Psychotherapy and Bipolar Disorder
Peer Support Groups
Peer support groups are a little like group therapy–but without the therapist. These range from ad hoc support groups formed by parents to professionally mediated support groups that may be available through a mental health clinic or public agency. Usually peer support groups do not charge participants, although a collection for snacks or meeting-room expenses might be taken up. Clinic-run groups, of course, may carry a fee.
Alcoholics Anonymous, Narcotics Anonymous, and other programs that use the 12-step model or a similar self-help approach are a particularly advanced kind of peer support group. These well-known programs bring together people with a common problem, and use methods for effecting personal change and supporting all members of the group that can be very effective. If substance abuse or dependency, eating disorders, or compulsive behavior disorders are additional problems for your bipolar child, you may want to look into the resources available along these lines.
The support experienced and friendships made in a peer support group can be very helpful for almost any family. Peer support groups for patients themselves can also be great–but without adult supervision, they can also be dangerous for bipolar teens. Before your child joins a support group, find out more about the program and the other participants. Some support groups provide a wonderful healing environment where young people with bipolar disorders can share their experiences with others who have been there. In a few strictly patient-run support groups for youth, however, solid information can go missing and misinformation can be spread. That can turn support group meetings into parent-bashing sessions, or lead participants to stop taking their medications due to peer pressure.
Local support and advocacy organizations, such as the National Alliance for the Mentally Ill (NAMI) and the National Depressive and Manic-Depressive Association (NDMDA), are often involved in setting up, sponsoring, and helping parents find peer support groups for bipolar children.
If your child is in a day treatment center, residential center, or hospital, milieu therapy is probably one of the program’s underlying concepts. “Milieu” is a French word for site and setting. Milieu therapy endeavors to make the site and setting of everyday activities in a school, hospital, or living center therapeutic. This requires paying close attention to physical characteristics, such as making sure that the classrooms and dorms are not dingy and depressing, and ensuring that toys, games, and activities are available that build positive experiences and help to eliminate negative behaviors.
Of course, careful structuring of interpersonal relations in the milieu is of prime importance. Every interaction between a patient and a staff member has therapeutic potential, whether that staffer is the cafeteria cook or an actual therapist.
This is obviously a thoughtful, intelligent premise for constructing a program to support and enhance the lives of young people with mental illness. If a program promises to follow the precepts of milieu therapy, that’s usually a good sign. Parents may also be able to take some ideas from milieu therapy and use them at home; see “The therapeutic home,” later in this chapter.
The most common place for children to see a counselor is at school. School counselors usually have a dual role: they advise students on academic issues and guide them through the college admissions process, and they also help them with personal problems. In the latter role, their focus is on maintaining wellness rather than on treating psychiatric disorders.