What Would Digital Early Intervention for Bipolar Disorder Look Like? Theoretical and Translational Considerations for Future Therapies

Abstract

There are growing calls for the development of early intervention/preventive interventions for young people identified to be at risk of bipolar disorder (BD), and digital delivery appears to be a strong candidate delivery method. To date, no such interventions exist, and the aim of this perspective paper is to advance the literature by reviewing theoretical issues related to early intervention in BD and introducing a framework for design of feasible, acceptable, and effective online psychosocial interventions for this population. It is concluded that, by adopting an appropriate transdiagnostic and humanistic framework, and recognizing emerging tenets of digital psychotherapy development, testable online interventions for young people at risk of BD are within reach.

Keywords: agency; co-design; engagement; online; resilience; smartphone; staging; transdiagnostic.

Figure 1

Intervention design framework for feasible, acceptable, and effective online intervention for young people at risk of BD.

Figure 2

Possible elements of therapeutic content for online early intervention for young people at risk of BD. Blue (BD-specific) and purple (strengths-based targets) are core modules; Orange are optional modules based on young person’s current concerns (derived from empirical literature on prevalent problems in high-risk populations, or symptoms elevating risk). CBT, cognitive behavioral therapy; IPSRT, interpersonal and social rhythm therapy; MBCT, mindfulness-based cognitive therapy; ACT, acceptance and commitment therapy; SCT, self-compassion therapy; FFT, family-focused therapy; CBT-I BD, cognitive behavioral therapy for insomnia, modified for BD.