I received a phone inquiry recently from a mother concerning her adult son. Apparently, he has been diagnosed with bi-polar disorder and has had numerous problems with school, drugs and the law as a result. He was put on medication but has stopped taking it and has refused any kind of therapy. The mother had read about SMART Recovery, a free alternative group style self-help program for alcohol and drug treatment based on principles of Rational Emotive Therapy and Cognitive Therapy.
Most recently he had been arrested. His car was stopped for reckless driving and he was found to have an unprescribed bottle of anti-anxiety drugs in his possession. The mother wanted to know if the self-group would be worthwhile.
Since bi-polar disorder is made up of both severe depression coupled with periods of behaving in impulsive and manic ways, I told her straight out that her son needed to be on his medication and in individual treatment. I felt the voluntary group self help might be useful in addition but not in place of the other treatments. When she replied again that he wouldn’t cooperate, I told her to allow the natural consequences to unfold and allow him to stay in jail until his court date. The judge will determine whether he will go to jail or insure that he gets treatment in lieu of jail time. With bi-polar disorder, beyond the medication, treatment needs to address his underlying core issues and help him develop better awareness of this thought and control over his feelings. I did not explore with mom the details of her “enabling” behaviors but pointed out if she continued to bail him out, more serious problems were likely in store.
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