Stress Management Intervention for Living With Epilepsy (SMILE)

Inclusion Criteria: * Age 18 years and above * English speaking * Partial epilepsy consistent with ILAE criteria supported by either EEG or MRI data * Experiencing at least 2 seizures/month * Reported awareness of all seizures, including seizures in a cluster * One of the following: 1. Patient-reported ability to self-predict seizures 2. Patient-reported awareness of trigger factors, including stress 3. Patient-reported awareness of premonitory features * Able to maintain accurate e-diary independently * Minimum 6th grade reading level as screened by WRAT administration * Must be on a stable dose of anti-epileptic drugs for at least 30 days prior to study entry * May be on stable dose of SSRI, SNRI, or atypical antipsychotic for at least 6 months * May be on a stable dose of benzodiazepines (if so, dose stable for at least 30 days prior to study entry) For inclusion in clinical trial phase, patient must be/have: * A minimum of 4 seizures documented in the 8-week baseline phase (or 6 seizures in the 12-week extended baseline phase) * At least 1 seizure per 4-week period in two of the three 4-week periods in the extended baseline phase * Diaries satisfactorily completed during baseline phase * Complied with study requirements during the baseline phase Exclusion Criteria: * Non-motor simple partial seizures only * Concurrent VNS use * History of suicide attempt within the past 2 years * Current suicidality * Not competent to sign consent * Status epilepticus within the previous 6 months * Began regularly using behavioral techniques for stress reduction within past 3 months * Did not benefit from an adequate trial of a valid stress reduction technique * Progressive neurologic condition that the investigator believes would affect seizure frequency * Any history of substance abuse within the previous 2 years * History of poor medication compliance as judged by the investigator * Psychiatric illness that requires change in medication dose * Any medical or psychiatric condition that would impair reliable participation in the trial * Intermittent use of benzodiazepines (if used for sleep, will be determined case by case)