The problem: Bipolar disorder (BD) is a serious disorder of mood, associated with high rates of relapse and significant morbidity and mortality1. Best practice management of BD involves both psychological treatment and pharmacotherapy, but most patients worldwide cannot access the psychological component of best practice care2. Consumers, clinicians and governments are calling for online interventions to help solve the global access problem. Australia is well placed to lead these efforts.
Progress to date: The completed ORBIT (Online, Recovery-focussed, Bipolar Individualised Treatment) randomised controlled trial (RCT) found that recruitment was highly feasible (randomising N = 302 people from 19 countries) and two contrasting online interventions were highly valued and safe3. The trial’s specified primary finding was null: a novel mindfulness/acceptance intervention did not separate from a quality-matched active control (psychoeducation) in improving quality-of-life (QoL) amongst people in late-stage BD. However, following best practice in psychotherapy development/evaluation, the ORBIT project was designed to inform iterative work into these complex interventions.
Proposed solution: The ORBIT research program has delivered a feasible, acceptable, valuable and safe foundation for improved global access to evidence-based psychological intervention for people with BD. The ORBIT Real-time Digital User Experience (ORBIT Redux) intervention will improve on the effectiveness of ORBIT in three ways: integrate a companion smartphone app into the web-based program; combine the mindfulness/acceptance and psychoeducation content tested in ORBIT; and target people across all stages of established BD whose current level of QoL warrants intervention.