Psychoeducational treatment for school-aged children with bipolar disorder
ABSTRACT Bipolar disorder (BPD) has received increasing attention from public and professional sources. Although pharmacologic treatments are considered the sine qua non in the treatment of youth with BPD, psychosocial interventions are critical to assist the child and family cope with symptoms that carry with them significant morbidity and mortality. Treatments developed to date are few in number; all are psychoeducationally based, using cognitive-behavioral and family systems interventions within a biopsychosocial framework. This paper reviews possible mediators of outcome, including caregiver concordance, children's social skills, hopelessness, and family stress. The author has developed two family-based psychoeducational interventions for the treatment of youth with BPD: multifamily psychoeducation groups (MFPG) and individual family psychoeducation (IFP). These treatments are both described and the results from a previously published randomized clinical trial (RCT) of MFPG are summarized. Then, new findings from an RCT of IFP are presented, along with preliminary pilot data from an expanded version of IFP. The paper concludes with recommendations for future research.
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- "Moreover, family psychoeducation targeted to caregivers and youth conjointly is especially helpful for youth receiving psychiatric medication (Fristad, 2006). Several researchbased protocols exist for childhood disorders in addition to ADHD— including depression (Sanford et al., 2006), bipolar disorder (Fristad, 2006), and eating disorders (Geist, Heinmaa, Stephens, Davis, & Katzman, 2000). Family-Based Medication Decision-Making Family-based medication decision-making interventions, in which family history and attitudes about psychiatric medication are systematically processed in the context of current options and benefit-cost decisions about adolescent ADHD medication, appear to be prerequisite for safe and consistent medication use in teenagers with ADHD. "
ABSTRACT: Attention-Deficit/Hyperactivity Disorder (ADHD) is highly prevalent among adolescents enrolled in behavioral health services but remains undertreated in this age group. Also the first-line treatment for adolescent ADHD, stimulant medication, is underutilized in routine practice. This article briefly describes three behavioral interventions designed to promote stronger integration of medication interventions into treatment planning for adolescent ADHD: family ADHD psychoeducation, family-based medication decision-making, and behavior therapist leadership in coordinating medication integration. It then introduces the Medication Integration Protocol (MIP), which incorporates all three interventions into a five-task protocol: ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about best practices for medication integration across diverse settings and populations: integrating medication interventions into primary care, managing medication priorities and polypharmacy issues for adolescents with multiple diagnoses, providing ADHD medications to adolescent substance users, and the compatibility of MIP intervention strategies with everyday practice conditions.Child & Family Behavior Therapy 10/2014; 36(4):280-304. DOI:10.1080/07317107.2014.967631 · 0.67 Impact Factor
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- "Counselors read the items aloud to the children as a group to facilitate comprehension. Both scales were derived from satisfaction measures developed for the MFPG (Fristad, 2006). "
ABSTRACT: Objective: No psychosocial treatments have been developed for children with ADHD and severe mood dysregulation (SMD) despite the significant prevalence and morbidity of this combination. Therefore, the authors developed a novel treatment program for children with ADHD and SMD. Method: The novel therapy program integrates components of cognitive-behavioral therapies for affect regulation with a parent-training intervention for managing recurrent defiant behaviors. It consists of nine 105-min child and parent groups run in unison. A pilot trial was conducted with seven participants with ADHD and SMD ages 7 to 12 who were on a stable stimulant regimen. Results: Six of the seven (86%) families completed the program. Participants showed large improvements in depressive symptoms, mood lability, and global functioning. Milder improvements in externalizing behaviors were observed. Conclusion: Results suggest the feasibility and potential efficacy of the therapy program for children with ADHD and SMD and warrant a larger controlled trial. (J. of Att. Dis. 2012; XX(X) 1-XX).Journal of Attention Disorders 02/2012; 17(6). DOI:10.1177/1087054711433423 · 2.40 Impact Factor
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- "One review supports FPE as helpful in reducing family tensions and dysfunction and fostering more effective use of professional services (Diamond and Josephson, 2005), although there have been null findings as well (Ruffolo, Kuhn, & Evans, 2005). Most prominently, Mary Fristad and various colleagues have created both individual and multi-family FPE interventions for children with mood disorders and their parents, as adjuncts to clinical treatment (Fristad, 2006; Fristad, Gavazzi, & Mackinaw-Koons, 2003; Klaus & Fristad, 2005). Their initial evaluation research has been promising. "
ABSTRACT: Among potential resources for people with serious mental illnesses (SMI) and their families, professionally delivered family psychoeducation (FPE) is designed to engage, inform, and educate family members, so that they can assist the person with SMI in managing their illness. In this article, we review research regarding FPE outcomes and implementation since 2001, updating the previous review in this journal (McFarlane, Dixon, Lukens, & Lucksted, Journal of Marital and Family Therapy 2003; 29, 223). Research on a range of FPE variations continues to return mostly positive effects for adults with schizophrenia and increasingly, bipolar disorder. More recent studies include functional outcomes as well as the more common relapse and hospitalization. FPE research involving adults with other diagnoses is increasing, as is FPE research outside the United States In both cases, uneven methodologies and multiple FPE variations make drawing conclusions difficult, although the core utility of access to information, skill building, problem solving, and social support often shines though. Since the previous review, several FPE programs for parents of children or youth with mood disorders have also been developed, with limited research showing more positive than null results. Similarly, we review the developing inquiry into early intervention and FPE, short-form FPE, and cost studies involving FPE. The second half of the article updates the paradox of FPE's evidence base versus its persistently low use, via recent implementation efforts. Multiple challenges and facilitating factors across healthcare systems and financing, individual programs and providers, family members, and consumers shape this issue, and we conclude with discussion of the need for empirical evaluation of implementation strategies and models.Journal of Marital and Family Therapy 01/2012; 38(1):101-21. DOI:10.1111/j.1752-0606.2011.00256.x · 1.01 Impact Factor