A good family therapist will be someone who is supportive and who is also knowledgeable about the biological nature of bipolar disorders and any co-morbid conditions. The last thing you need is a therapist who blames your child for her own difficulties. You also don’t need to see someone who blames your parenting skills.
That said, some parenting styles and behaviors are especially detrimental to bipolar kids. Physical, sexual, and emotional abuse are just the most obvious examples. Children with bipolar disorders are emotionally fragile, and may be affected more strongly by family stresses such as financial difficulties, marital discord, and divorce. Family therapy can provide a venue for putting these issues on the table, for healing the pain caused by errors and misunderstanding and, perhaps most importantly, for setting family ground rules that ensure they don’t happen again.
Another area where family therapy can help is identifying other family members who may have undiagnosed bipolar disorder or another related condition. Because of the genetic nature of manic depression and the low rate of appropriate diagnosis, it is fairly common for a parent to be diagnosed after their child. The thought styles and symptoms associated with bipolar disorder can then become a focus of family therapy, helping all family members understand each other better, improve how they relate to each other, and become a more cohesive and supportive unit.
As in any type of interpersonal treatment, there are a few common pitfalls to family therapy. Misplaced assumptions are one. Although piles of self-help books have been written about family relationships, the truth is that every family is a unique blend. Although knowledge of common personal behavior patterns and family structures can certainly be useful, watch out for a therapist who instantly labels your family as having typical adult children of alcoholics (ACOA) problems or who uses some other quick pop psychology explanation. The assumptions that accompany labels can prevent appropriate therapeutic work, and may lead the therapist away from concentrating on those of your family’s needs that are specifically related to bipolar disorder.
Families also need to know that therapy is not a cure-all, although it will sometimes be presented that way by well-meaning professionals. If your child’s difficulties are such that medications, therapy, and even hospitalization do not help much–and although these cases are the minority, they do exist–the goals of family therapy will need to be identifying survival strategies for coping with unmanageable symptoms, or it will probably be a useless exercise.
–Cindy, mother of 16-year-old Nathan (diagnosed bipolar disorder, OCD, ADHD, post-traumatic stress disorder, chemical dependency, bulimia)
Group therapy brings together several people who are dealing with the same or similar problems, placing them under the guidance of a professional therapist. Within the group meetings, they can help themselves and each other.
Like family therapy, group therapy can be a very positive experience. Your child can form supportive relationships with peers as well as with her therapist, and will get the benefit of the other participants’ real-life experiences and insight. Group therapy also tends to be less expensive than individual therapy sessions.
You may be able to take part in therapy groups for parents of bipolar children, or your child may be able to be in a group for bipolar kids around the same age. As long as the therapist in charge is knowledgeable and supportive, group therapy can be very useful for almost any patient and family. It is especially powerful with adolescents, who are often more likely to listen to their peers than to an adult therapist. Most residential centers, day treatment facilities, and hospitals use some form of group therapy with their young patients.
Some people never feel comfortable being open in a group situation, however. For these very introverted types, individual therapy is a better fit–although ability to function in a group may be one of the goals of that therapy, leading to group therapy later on.