Table 1.

Components of the Healthy Lifestyle Behaviors Program

Component	Topics addressed	Therapeutic goals
Bipolar disorder psychoeducation (3 sessions)	Overview and rationale of Integrated Risk Reduction Intervention Education about bipolar disorder Importance of a balanced lifestyle Prevalence and impacts of common health risk behaviors in patients with bipolar disorder: nicotine, alcohol, and drug use	Increase understanding of the importance of balance lifestyle and ways to achieve it over the next 16 weeks Identify important activities to enhance sleep/wake and social rhythms Enhance adherence to self-monitoring of sleep/wake and social rhythms and exercise
Healthy sleep/wake and social rhythm practices (4 sessions)	Education on sleep/wake disturbances and mood disorders Relationship between disruptions in sleep/wake and social rhythms and onset and maintenance of mood symptoms Education on healthy sleep/wake rhythms and habits Education on healthy social rhythms and habits Identifying, implementing, and consolidating sleep/wake and social rhythms Effects of nicotine, alcohol, and drugs on sleep and social rhythmicity Eating habits and physical activity as important cues to enhance sleep/wake and social rhythms Relapse prevention for sleep/wake and social rhythms	Continue self-monitoring of exercise and sleep/wake and social rhythms Behavioral interventions to enhance and consolidate sleep/wake and social rhythm regularity in a gradual manner Initiate self-monitoring of food intake
Weight loss: nutrition (4 sessions)	Education about healthy eating habits How to make healthy food choices How to lose weight Ways to eat fewer calories and less fat Exercise and weight loss Alcohol use in weight management Relapse prevention for healthy eating and weight loss	Enhance/maintain adherence to self-monitoring of food intake Reduce calorie intake by 500 calories per day in a progressive manner Achieve a modest weight loss (5% to 7% of initial weight)
Weight loss: physical activity (4 sessions)	Education about the importance of physical activity and time management strategies to incorporate exercise in a weekly routine Education about moving more and exercising safely Identifying ways to add interest and variety to physical activity plan How to stay motivated; relapse prevention	Identify and adhere to number of minutes of exercise to achieve over the next 4 weeks Incorporate moderate-intensity exercise for 30 minutes 3 to 5 times per week in schedule
Smoking cessation (2 optional sessions)	Review the effects of smoking on health discussed in Module 1 Education about the interactions between nicotine and medications used to treat bipolar disorders Education about stimulus control and smoking Identify relationship among smoking behaviors, sleep and social rhythms, eating habits Education about symptoms of recovery from smoking Education about available resources to support people who quit smoking	Self-monitoring of smoking behaviors and triggers Identify benefits of quitting smoking Plan smoking cessation: identify a quit day and conduct a quit ceremony Identify and incorporate coping skills to manage urges to smoke