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Family Therapy for Bipolar

Bipolar Disorder in Children - Try Family Therapy

The results of a recent research article, published in a 2013 issue of the Journal of the American Academy of Child and Adolescent Psychiatry, found that family therapy is a more effective treatment method when compared to educational treatment programs of a shorter duration. This is true in cases of children who are considered to be at a higher risk for the development of bipolar disorder.

Children and Adolescents Respond To FFT

Stanford University School of Medicine researchers discovered that adolescents and children with either major depressive disorder or sub-threshold types of bipolar disorder actually responded more positively to a 12 session family focused treatment (FFT) than to a briefer educational program of treatment. These youth also had a minimum of one first-degree relative (parent or sibling) who had bipolar disorder.

Research participants included 40 individuals (average age of 12 years) who were at an increased risk of developing bipolar disorder. Diagnoses included the following conditions:

  • Major depression
  • Cyclothymic disorder, which is a milder form of bipolar disorder.
  • Bipolar disorder, not otherwise specified, which involved recurring and/or brief episodes of mania or hypomania, not meeting full diagnostic criteria outlined for bipolar disorder in the DSM-V.
  • Had a minimum of one first-degree relative (typically a parent) diagnosed with either bipolar I or bipolar II disorder.

Researchers randomly assigned the 40 patients to the following two treatment groups:

  • Twelve family focused treatment (FFT) sessions, spread over a 4 month period. This group consisted of psychoeducation (learning strategies in order to manage mood swings), training in problem solving skills, or training in communication skills.
  • One to two educational control (family informational) sessions.
  • Continue Reading to Learn:
  • How FFT affects depression symptoms
  • Why emotion expression alters treatment results
  • What leads to positive treatment effects

Symptom Improvement with FFT for Bipolar Disorder Treatment

At the beginning of the study, 60% of all participants were taking psychiatric medications and continued taking them for the duration of the clinical trial. Study findings revealed that those in the family focused treatment group experienced overall recovery from their initial depression symptoms much more quickly. They took 9 weeks (on average) to recover as compared to 21 weeks (on average) for participants in the family information group. In addition, study participants who were placed in the FFT group experienced more weeks of full remission from their mood symptoms, over the one year study period, as well as mania symptom improvements as measured by the Young Mania Rating Scale.

Those study participants who lived in families rating high in emotion expression (measurement of emotional overprotectiveness and/or critical comments in parents) took close to two times as long to recover from mood symptoms as opposed to participants living in families that rated low in emotion expression. However, a secondary analysis revealed that youth who lived in families with high expressed emotion, who were treated with the family focused treatment method, experienced more weeks of remission during the year when compared to those youth who were treated with education alone.

Study authors cautioned that a follow-up period of only one year was too short to definitely say if any of these participants would actually go on to develop full bipolar disorder. They also stated that addressing bipolar disorder in its earliest stages, stabilizing existing symptoms, as well as assisting families with effective coping mechanisms to deal with their children's mood swings, could all have positive effects on the long term outcomes of a child at a high risk for this disorder.


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