Relationship issues and family work

Other things may change us, but we start and end with family. Anthony Brandt (in Simpson, 1988, no. 3740) In this chapter we discuss the role of family work in interventions with young people with bipolar disorder. We recognize that family work is a specialized area and highly recommend Miklowitz's (2008) Bipolar Disorder: A Family-Focused Treatment Approach (second edition) and Miklowitz and Goldstein's (1997) Bipolar Disorder: A Family-Focused Treatment Approach, which have heavily influenced our intervention. We also acknowledge that some of the family therapy literature describes highly detailed interventions, particularly for communication skills and problem-solving (e.g. Mueser & Glynn, 1999). However, as with the rest of this manual, we place a strong emphasis on “real world” work and the following describes interventions that we have found effective when working with our population. While for simplicity we have included this as a separate chapter, we suggest that in clinical work, the components described and the philosophy outlined should be interwoven throughout the intervention rather than being provided as a discrete module. The rationale behind family work There are a number of reasons for including family and relationship work in a psychological intervention for young people in the early phase of bipolar disorder. Firstly, in our population of young people aged between 15 and 25 years, almost 56% were living with their families, or had returned to the care of their families after developing their first episode (Hasty et al., 2006).