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334 REVERSIBLE DISORDERS OF BRAIN DEVELOPMENTPsychotherapy can be less invasive than pharmacotherapy and may prove as oreven more effective in illness prevention. Unlike treatment with medication, whichmay be accompanied by deleterious side effects and cannot specifically treat psychosocialstressors, psychotherapy is a safe modality that can be designed to addressspecific stressors such as unstable family environments and ineffective copingstyles. Therefore, although requiring more time and conscious effort from bothpatients and clinicians, psychotherapy has the potential for precise, targeted intervention.Utility of Psychotherapy in the Treatment of BDOne can infer the utility of psychotherapeutic interventions for the prevention ofBD development from data supporting the efficacy of psychosocial interventionsfor the treatment and prevention of relapse of BD. It is currently recommended thatall patients with BD receive both medication and adjunct psychotherapy (Keller,2004; Kowatch et al., 2005). Thus, although extensive advances have been made inthe pharmacological treatment of BD, it has become apparent that medication aloneis not enough for the management of this chronic, recurrent illness. Medicationnoncompliance, lack of ability to recognize symptom exacerbation, and the inabilityto cope with stressors that precipitate illness episodes are problematic for manyindividuals with BD and are often related to illness relapse (Lam, Hayward, Watkins,Wright, & Sham, 2005; Miklowitz et al., 2000; Vieta & Colom, 2004).Psychoeducation, cognitive behavioral therapy, family therapy, and interpersonaland social-rhythm therapy have all been demonstrated to decrease frequencyof mood episodes, increase medication compliance, and improve overall functioningin adults with BD (Frank, Swartz, & Kupfer, 2000; Lam et al., 2005; Miklowitzet al., 2000; Perry, Tarrier, Morriss, McCarthy, & Limb, 1999). Although thesetreatments vary in theoretical approaches, they all share a focus on medicationadherence, symptom recognition and management, social and family problemsolving, and improvement of communication skills (Otto, Reilly-Harrington, &Sachs, 2003). More recently, researchers have begun to modify and test the efficacyof adjunctive psychosocial interventions for children and adolescents withBD. Though still under development, treatments such as Family Focused Therapyfor Adolescents (FFT-A; Miklowitz et al., 2004), Multi-Family PsychoeducationGroups (Fristad, Gavazzi, & Mackinaw-Koons, 2003), and a modified cognitivebehavior therapy combined with family therapy (Pavuluri et al., 2004) have showninitial success in decreasing symptom severity and preventing relapse in childrenwith BD.FFT-A is a modification of the adult version of FFT, addressing developmentalissues and unique clinical presentations of adolescents with BD (Miklowitzet al., 2004). FFT has been shown to reduce relapse rates, enhance stabilization ofmood symptoms, improve medication compliance, and decrease stressful familyinteractions in adults with BD (Miklowitz et al., 2000). In an open trial of this