Table 3.

Tasks and contents of each patient.

Module	Patient 1 (Kim)	Patient 2 (Meg)	Patient 3 (Hank)
A. Psychoeducation	Patients were provided with the following information: the prevalence of bipolar disorders is about 2% and the prevalence in men and women, which reaches 5% when subthreshold bipolar conditions are included, is about the same [33, 34]. The highest risk is associated with adolescence, especially peaking between the ages of 15 and 20 [34, 35]. Bipolar disorder is prone to significant social disability and to relapse [36, 37]. It is also reported that episodes of mania and depression are periodic [38, 39] and that episodic periods can become increasingly shorter [40]. Anxiety plays a significant role as a risk of recurrence [41], and there is a tendency for worse outcomes in the presence of substance abuse [42, 43]. Suicide rates are 0.4% per year, 20 times the rate of suicide in the general population [39]. Furthermore, patients were introduced to the six most common precursors to mania (decreased sleep time, increased goal-directed activity, increased irritability, increased sociability, lost thought, and increased optimistic thinking) [23, 24, 44], and they were explained that being aware of his prodromal symptoms and developing and practicing skills to cope are the core of CBT [26].
B. Case conceptualization and therapeutic goal setting	When she meets a person, she thinks “Is she going to say something negative?” She reinforces the belief, “I'm worthless.” As a result, she does not leave the house and does not consult anyone. Goals: increase outings, resume hobbies, and talk to colleagues.	Meg was depressed about the fact that the inside of the house is scattered, and the nonfunctional belief, “I am lazy and useless,” is activated. Meg drives purpose-oriented activities to regain self-confidence; therefore, she always postpones annoying routines. Goals: cleaning up her house, managing money, and keeping on living comfortably without bipolar disorder.	Hank's mood is uplifting; he overdoes his work, makes mistakes, and activates the nonfunctional belief, “I am a bad person.” To get away from it though, he was immersed in work. Goals: determine the amount of work, manage money, and join the community.
C. Monitoring activation and mood	Hypomanic: decreased sleep time, increased activity, talkativeness, and extravagance. Depression: loss of appetite, self-responsibility, worthlessness, loss of interest, abdominal pain, and headache.	Hypomanic: decreased sleep time, increased purpose-oriented activities, increased sociability, increased optimistic thinking, and talkativeness. Depression: decreased interest and activity, sad mood, reduced motivation, reduced self-esteem, and pessimistic thinking.	Hypomanic: reduced sleep time, increased activity, talkativeness, frustration, increased money, increased work, and approaching women. Depression: abdominal pain, decreased interest and activity, sad mood, reduced motivation, pessimistic thinking, and increased sleep.
D. Mastering coping behaviors with prodromes	Hypomanic precursors: taking a break, calling a family member, and consulting a physician. Depression precursor: meeting friends and family and watching favorite pictures.	Hypomanic precursors: doing daily routines such as housekeeping and cleaning and performing unscheduled actions (delayed) in the 24-hour transition. Depression precursor: exercising and meeting friends.	Hypomanic precursor: when shopping, do not buy immediately. Wait for a week, before deciding to buy things added to an online shopping basket. Depression precursor: walking, meeting an older brother, not falling asleep, and not reflecting alone.
E. Establishing sleep and daily routine	Schedule activities during the day, wake up on time, and consume meals regularly.	Meg's daytime activity has improved her sleep quality at night. She refrained from taking a nap and excessive caffeine.	Hank decides to go to work on weekdays, even if he does not feel good. Overtime is restricted to 19:00, even if there is work left. Hank managed bathing, muscle training, and game time.
F. Rescripting dysfunctional beliefs	Kim identified the beliefs “I am worthless” and “Everything will fail” and rewrote it as “The future is unpredictable, let us act first.”	Meg identified the belief “I am useless and worthless” and rewrote it as “I am loved by friends and family.”	Hank identified the belief “I am a bad person and I will lonely for life” and rewrote it as “I am single now; I do not know what will happen in the future. I have brothers and friends.”