title: Facilitated Integrated Mood Management for adults with bipolar disorder.
abstract: OBJECTIVE
  We describe the development of a five-session psychoeducational treatment, Facilitated Integrated Mood Management (FIMM), which contains many of the core elements of longer evidence-based psychosocial treatments for bipolar disorder. FIMM incorporated a novel mood monitoring program based on mobile phone technology.
  
  
  METHODS
  Adult patients with bipolar I and II disorders (N = 19) received six sessions (Pilot I: n = 14) or five sessions (Pilot II: n = 5) of FIMM with pharmacotherapy. Treatment facilitators were novice counselors who were trained in a three-day workshop and supervised for six months. FIMM sessions focused on identifying early signs of recurrence, maintaining regular daily and nightly routines, rehearsing mood management strategies, maintaining adherence to medications, and education about substance abuse. Patients sent daily text messages or e-mails containing ratings of their mood and sleep, and weekly messages containing self-ratings on the Quick Inventory of Depressive Symptomatology (QIDS) and the Altman Self Rating Mania Scale (ASRM). Patients also completed a weekly mood management strategies questionnaire.
  
  
  RESULTS
  Of the 19 patients, 17 (89.5%) completed FIMM in an average of 9.2 ± 3.4 weeks (Pilot I) and 7.6 ± 0.9 weeks (Pilot II). Patients reported stable moods on the QIDS and ASRM over a 120-day period, and on average responded to 81% of the daily message prompts and 88% of the weekly QIDS and ASRM prompts. Facilitators maintained high levels of fidelity to the FIMM manual. Patients' knowledge of mood management strategies increased significantly between the first and last weeks of treatment.
  
  
  CONCLUSIONS
  Patients with bipolar disorder can be engaged in a short program of facilitated mood management. The effects of FIMM on the course of bipolar disorder await evaluation in randomized trials. The program may be a useful adjunct to pharmacotherapy in community centers that cannot routinely administer full courses of psychosocial treatment.
authors.affiliation: Department of Psychiatry, University of California at Los Angeles Semel Institute, UCLA School of Medicine, Los Angeles, CA 90024-1759, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Miklowitz
authors.forename: Jonathan
authors.initials: J
authors.lastname: Price
authors.forename: Emily A
authors.initials: EA
authors.lastname: Holmes
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rendell
authors.forename: Sarah
authors.initials: S
authors.lastname: Bell
authors.forename: Katie
authors.initials: K
authors.lastname: Budge
authors.forename: Jean
authors.initials: J
authors.lastname: Christensen
authors.forename: Joshua
authors.initials: J
authors.lastname: Wallace
authors.forename: Judit
authors.initials: J
authors.lastname: Simon
authors.forename: Neil M
authors.initials: NM
authors.lastname: Armstrong
authors.forename: Lily
authors.initials: L
authors.lastname: McPeake
authors.forename: Guy M
authors.initials: GM
authors.lastname: Goodwin
authors.forename: John R
authors.initials: JR
authors.lastname: Geddes
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect / Q000502:physiology*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D017028:Caregivers / Q000523:psychology; D002940:Circadian Rhythm / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019359:Knowledge; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D060145:Text Messaging; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult