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I was reading one of my professional journals and thought some of you might be interested in a study I found described there. In The Complete Practitioner, August, 2003, an article entitled “Family-Focused Treatment for Bipolar Disorder” describes a study in which, following hospitalization, patients were either assigned to family focused psychoeducational therapy or individual-focused therapy. The results were very interesting, though probably not surprising to anyone who is a caretaker. First, some background: Goals of the family-focused treatment included: psycho-education about bipolar disorder (symptoms, course, causes, and treatment of bipolar disorder), communication enhancement training (active listening, positive and negative feedback, making positive requests for changes), and problem solving skills (identification of specific problems, brainstorming of solutions, evaluating advantages and disadvantages of each, implementing a solution and evaluating the outcome). The goals of individual-focused therapy were: patient-education about the disorder, monitoring and increasing the awareness of symptoms, crisis intervention, practicing what to do in a relapse situation, and reduction of stressors. All patients stayed in therapy and continued on drugs after release from the hospital. During the first year there was no difference in the results of the two studies, probably because of the high intensity of help for both groups following hospitalization. But during the second year of follow up, patients who had received 21 sessions of family-focused therapy were less likely to experience a mood disorder relapse or to be hospitalized than patients who had received 21 sessions of individual therapy. Medication did not account for the difference. The authors suggest that family-focused therapy “had its greatest impact on assisting patients and their families to avoid the need for rehospitalization during a period of symptomatic deterioration.” The authors conclude that family-focused therapy “is a useful adjunct to pharmacotherapy in decreasing the risk of relapse and hospitalization frequently associated with bipolar disorder.” The implication for us all as caretakers is to be sure that the entire family has educational and therapeutic help from mental health professionals after our loved one’s hospitalization. And then I would also suggest the Family to Family Program given by NAMI and led by caretakers themselves. I attended this course myself years ago. And although I am a mental health professional, I learned an awful lot. The material is well written, and the group support and validation that we give each other is “priceless.” The two books the authors referred to were: Bipolar Disorder: A Family-Focused Treatment Approach, New York: Guilford Press, 1997; and Family Care of Schizophrenia: A Problem Solving Approach to the Treatment of Mental Illness, New York: Guilford Press, 1984. Tip for the Month: The weather is about to change – go for a walk, bike ride, or drive in the country. And always remember to take care of yourself first so you have energy to take care of others. Never Give Up!! Wishing you love, patience, and persistence Barbara R. Grace, PhD, NCSP, CAHt, RoTh The Grace Center for Mind, Body, and Spiritual Healing 118 Barrington Commons Plaza, Suite 227 Barrington, Ill 60010 847-382-3232
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