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Background: Little is known about scaling up and disseminating online interventions for bipolar disorder (BD). ORBIT was developed to address limitations of existing psychological therapies for people in late stage BD. It is delivered in a brief multi-media format, targeting quality of life (QoL) through emotion regulation, sleep and self-concept mechanisms. Here, we report on ORBIT's development from a positive pilot study to large-scale international trial. Methods: Inclusion criteria for the pilot were: self-reported primary diagnosis of BD, 6 or more episodes of BD, under the care of a medical practitioner, proficient in English, 18–65 years of age. To test international feasibility, ORBIT was hosted at Swinburne University, Australia while participants were recruited through our network in Canada. Primary outcome was change on the Brief QoL.BD. Results: Twenty-six people consented to participate (age M = 46.6 years, SD = 12.9; 75% female). Complete pre- and post-intervention data obtained from 16 (38.5% attrition). Completers analysis found QoL was improved post-treatment (M = 42.63, SD = 8.68) compared with baseline (M = 39.19, SD = 9.22), t(15) = 2.88, 95% CI: 0.89–5.98, p = 0.011. Improvement was of large magnitude (partial η2 = 0.36), and all completers reported they would recommend the program to others. Conclusion: Pilot testing found ORBIT feasible, acceptable, and efficacious. Full development and testing raises important questions about engagement/retention, safety, and maintenance of treatment effects. Careful attention to these issues has potential to reinvigorate thinking about psychological intervention for BD, as we move from ‘treatments’ to ‘offers’.
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