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Running Head: CHILDREN WITH BIPOLAR DISORDER Children With Bipolar Disorder: How To Break Down Barriers and Work Together Effectively Purpose of Study "Children with Bipolar Disorder: How to Break Down Barriers and Work Together Effectively," by Barbara Macinaw-Koons and Mary A. Fristad, discusses the challenges that parents have when attempting to get treatment for children with bipolar disorder. The purpose of this study was to "provide a voice for many families of children with bipolar disorder…" (Mackinaw-Koons and Fristad, p. 481). The researchers wanted to find better ways of working with families to improve their experience in treatment.
The researchers designed "dos and donts" of treatment for clinicians. Methods The researchers created two psychosocial treatment trials. The first study was to determine "the effectiveness of a multi-family psychoeducation group therapy program" (481). The first group was comprised of 135 families, with children 8-11 years of age, who were bipolar or had depressive spectrum disorder. In this group, 45% came from two biological parent families, 55% came from blended, single parent, adopted parent and lesbian parent families.
Socioeconomic background for families ranged between $20,000 and $100,000. The majority of children were Caucasian (90%), with 10% African American. This group participated in group therapy and 25% were from rural areas. The second group was the same in terms of demographics, but it consisted of only 20 families with children 8-11 years old, and they were seen individually. In this group 40% came from rural and/or geographically remote areas. Families in both groups were encouraged to continue their regular treatment options throughout the course of the study.
Detailed information about all the services families received was collected four times over the 18 months of the study (481). All information was gathered through interviews with the families. Findings and Conclusions This study set out to show what parents experienced as they took their children through the mental health system. What they found was that parents had similar experiences. Most felt guilty about having a child with this disorder. They felt that their children were often misdiagnosed, they were given a treatment plan to use, and when it didnt work, the clinicians blamed them (the parents) for not parenting correctly or not following a behavior plan properly.
"Without understanding the childs full diagnostic profile, treatment plans are often not helpful and sometimes harmful." (482). To help clinicians, they presented the "dos" and "donts" list in hopes that clinicians will be more aware of how to work better with families.Observations and Opinions Although this study will probably be helpful to families, I am not sure how well it will work with clinicians. Since clinicians work from a medical model that is based on some version of the Diagnostic Statistical Manual (DSM-R), and this is used for insurance purposes, it will be difficult to change the view of the clinicians.
I believe that the researchers are asking for the clinicians to make a paradigm shift that may not be possible because of insurance needs. I didnt feel that the sample they used of 155 children was large enough to make a difference, and since 95% of the children were Caucasian, there didnt seem to be a cultural significance. Also, parents who have been through challenges with the "system" may be biased or stressed about what they need, so their information may be biased. I dont think it will have real relevance to clinicians, unless more families are interviewed.
I would have also liked to see clinicians be part of the study in some way.ReferencesMackinaw-Koons, Barbara and Fristad, Mary (2004). "Children with Bipolar Disorder: How to Break Down Barriers and Work Together Effectively." Professional Psychology: Research and Practice, Vol. 35, No. 5. 480-484.
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