David J. Miklowitz, Ph.D.

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1 Family and Friends Seminar Improved Interactions = Improved Outcomes David J. Miklowitz, Ph.D. Division of Child and Adolescent Psychiatry UCLA School of Medicine 760 Westwood Plaza Rm Los Angeles, CA dmiklowitz@mednet.ucla.edu

2 Handout # 2 Elated mood Decreased need for sleep Symptoms of Mania Increased activity Increased sexual thoughts Being overconfident or unrealistic Talking fast Easily distracted Racing thoughts, Loss of self-control

3 Handout # 2 Continued Low mood or sadness Low self-esteem Symptoms of Depression Tearfulness Trouble concentrating Some people also: feel really tired or low in energy wish they weren t alive feel worthless or guilty Sleeping too much or too little Increase or Decrease in Appetite Loss of interest in activities/boredom

4 Handout # 3 Recent Life Events Things that have stressed you out lately: STRESS Thermometer Things you did to help you feel better:

5 Handout # 4 Factors Affecting Your Brain Environment No control over feelings Symptoms Stress with family and friends Genetics School or work is hard

6 Handout # 6 Risk and Protective Factors For Mood Problems Risk Factors Drug / alcohol abuse Poor sleeping habits Not following daily routines Stressful life events Family conflict or distress Protective Factors Taking appropriate medicine Social / family / community supports Using communication & problem-solving skills Using treatment resources like Talking to your doctor or counselor

7 Stress Shield Stress Buffers Getting more sleep Taking your medications Less stress Good communication in your family

8 Handout # 8 How Can The Family Help? Help family members get treatment and services Support the use of medication Maintain tolerant and calm home atmosphere Have fair expectations of each family member Keep regular family routines (e.g., mealtimes) Know your own limits

9 Handout # 10 The Four Basic Communication Skills Expressing Positive Feelings Active Listening Making Positive Requests for Change Expressing Negative Feelings about Specific Behaviors

10 Handout # 11 Expressing Positive Feelings Look at the Person Say Exactly What S/He Did That Pleased You Tell Him/Her How You Felt When S/He Did That

11 Handout # 12 Catch a Person Pleasing You Day Monday Person Who Pleased You Exactly What Did They Do That Pleased You? What Did You Say to Him or Her? Tuesday Wednesday Thursday Friday Saturday Sunday Examples Looking Good Having a chat Being considerate Being on Time Making a suggestion Going Out Helping at Home Going to Work Showing Interest Cooking Meals Offering to Help Taking Medicines Working in Yard Tidying up Attending Treatment Being Pleasant Making Bed Making Phone Call

12 Handout # 13 Active Listening Look at the Speaker Attend to What is Said Nod Head, Say Uh-Huh Ask Clarifying Questions Check Out What You Heard

13 Handout # 14 Communication Skills Assignment Day Mon Person You Talked To What You Talked About What Positive Feedback Did You Give? What Active Listening Skills Did You Use? What Positive Requests for Change Did You Make? Tue Wed Thu Fri Sat Sun

14 Handout # 15 Making a Positive Request Look at the Person Say Exactly What You Would Like Him or Her to Do Tell Him or Her How You Would Feel When S/He Did That In Making Positive Requests, Use Phrases Like: I would like you to. I would really appreciate it if you would. It s very important to me that you help me with.

15 Handout # 16 Expressing Negative Feelings about Specific Behaviors Look at the person; speak firmly Say exactly what he or she did that you did not like Tell him or her how you felt when s/he did that Suggest how the person might prevent this from happening in the future

16 Handout # 17 Expressing Negative Feelings about Specific Behaviors Assignment Day Mon Person Who Displeased You What Exactly Did He or She Do That Displeased You? How Did You Feel (angry, sad, etc.)? What Did You Ask Him or Her to Do in the Future? Tue Wed Thu Fri Sat Sun

17 Handout # 18 Solving Problems Identify and Agree on the Problem Suggest Many Possible Solutions Discuss Pros and Cons Agree on Best Solutions Plan and Carry Out Best Solution(s) Praise Efforts; Check out if it worked!

18 Handout # 19 Problem Solving Worksheet Step 1: Define What is the problem? Talk. Listen. Ask questions. Get everybody s opinion. Step 2: List all possible solutions: Brainstorm. List all ideas, even bad ones. Have everyone come up with at least one possible solution. DO NOT EVALUATE ANY SOLUTION AT THIS POINT. (1) (2) (3) (4) (5) (6) Step 3: Discuss and list the advantages and disadvantages of each possible solution. Advantages (Pros) Disadvantages (Cons)

19 Handout # 19 (continued) Step 4: Choose the best possible solution OR solutions and list. (May be a combination of possible solutions.) Step 5: Plan how to carry out the chosen solutions AND set a date to carry it out. Date: A. Specifically decide who will do what. List. B. Decide what resources will be needed; list and get them. C. Think about what can go wrong when you try it, and figure out how to overcome the problems. D. Practice carrying out the solution. E. DO IT! (ON TIME) Step 6: Review the solution and give positive feedback to all family members about their participation. Step 7: If the plan didn t work, go back to Step 1 and try again. Do not become discouraged.

20 Handout # 20 Feelings that kids may have in response to their sibling s mood disorder (bipolar, depression) Trying to be the good kid Avoiding your brother/sister Avoiding the family/ Isolating yourself Anger Embarrassment Denying your own needs Taking on the role of holding the family together Being very quiet

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