Early Recovery Adherence Therapy for Bipolar Alcoholics
Condition: Bipolar Disorder; Alcohol Use Disorder
MeSH terms: Alcoholism; Bipolar Disorder
Study type: Interventional

Summary: 
      Effective psychosocial interventions for individuals with an alcohol use disorder
      co-occurring with a severe mental health problem such as bipolar disorder are lacking.
      Treatment engagement, adherence, and retention are a major challenge and crucial to achieving
      a favorable outcome. The early phase of recovery is a key period during which an effective
      intervention exerts its most significant impact. Our proposed treatment intervention is aimed
      at addressing early recovery issues, engagement, and treatment and medication adherence in
      bipolar alcoholics.

      We propose to develop and refine a theoretically based and procedurally specified individual
      adherence therapy intervention for co-occurring alcohol use and bipolar disorder in early
      recovery, to develop standardized procedures, methods, and techniques so that treatment is
      delivered with a high degree of fidelity and competence, and to test the efficacy of this
      intervention through a randomized, parallel-group design comparing this new intervention with
      current regular clinical care.
    

Detailed description: 
      Co-occurring alcoholism and bipolar disorder is a significant comorbid condition representing
      serious clinical challenges and treatment difficulties and is associated with severe
      disabilities, morbidity, and heightened risk for suicide. Despite the recent increased
      attention to the problem of psychiatric comorbidity with alcoholism and other substance use
      disorders, little research has been conducted on this complex form of comorbidity, especially
      in regard to effective treatment approaches.

      Enhancing treatment engagement, adherence, and retention is perhaps the most challenging
      clinical concern faced by clinicians caring for this population. Poor adherence is a major
      clinical problem among bipolar disorder with alcoholism. Poor adherence is associated with
      substantial medical expenses and loss of productivity.

      Factors interfering with treatment adherence range from access to treatment, to health care
      providers disposition towards these patients, and to symptoms related to both bipolar
      disorder and alcoholism. Enhancing motivation for treatment and improving treatment adherence
      are essential components for an initial treatment intervention for this population. Our
      proposed treatment intervention is based on the principles of Motivational Enhancement
      Therapy and also integrates psychosocial and pharmacotherapy interventions that have been
      successfully used with alcoholism and other addictive disorders. It is practical and easy to
      learn and administer in the framework of general clinical care by health professionals with
      varied educational backgrounds.
    

Intervention name(s): Adherence therapy
Intervention type(s): Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Bipolar; Alcoholism