Healthcare Training Institute - Quality Education since 1979
Psychologist, Social Worker, Counselor, & MFT!!

Section 1
Track #1 - Introduction

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Welcome to the Home Study Course sponsored by the Healthcare Training Institute, homestudycredit.com.  This course deals with Bipolar children.
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Our primary intent for this home study course is to provide quality education to foster your professional growth.  The Institute has provided quality education since 1979.
 
Hi.  My name is Jared Baxter.  I will be the narrator of this CD set.  We appreciate that you have chosen us as a vehicle for you to earn your Continuing Education Credit.

The purpose of the course is to assist you in increasing your knowledge regarding bipolar children.  As each case study is given, if the concepts seem to be applicable to your situation, I encourage you to turn your CD player off and make a few notes regarding the application of the principle to your setting.  However, these notes are for your purposes only and are not to be sent to the Institute.  Also each track is very content dense.  So feel free to replay the track to review the content either for your own purposes, or if you feel appropriate play the track in an individual or group session for client education.  Also permission is granted to reproduce this CD.  We encourage you to duplicate give copies of this CD to colleagues, clients, etc. as you deem appropriate. We feel the information on our CD's is valuable.  Thus, we have an interest in distributing CD's in as many ways as possible, to benefit the greatest number of people, who have a need and are receptive to this practical information.

The questions in your Answer Booklet are sequential and deal with the section of content that preceded it.  For this reason, to facilitate the answering of each question, you might read the question from the Answer Booklet prior to listening to that CD track.  By knowing what the question is ahead of time, you will then know the content to listen for that contains the answer.  So just a hint, after you write down the answer to a question in your Answer Booklet, read on to the next question in order to give you a “heads up” to listen for the content that contains the answer to the next question.

Merely write the correct letter on the corresponding blank line in your answer booklet. Each answer is only used once. Keep in mind there is nothing tricky or hard about these questions.  They are merely intended to verify the playing of this CD.

For the purpose of brevity, most generally, I will use the term “therapists” or “mental health professional.”  However, don’t let these terms deter you from applying the concepts to your situations.  When you hear the word “therapists,” if your job title is social worker, psychologist, marriage and family therapist, mental health counselor, professional counselor, resident director, program assistant, etc. merely substitute the appropriate term that is the most meaningful to you. In short, don’t let my use of the term “therapists” cognitively set you off track from hearing the content because your job title is school counselor, for example.  I will also use the term “client” for the purposes of brevity.  However, if you deal with patients, residents, students, consumers, etc., transpose “client” for the term that is the most meaningful to you in your work setting. 

On this CD set we will discuss such topics as: Helping parents understand, Unique Manifestations in Bipolar Children, Suicide, Distinguishing Between ADHD and Bipolar Disorder, Self-Destructive Behaviors, Triggers, Coping with Raging Clients, Coping with Paranoid and Fearful Clients, Mixed States, Taking Medications, Antidepressant Therapies, Stress in Bipolar Child Clients, Relating to Other People, and the Importance of a Healthy Lifestyle.

So  let’s get started

Lesson 1: Helping Parents Understand

Often, I have found that parents of bipolar children do not recognize the disorder in the early years.  Many convince themselves that the dramatic ups and downs of their son or daughter is the normal fluctuations of a creative genius in the making.  Sometimes, as you know, when a child goes through an extensive manic period, he or she may be misdiagnosed by the parent with ADHD.  Children with bipolar disorder often fluctuate moods more quickly and frequently than adults with the disorder.  For children, mood swings might occur several times a day and sometimes with mixed moods in which their mania combines with depression.  Often, parents have a difficult time accepting the fact that their child might have a mood disorder On this track, we will discuss helping parents understand their child’s condition. This is done by developing a family history; understanding a child’s symptoms; the “Knowing Your Child” exercise; and the “Mood Chart” exercise.

#1 Family History
The first technique I use in introducing a parent to bipolar disorder is developing a family history.  Many times, children with the disorder come from family’s in which one member has also been diagnosed.  If there is a family history of bipolar disorder, there is an even greater chance that a child is at risk for developing the disorder or is in fact suffering from the disorder itself.  Chris, age 9, had been referred to me by his mother, Martha.  Martha stated, “Chris had always been high maintenance even in the womb!  It seemed as though the entire time I was carrying him, he was in motion.  I had always suspected a mood disorder, as I myself am bipolar.”  As you can see, Chris had a family history of bipolar disorder.  Often, I emphasize that a family member with the disorder might be of great support to a younger client who is feeling confused about his behaviors.

#2 Understanding the Symptoms
The second technique I use in helping a parent of a bipolar disorder child is understanding the symptoms.  As we said earlier, a child’s mood fluctuations occur more rapidly and sporadically throughout the day.  The first manifestation of the disorder occurs in the form of depression, which can show itself through irritability or anxiety.  This can be followed either immediately or much later by a manic episode which can seem like an energetic irritability.  During a manic state, parents tend to misdiagnose their own children with ADHD because of their inability to concentrate, bypassing the less observable depressive state.  Rita was the mother of 10 year old Anne, who had gone in for treatment for ADHD.  Rita stated, “Well, she was just acting crazy, I didn’t know what to do.  I thought she had ADHD, so I took her to a specialist and they put her on medication.  But that only made things worse.”  Anne had been misdiagnosed with ADHD when in reality she most likely had early onset bipolar disorder.

Technique:  Knowing Your Child
To help parents like Rita understand their children’s diagnosis better, I gave her a list of questions to review and answer on her own which helped her focus on the symptoms of Anne’s disorder.  I called this list, “Knowing Your Child”.  The list included the following questions:

I also gave Rita a list of the DSM’s bipolar symptoms.  When she returned, Rita stated, “I never understood it, but there are times when Anne would not fall asleep and there are times when she’d sleep right through the afternoon.  Now I understand that her attention span habits occurred when she was on a high point and that the ADHD drugs only brought her lower when she was depressed.”  As you can see, educating a parent will help further down the line during treatment.  I have found that once a parent understands the disorder, they can become a variable ally in monitoring a child’s symptoms.

Technique:  Mood Chart
In addition to family history and symptoms, the third technique I use in introducing a parent to a disorder is develop a “Mood Chart”.  Children, like adults, have early warning signs before they plummet into a depressive or manic episode.  However, parents of children with the disorder have to be twice as diligent due to the rapid mood swings in a child.  I ask parents to make a chart with seven columns and an unlimited number of rows.  The columns are labeled
“date”
“mood observed”
“trigger”
“energy level 1=low, 10=high”
“time began”
“time ended”
“recent med change? Yes or no”. 

Obviously, the date is written under the column “date”.  I ask parents of child clients to describe the mood observed to the best of their ability, using such words as “angry” “energized” or “apathetic”.  They’ll also want to note any triggers such as a bad day at school or a game whose outcome was not favorable.  Noting triggers can be a great asset in predicting and preventing mood swings.  The energy level should also be noted, using a scale of 1 to 10, 1 being a low level of energy indicating depression and 10 being a high level of energy, indicating a manic state.  The columns “time began” and “time ended” are also important because it gives the parent and yourself an estimate of how long a manic or depressive period will last.  Also, the column “recent med change” will rule out any possibility of the moods being affected by a change in prescription or dosage.  By using this technique, adults can predict mood swings before they become too much to handle.

On this track, we discussed helping parents understand their child’s condition by developing a family history; understanding a child’s symptoms; the “Knowing Your Child” exercise; and the “Mood Chart” exercise.

QUESTION 1
What are four techniques useful in helping parents understand their child’s condition? To select and enter your answer go to Answer Booklet.