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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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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ABSTRACT: The role of family dynamics in symptoms, course, and outcome of pediatric bipolar disorder (PBD) has been extensively studied. Individual caregiver characteristics have received less attention in the literature. Understanding how caregiver traits are related to child symptoms could have important implications for psychosocial treatment of PBD, where the parents are heavily involved. This study explored the direct and interactive associations between parent psychopathology, stress, efficacy, and coping and symptoms of PBD in 64 parents of children meeting DSM-IV criteria for bipolar I, II, or NOS. Parent psychopathology predicted increased child mania and depression severity among parents with low, but not average or above average use of coping skills. Without effective coping skills, parent psychopathology may have effects of the severity of their child’s symptoms of mania or depression. Future research should explore the extent to which interventions that teach caregivers effective tools and skills to cope with their child’s illness mitigate the effects of their own psychopathology.Journal of Child and Family Studies 05/2014; 24(5). DOI:10.1007/s10826-014-9952-1 · 1.42 Impact Factor
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ABSTRACT: We report here our studies on the effects of group psychosocial therapy (PST) in adolescents with schizophrenia spectrum disorders on the dynamics of their social functioning using the PedsQL questionnaire and the Children’s Global Assessment Scale (CGAS). Statistically significant improvements in the main indicators of adolescent social functioning at the end of the treatment cycle (three months) were obtained, while there were no significant differences between the study group (treatment with PST) and the reference group (without PST) in therapeutic dynamics on the PANSS, demonstrating the efficacy of group PST in the rehabilitation of adolescents with schizophrenia spectrum disorders. Three subgroups of patients were identified in the study group, with different trends in social functioning depending on the type of course of the disorder.Neuroscience and Behavioral Physiology 12/2014; 45(1). DOI:10.1007/s11055-014-0036-x