense of what they took to be positive about their bipolar experiences. Interpretative Phenomenological Analysis was used in the collection and analysis of data from 10 individuals in the UK.
Results
Positive aspects were numerous, highly valued and participants welcomed the opportunity to discuss them. Three important themes emerged: 1) Direct positive impact of bipolar experiences on everyday life including amplification of internal states, enhanced abilities and more intense human connectedness; 2) Lucky to be bipolar – the sense of having been given a special gift; 3) Relationship between the self and bipolar experiences.
Limitations
Given the small size, further research is needed to explore how widely positive aspects of BD are experienced.
Conclusions
These themes highlight the need to invite people to talk about the positive aspects of their bipolar experiences as well as the difficulties they face. This may help us to understand ambivalence to current treatment and to develop interventions that minimise the negative impacts, whilst recognising and potentially retaining some of the positives.
