How Well Does Therapy Work for Bipolar Disorder?

Parents sometimes worry when they don't see immediate results in their child's progress after therapy; they wonder if they are wasting their money and their time. But it's important to be patient: Psychotherapy is a long-term investment. Although it may seem that a child is not internalizing what he's learning and that therapy is not producing any immediate returns, a youngster may be banking away for future use the coping skills he's learning now. The benefits can take years to surface, as it can take time for children to begin to transfer what they learn in therapy to the outside world. As the child gets older, develops more self-control, and becomes more mature, he will draw on the tools he's been given for years to come.

I've had many parents tell me that they initially did not believe that therapy had helped their child but later realized that it had made a huge difference over time. Here's what the mother of Herman, age eleven, had to say about his psychotherapy experience:

I believe it was Herman's four-year physical when I broke down in tears asking for help. I explained to Herman's pediatrician that I could not handle this child's behavior; we needed further help. My pediatrician referred me to a psychotherapist, and for years, the therapist and I worked on how to handle Herman's dangerous, defiant, and often destructive behavior. I began reading books on positive discipline and learned everything I could about parenting. Herman began seeing a behaviorist for individual therapy, and we all became involved in family therapy.

Meanwhile, we began to see a child psychiatrist who worked tirelessly with us for several years trying to get Herman's medications adjusted. The medications seemed to help for a while but never were perfect. No matter what kind of therapy we provided, it didn't seem to help. We felt as though nothing could help until his biology changed. We began to feel he would never be any better no matter what type of help was provided. We decided at one point to discontinue behavior therapy. What was the point of spending the time and the money? We were on a roller-coaster ride with no signs of stopping.

At one point, we had Herman get neuropsychological testing to help determine the presence of cognitive and/or neurologic deficits. These tests were helpful in understanding what specifically was difficult for him. I do believe the information we gained was helpful in showing Herman that we understood what his difficulties were. I think he felt he could trust us completely with the unbearable pain and unrest that lay within him. I gradually began to realize that the psychotherapy was helping more than we thought.

During the past year, Herman's medication combination finally seemed to really work. He has been the most stable he has ever been, with a few bumps in the road. He has a very clear understanding of how he feels and can now verbalize his feelings, which is very helpful. During the summer, Herman has been going to sleep-away camp. I can see changes in him positively ever since he started camp. I can see him implementing the skills he has absorbed. I know the roller-coaster ride is not over. There will be many more chapters to follow, but I can see the light. There is some normalcy in his life and in ours.

The neuropsychological testing to which Herman's parent refers is a battery of cognitive tests that examine brain function and attempt to identify problem areas. By using this type of testing to clarify a child's deficits, teachers and parents can learn how to help him compensate for areas of difficulty.

Once Herman's medication helped him achieve biologic stability, all those years of hard work in a variety of therapies proved to have been most valuable. After Herman achieved stability, his life changed. He and his family have been much happier, and Herman has become far more successful in his involvement with the outside world.

Stories such as Herman's should be kept in mind when you feel as though therapy serves no purpose. Sometimes, you discover that psychotherapy really does help, even if its effects are somewhat delayed. In many cases, it's the combination of therapy and medication that, in the end, turns a child's life around. And the earlier the intervention, the more profound its effect will likely be.

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