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Cognitive-behavioral therapy (CBT) is being used, individually or in group format, to improve outcome and prevent relapse of patients with bipolar disorder (BD). CBT shows nevertheless limitations with regard, mainly, to patients having undergone a great number of mood episodes. In one published study, patients with more than 12 mood episodes typically did not respond favorably to the procedures, and for some, their clinical condition worsened.
Understandably, a high dropout rate has also been observed in other studies.
ObjectivesTo overcome these limitations, we combined CBT with mindfulness meditation.
MethodsIn our mood clinic, two different programs have been proposed to this day:
- A short mindfulness-based, stress-reduction program (8 weekly sessions), well-adapted to bipolar patients :
- A program of 20 weekly relapse prevention sessions, including 5 consecutive constructive therapy stages (T. Bonvalot et al.: Constructive Psychotherapy of Bipolar Disorder: A New Approach (abstract) - Bipolar Disorders, special issue, June 2009).
Bipolar patients with more extensive clinical conditions are successively invited to participate to both programs.
ResultsEvery session has been facilitated by a mindful attitude progressively developed by the patients all along the programs.
We observed that mindfulness meditation, along with CBT, presents most often a high acceptation level on the part of most bipolar patients, and a capacity to restore self-image, self-confidence and hopefulness.
ConclusionThe patients’ involvement in the treatment programs have developed on a regular basis, and consequently a low dropout rate has been observed.
These observations are to be now formally evaluated.
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