Help for parents with bipolar disorder

Parents with bipolar disorder are taking part in a study that will give them the chance to follow a highly successful parenting skills programme.

Dr Steven Jones and Dr Rachel Calam at the University of Manchester's School of Psychological Sciences assess the volunteers' current mood and experiences of parenting with an online questionnaire before offering some of them help via an online version of the Triple P Positive Parenting Programme that featured on the ITV1 television series called ‘Driving Mum and Dad Mad'.

The Triple P system, developed by Australian clinical psychologist Professor Matt Sanders, is known to be effective in modifying and improving children's behaviour by rebuilding positive relationships, tackling discipline and setting rules and limits.

The first series of ‘Driving Mum and Dad Mad' in spring 2005 followed the experiences of five families attending a Triple P group. An average of 4.23 million viewers watched the show, with 500 families taking part in a parallel study by Dr Calam, The Great Parenting Experiment. All the parents who followed the TV series and used the strategies shown reported improved behaviour in their child and greater confidence in managing it. The group receiving additional web-based information and email support experienced an even greater improvement, and six months after the series most of the families reported long term benefits and continued improvements to their children's behaviour.

Dr Jones said: “Parents with bipolar disorder face many challenges in bringing up their children with key facets of the disorder, such as instability of mood and behaviour, impulsivity and anger problems, likely to lead to parenting difficulties. These difficulties can serve as stressors likely to contribute to distress, destabilisation and possible relapse in the parent. At the same time, recent research suggests that children of parents with bipolar disorder are at increased risk of behavioural and emotional disturbance, which are risk factors both for their own development and for parental mental health.

“This study is a great opportunity for these parents and their children. Triple P is a very good, sound programme that has helped many families. Professor Sanders has used this with depressed mothers and had good results.”

He added: “We hope that this system will prove to be a beneficial, efficient way of delivering help to parents with bipolar disorder and their families, and services can adopt it with little cost to them. There are 60 million people in this country and 1.5% of them are diagnosed with this disorder, which is a lot of people. At the same time there are a very small number of clinical psychologists so face-to-face therapy is expensive and difficult to get. But this study could lead to, say, a Manchester intervention from London.”

Dr Jones and Dr Calam, who are also working with MDF The Bipolar Organisation on this study, are now recruiting more parents who have been diagnosed with bipolar disorder, have children aged three to ten and online access.

The initial questionnaire will assess family background, parental and family chaos, strengths and difficulties in the face of child behaviour, mood in terms of mania or depression and patterns of stability such as leading an orderly life and getting enough sleep. This will involve a combination of a standardised measure of child adjustment, a self report measure of parental symptoms and questions designed specifically to establish the extent to which parents think that a parenting intervention would be helpful to them and how likely they would be to take part if one was offered, and a self report measure of parental symptoms. It will thus establish whether the parents would have an interest in a self-directed version of Triple P, as this would be a cost-effective way of evaluating delivery of parenting interventions to a geographically dispersed group with variable access to high quality parenting services, and how their current mood symptoms influence this level of interest.

The first questionnaire will be followed by ten weeks on a self directed Triple P programme for some of the sample and no intervention at all for the others (the control group). This will be followed by a second questionnaire to assess how each area has been affected by the intervention and if the families' situations have changed. The control group will then be offered the chance to take part in the Triple P programme.