Mood Disorders Clinic (formerly Bipolar Clinic)
Eligibility
The Mood Disorders Clinic accepts referrals for children/youth ages 6-18 that are diagnosed with Bipolar Disorder or where a physician queries a mood disorder. Due to the complexity of Paediatric Bipolar Disorder and the long-term implications of diagnosis, after pre-screening a comprehensive assessment will be completed on all referrals with a high likelihood of mood disorder.
Assessment
The assessment process is in 3 parts.
Part A (Pre-screening)
The purpose of this step is to determine the likelihood of a mood disorder and avoid unnecessary extensive time waiting for the comprehensive evaluation, through systematic review of the referral information. This is a parent/guardian and child interview and completion of screening measures.
Part B
This standardized interview (WASHU-KSADS) is a validated evidence based tool used in assessing Early Onset Bipolar Disorder.
This part of the assessment occurs in the client's community or at CPRI. Clients who function within normal range of intellect will receive an extensive standardized diagnostic interview/questionnaire. If intellectual functioning is in question, a psychological assessment completed in your community prior to assessment is suggested. The WASHU-KSADS interview will be completed with the child/ youth and his or her guardian by a Community Behaviour Consultant (CBC) trained to conduct the interview.
Part C
The assessment interview is scored and reviewed by other staff members of the clinic team (psychology, psychiatry). A psychiatric consultation is booked and completed with the client and guardian at CPRI. The psychiatrist may make recommendations and give a diagnostic impression and diagnosis. Further assessments may be required.
Treatment Services
Clients diagnosed with Bipolar Disorder will be offered an 8-10 week intensive group session. This may include a parent/child treatment group that runs concurrently. These sessions are based on a cognitive behavioural therapy model with a psycho-educational component. An anxiety based treatment group may also be provided to clients presenting with symptoms of anxiety. Psychiatric follow-up could occur while client/family is attending treatment groups. During this time, clinic staff will be available to consult about the clients' progress and ongoing treatment needs to the community. If appropriate, treatment groups can occur in the client's community.
Clients who are not diagnosed with Bipolar Disorder may be referred for other services within CPRI if appropriate or back to their community. Supports can be provided by clinic staff in the community to children and youth, families and agencies as a follow up to the assessment outcome. These supports may include psychiatry, occupational therapy, social work, art therapy, behavioural consultation and psychology. These interventions are provided through presentations and consultation.
Other community partners requesting information about Mood Disorders can access presentations through our Speaker’s Directory (in the Resources Section).
Treatment Transition
After completion of the group treatment, clinic staff will partner with the clients' community supports (e.g., community mental health centre, school, therapist, youth worker, youth group, Wraparound teams & Physician) to develop a long term transition plan to support a client in their community.
This would include review of clinic sessions, staff training, implementation of management strategies for school and home and educational workshops to the community. Transition planning is to support the child/youth in his/her home community. Booster sessions are offered to children/youth and their guardians at intervals after clinic treatment has ended.
Psychiatric Consultation
Clinic staff are available to consult with communities as needed. The clinic psychiatrist can be available to consult to a community physician. Access to the clinic psychiatrist is on a consultative basis and should not be seen as a replacement for the primary physician.
Parent Resource Group
All parents with children diagnosed through the clinic with a Mood Disorder are invited to attend a staff supported parent support group. When possible, technological aids can be arranged to assist parents to access the group (e.g.; videoconference, teleconference.)
Clinic staff can assist communities/families to organize groups in their community.
Outcome/Evaluation
Scales/questionnaires pertaining to treatment outcomes will be required on a regular basis during treatment and post treatment to evaluate treatment outcomes.
To ensure the clinic is meeting client/family and community needs evaluation and satisfaction questionnaires will also be completed at different intervals during CPRI involvement.
In February of 2006, CPRI received a Program Evaluation Grant from the Centre of Excellence of the Children's Hospital of Eastern Ontario to conduct an evaluation of the treatments offered by the Bipolar Clinic. The following poster highlights our findings. If you would like more information, please contact the Program Manager of Applied Research, Dr. Shannon Stewart at (519) 858-2774 Ext. 2064.