Q:  This is such a long story, but ill summarize it up.  my husband may be
getting custody of his 7year old boy.  The little boy has had a bumpy road. He was took away from his mother 2 times because of neglect and abuse. I know the little fellow has been through alot. His grandparents had legal gaurdianship of him, but now he is in a treatment center and has been diagnosed with bipolar and adhd.  my husband never knew he exsisted until he was 4 and could never contact him because his mother had him on the go. The child had been in 5 different  schools in 1 year.

  Anyway, my husband may be getting custody of him. We are gradually getting to know him, and he has a brother, our child, that he has never met. If he does join our family, how can we make him feel at home? how can we let him understand that we love him and he would never have to go through what he has been through?

Please help.


Dear A,

     Establish and maintain an open relationship with the grandparents in the event one does not already exist.  Contact the treatment center, for example, through the social services department and set up meetings to ease the transition as often as appropriate prior to the child moving into your home.  The treatment team can provide you an advantage in that they are already familiar with the child's needs, strengths and weaknesses.  Take advantage of the professionals and family who know then child best in order that you can have a plan in place in your home, for example, with regard to your ability to stay calm and be a model of desired behavior, providing positive behavioral choices, good conflict management skills, the ability to laugh at  your own mistakes, etc.

     The child's treatment team should have developed a 'behavior intervention plan'.  When the child is stable, you need to build the child's skills that lead to approriate reactions and behavior, including emotional labeling, empathy, anger management, social rules, nonverbal communication, and making amends.  You will also benefit from training by members of the treatment team in nonviolent crisis prevention, focusing on verbal deescalation techniques to avoid crises.

     In addition to assisting you to manage challenging behavior, the treatment team of professionals should be able to assist you with recommendations dealing with modifying the physical environment, side effects of medication, events that trigger acting out, symptoms suggesting a call to the psychiatrist.  You will also need assistance setting up a transition from the treatment center to a new learning environment whether it is within a school or a psychiatric day program with a learning component.

     Ask the treatment team for recommendations regarding community resources that include a psychiatrist and psychologist or therapist with whom you feel you can and will communicate openly about all your child's behaviors and symptoms.  Your son may have had a very rough existence for a considerable period of time but do not feel guilty about his past.  You cannot change it but you can learn from it and begin to provide the stability, love and treatment that he has needed for those earlier years.  Keep him on his treatment.  It takes great patience to get the correct medications and dosages and once there is improvement, your child should continue taking his medication for the rest of his life.  Bipolar disorder is a chronic disease.  Like diabetes, it requires constant treatment and re-evaluation.

     Children with bipolar disorder need adults around them who are positive, calm, firm, patient, consistent, loving and who encourage them to behave appropriately.  Praise elicits positive behaviors while negativity helps the child spin out of control. Children with bipolar disorder are similar in many ways to their "normal" counterparts.  Sit down with your husband and discuss what your needs are in your relationship as well as with the new member of the family.  Set clear boundaries about what you will and will not tolerate within the guidelines of the treatment plan and stick to what you agree upon.  Try to share equal responsibility for providing both praise with structure and discipline or at least demonstrate to your son that you are both on the same page.  Consider joining a support group of parents who have children with bipolar disorder.  Good luck in your venture.  Some excellent resources are listed at the bottom of this response.

CHILD AND ADOLESCENT BIPOLAR FOUNDATION
 http://www.bpkids.org/site/PageServer

NATIONAL MENTAL HEALTH ASSOCIATION
http://www.nmha.org/children/children_mh_matters/mood

NATIONAL ASSOCIATION ON MENTAL ILLNESS
http://www.nami.org/Template.cfm?Section=By_Illness&te

AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY
http://www.aacap.org/


David Schafer, M.Ed.
Staff Psychologist


Published April, 2006