Handling emergencies and treating mood episodes pharmacologically are first steps in managing risk; this should be followed up with treating substance abuse and trait impulsivity and with involving significant others and teaching coping skills. Recognizing the impact of early trauma on a patient can help improve the therapeutic alliance and lead to better outcomes. - See more at: http://www.psychiatrictimes.com/bipolar-disorder/violence-bipolar-disorder/page/0/3#sthash.JOyyWia3.dpuf