Pragmatic Patient-oriented Extension Study of Dialectical Behavior Therapy Booster Sessions for Youth With and/or at Familial Risk for Bipolar Disorder

Inclusion Criteria The participant must meet all of the inclusion criteria to eligible for this clinical trial: 1. Has completed participation in the DB1 study (049-2021) or the DB3 study (009-2021); 2. English speaking; 3. Age 14 years, 0 months to 26 years, 11 months; 4. Meets diagnostic criteria for bipolar disorder by KSADS-PL(\< 20 years of age) OR SCID-5-RV (≥ 20 years of age) OR have a biological parent/sibling with BD (type I or II) confirmed via KSADS-PL or SCID-5-RV; 5. Followed by a psychiatrist who provides ongoing care; 6. If BD-I, taking ≥1 mood stabilizing medication (i.e., antimanic anticonvulsant, antipsychotic, and/or lithium); 7. Able and willing to give informed consent/assent to participate. Exclusion Criteria An individual who meets any of the following criteria will be excluded from participation in this clinical trial: 1. A life-threatening medical condition requiring immediate treatment; 2. Current victim of sexual or physical abuse; 3. Current substance use disorder other than mild cannabis or alcohol use disorder; 4. Evidence of mental retardation, moderate to severe autism spectrum disorder, or organic central nervous system disorder by the K-SADS-PL, parent report, medical history, or school records that would interfere with active participation in DBT.