Pilot Study of a Brief Sleep Intervention for Suicidal Ideation in Bipolar Disorder.

OBJECTIVE: We investigated the feasibility and acceptability of a brief sleep intervention and sleep monitoring device in bipolar disorder (BD), as well as the intervention's effectiveness in reducing suicidal ideation through improved sleep quality and duration. METHODS: Participants (N=13) with BD received 4 sessions of cognitive-behavioral therapy for sleep disturbance and completed assessments of the intervention and sleep device acceptability, mood, suicidal ideation, and sleep at pretreatment and posttreatment. RESULTS: Feasibility and acceptability of the intervention were high at both pretreatment and posttreatment and did not significantly change by the intervention's conclusion, although participants reported being significantly more likely to recommend the intervention to others at posttreatment. The sleep device was easy to understand, wear, and did not interfere with participants' sleep. Suicidal ideation and depressive symptoms significantly decreased from pretreatment to posttreatment (P<0.05). There were small, but not significant, improvements in the percentage of time spent in stable sleep and total average nightly sleep. CONCLUSION: The potential of this intervention for reducing suicidal ideation and improving sleep is promising, but future research is warranted.

Money makes the world go 'round: A qualitative examination of the role funding plays in large-scale implementation and sustainment of youth evidence-based practice.

Funding is posited to affect evidence-based practice implementation, yet the complex interplay between financial matters and successful implementation is understudied. This study examined stakeholder perspectives on the impact of funding in evidence-based practice implementation. All participants were key stakeholders (e.g., clinicians, case managers, agency leaders; N = 41) involved in a trauma-focused cognitive-behavioral therapy implementation effort using a community-based learning collaborative model within the community's child welfare system. Semistructured interviews were conducted and qualitatively analyzed as part of a program evaluation of the implementation effort. Funding emerged as a key theme influencing implementation within this program evaluation from the perspective of all stakeholders. Thirty-four participants (83%) independently raised funding as an important factor affecting implementation outcomes across seven specific themes: (a) the impact of privatization, (b) turfism, (c) money as a primary implementation facilitator, (d) implementation costs impacting participation, (e) burden associated with funding evaluation efforts, (f) need for reimbursement practices to align with the use of trauma-informed treatment, and (g) a sense of shared mission to serve clients above money. Recommendations for addressing these challenges are provided. Future research should examine funding qualitatively and quantitatively across diverse communities and funding systems to improve understanding of the impact of funding on implementation and, ultimately, care provided to clients. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Feasibility and Acceptability of a Lifestyle Intervention For Individuals With Bipolar Disorder.

Individuals with bipolar disorder are at greater risk for cardiovascular disease and are less likely to adhere to lifestyle interventions than the general population. To decrease cardiovascular risk and improve adherence to lifestyle interventions, we developed the Nutrition Exercise and Wellness Treatment (NEW Tx). NEW Tx is an 18-session, 20-week cognitive behavioral therapy-based treatment comprising 3 modules: Nutrition, Exercise, and Wellness. To evaluate the feasibility and acceptability of this intervention as well as predictors of treatment satisfaction and expectations, 38 adult outpatients with bipolar disorder were randomized to either NEW Tx or a waitlist control condition. There was no statistically significant difference in dropout rates between the groups (26.3% in NEW Tx, 31.6% in the control condition). In the NEW Tx condition, participants attended a mean of 66.7% of sessions and reported moderate to high satisfaction. There were no study-related adverse events. We also found that expectations, but not perceived credibility (or believability), of NEW Tx (as measured by the Credibility/Expectancy Questionnaire) at baseline predicted treatment satisfaction (as measured by the Care Satisfaction Questionnaire) posttreatment. Manic symptoms at baseline predicted treatment satisfaction, and marital status predicted one's expectations of lifestyle interventions. Data suggest that NEW Tx is a feasible and acceptable intervention for individuals with bipolar disorder and that further research is warranted to explore potential moderators of treatment expectations and credibility in this clinical population.

Pilot study of a lifestyle intervention for bipolar disorder: Nutrition exercise wellness treatment (NEW Tx).

BACKGROUND: Individuals with bipolar disorder (BD) are more likely than the general population to develop risk factors associated with cardiovascular disease, one of the leading causes of morbidity and mortality in this clinical population. To address this disproportionate medical burden, we developed Nutrition Exercise and Wellness Treatment (NEW Tx), a lifestyle intervention for individuals with BD. METHODS: In this study, participants were randomized to NEW Tx (n = 19) or a treatment as usual waitlist (n = 19). We examine the intervention's efficacy to improve the physical and psychological outcomes of individuals with BD. Assessors were blind to participant condition throughout study duration. RESULTS: The NEW Tx group reported increased weekly exercise duration and overall functioning, and decreased depression and illness severity over the study duration. However, only improvements in functioning were significantly greater in the NEW Tx group than in the control group. There were no group differences in weight loss or mood symptoms over the study duration. LIMITATIONS: Limitations to this study include lack of objective measurement of exercise and a small and relatively homogeneous sample. CONCLUSIONS: These data suggest that a manualized lifestyle intervention for BD may not be ideal to improve lifestyle changes in this clinical population. Further research is needed to pilot personalized approaches to creating a healthy lifestyle in BD.