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Psychosocial Interventions regarding Youth Bipolar Disorder
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In the last section, we discussed three key aspects of stress on
bipolar child clients, which were biological processes; social factors; and
transitions. We also included three techniques to reduce these stresses. These
three techniques were Acclimation, Point System and Transition Form.
As you know, interacting with other children is a large
step in helping any child to relate in a healthy way to the world around
them. When a bipolar
child client is unable to communicate rationally with his or her peers, he
or she might not develop necessary social skills.
In this section, we will examine
three difficulties bipolar children have in relating to other children. These
three difficulties include impulsiveness; defiant attitudes; and disempowerment.
3 Difficulties of Relating to Other Children
♦ 1. Impulsiveness
The first difficulty bipolar children must face is their own impulsiveness. As
non-bipolar children mature, they become increasingly capable of manipulating
objects and events around them, thereby becoming free of concrete dependency
on them. I have found that a bipolar child, however, never connects with the sense of being able to control his environment. As a result,
this feeling of loss of control is translated into reactions that are impulsive
Such simple tasks as taking turns, waiting on others,
or holding back to talk first pose an imminent loss of control on bipolar children. This
can also be seen when a parent says the word no and a child reacts with rage. Faced
with a feeling of powerlessness, the bipolar child responds in the way his
or her body demands: a tantrum.
Kyle was a nine year old bipolar
client who could not share with others. When someone asked him
for a toy, he became angry. When I asked him if I might see one of his
toys that he was playing with, Kyle stated, "No! You’re too
stupid. Shut up and get your own Lego." When I asked again,
Kyle threw the Lego set across the room.
♦ 2. Defiant Attitudes
The second difficulty that bipolar children face in interacting with other
people is their own defiant attitudes. Like impulsiveness,
defiance is a way to control their surroundings. Bipolar children do
this by constantly standing their ground, admitting no new stimuli, no changes
and no transitions. Many times, this comes as a misinterpretation of a person’s
Such simple requests as "You’ve got to get
up now so you have enough time to get dressed" raises anxiety in bipolar
children and they respond with stubborn opposition. Over time, these
defiant behaviors in adolescents can be viewed as disrespectful and these
bipolar teens are often met with negative attitudes from teachers and other
authority figures. As a result, they isolate themselves even more,
which enhances their low self-esteem.
Technique: Communication - Misinterpreting Other People’s Requests
What many interpreted as Kyle’s irrationality was what I recognized as
a miscommunication. To Kyle, I was trying to encroach on his play time
and ruin his day. In his polarized mind, I was either a friend, or I
was an enemy. To help Kyle understand my intentions, I used the "Communication" technique. When
I asked Kyle again for the toy, I made sure to make my intentions clear. I
stated to Kyle, "Kyle, I see that you are playing with a fun toy. I
would like to have fun with you, but do not want you to stop
having fun. May I play with you, while you also play
Kyle’s second reaction was the complete opposite of
his first reaction. He let me sit with him and pick up his toy. I
then stated to Kyle that this was what sharing really was: playing with another
person. Think of your "Kyle". Is he or she misinterpreting other people’s requests? Is he or she overreacting to these requests?
♦ 3. Disempowerment - Tunnel
The third difficulty many bipolar children face when interacting with other
people is a feeling of disempowerment. Many times,
this occurs when a child is in a new environment or has to interact with
authority figures such as teachers or therapists. This could cause
them to fly into a depressed or manic state. Much of this feeling of
disempowerment comes from a lack of self-confidence. In
adolescents, this can be magnified by their changing social atmospheres and
their own hormonal growth. Have you found, like I, that adolescents
have a much lower self-confidence than adults or younger children?
they do not know how to handle their low self-esteem, teenagers become reclusive,
and this is true with bipolar and non-bipolar alike. However, the
danger, as you well know, is that bipolar teens left alone do not have the
support system to keep them from a manic or depressive state.
year old Jacqueline lost her self-confidence when her medication caused her
to gain around fifteen pounds. This extra weight bombarded her self-esteem
until Jacqueline became severely depressed. What I realized, and what
is true about many teenagers today, is that Jacqueline was emphasizing the
negative about herself instead of her positive attributes. This tunnel
vision causes many bipolar disorder teens and children to fall into a depressive
state which needs to be counteracted with empowerment.
Technique: Positive Questionnaire
To help Jacqueline gain confidence in herself, I suggested she fill out the "Positive
Questionnaire". I asked Jacqueline to finish the following
sentences, emphasizing her qualities. Jacqueline filled in the following
1. "My strengths are... my sense of humor and my willingness
to look on the bright side for most things."
2. "The aspects of my personality
I like best are... my drive to work hard and friendliness."
3. "The physical
features I like best about myself are... my eyes."
7 Other Phrases Jacqueline Used
Other phrases that
Jacqueline completed included the following:
1. I am proud of...
2. What I appreciate about me is...
3. My accomplishments are...
4. Ways in
which I take care of myself are...
5. The personality
traits that make me likable are...
6. What others
have told me they admire about me are...
7. When I feel
powerful I can...
After Jacqueline finished filling out these phrases, I asked her to put the
questionnaire in a place that she could see everyday. Jacqueline decided
to tape her questionnaire right above her bottom bunk so when she awoke each
morning, she saw her positive qualities before she even looked in the mirror.
In this section, we discussed three difficulties bipolar children have in relating
to other children. These difficulties included impulsiveness;
defiant attitudes; and disempowerment
In the next section, we will examine three aspects that
affect a bipolar child’s
healthy life style: sugar craving; exercising activity; and sleep.
Peer-Reviewed Journal Article References:
Boyers, G. B., & Simpson Rowe, L. (2018). Social support and relationship satisfaction in bipolar disorder. Journal of Family Psychology, 32(4), 538–543.
Chung, W. W., Vesco, A. T., Resko, S., Schiman, N., & Fristad, M. A. (2012).
Psychosocial interventions for youth with bipolar disorders: Combining clinicians' and caregivers' perspectives. Professional Psychology: Research and Practice, 43
Schwartz, L. A., & Feeny, N. C. (2007). The nature of and behavioral treatment of sleep problems in youth with bipolar disorder. International Journal of Behavioral Consultation and Therapy, 3(1), 88–95.
What are three difficulties bipolar children have in relating to other children?
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