Question of the Month: Achieving Integrated Care

How does a patient or family member get the professionals providing health care services to participate in an integrated approach?

This is where Bipolar Advantage is leading mental health. Our professional and education team will share their assessments and treatment options with each other and with you and your family. The patient determines who will receive shared information. This integrated team approach promises to be more effective in helping you achieve your goals. It promises better communication across the spectrum of care providers addressing your physical, mental, emotional, spiritual and career goals. Our team now provides their services by telephone consultation and on-line services to reach beyond the San Francisco Bay Area.

Our experience as family members and consumers is that we have to insist on integrated care, beginning with communicating clearly and openly with all of your care providers. Practitioners may ask that you sign a release so they can share your personal medical information with each other.

What about real physical conditions that may be aggravated by medications prescribed for mental health? Shouldn't there be more than one practitioner in on the conversation about the risks and benefits, and the management of those conditions while taking these prescriptions? Of course, a good psychiatrist doesn't want the trainer at the gym second guessing your needs for mental health prescriptions, but can't there be a conversation or an on-line communication, or a note given to the patient and family to educate and communicate with other practitioners? Ask for it, insist on it.

Integrated care goes way beyond that, it means finding a therapist, MD, a qualified peer counselor, a nutritionist, a fitness coach/trainer and even a spiritual counselor that understand your plans and goals for optimum wellness. They understand the advantage of communicating with each other and cooperate as a team.

For many people who cannot interact directly with the Bipolar Advantage Team it is necessary to educate your care providers and be very proactive regarding your care. We encourage families and consumers to expect the best and insist on it for yourself.

Avoid becoming self-limiting because services are not under one umbrella and are not covered by health insurance. It is more important that you put your team together with what you can afford and what you can find in your community. Don't wait for your health insurance or provider to give you everything. Beyond your medical team, creatively use your library, community center and church to enroll in classes and find people willing to be on your team for fitness, nutrition, life coaching, career counseling, yoga, meditation, or spiritual counseling.

New Videos on-line

Visit www.YouTube.com/bipolaradvantage and Subscribe! When we post new videos you will be notified. There are several videos for you to see now. There are many more in production that will be up soon!

Upcoming Workshops

Think ahead and register early for Summer Advantage Program Workshops. Workshops are filling early and a deposit will hold your spot. Remember we offer sliding scale, partial scholarships and family and professional discounts.

Bipolar Advantage offers essential, educational workshops throughout the year. Everyone can benefit from gaining knowledge and practicing the tools given at these workshops.

Click here for more information.

News and Events:

Tom Wootton at NAMI

Tom continues to speak regularly to NAMI affiliates throughout 2009.

A Special Evening in Conversation with Tom Wootton Wednesday, May 27, 2009 at NAMI San Mateo namismc@sbcglobal.net

Tom will hold a workshop at the NAMI National Conference in San Francisco in July of 2009 and he will be the keynote speaker to kick off the NAMI California State Conference on August 21.

Tom will be the guest speaker in September at NAMI West LA.

Dr. Peter Forster, MD presented "Evidence Based Treatments for Dual Diagnosis" in March in San Francisco. Covering various treatment models of co-occurring disorders. Dr. Forster presents at lectures, medical staff meetings, grand rounds and has consulted for hospital and behavioral health systems. You can visit Dr. Forster's website at http://www.gatewaypsychiatric.com

Dr. Michael Edelstein has spoken on "Communication Strategies for Building Consensus." in February and March in San Francisco. At the Austrian Scholars Conference in Auburn, Alabama he gave a talk on "How to be Happy in a Statist World."

Dr. Edelstein facilitates SMART recovery groups twice weekly in San Francisco at St. Francis Hospital on Hyde Street. These meetings are based on Rational, Emotive, Behavioral Therapy (REBT) and are an alternative to the 12-step model. The meetings address any and all addictions and are free and open to the public at no charge. Visit his website for details.

Dr. Edelstein's new book "Stage Fright: 40 Stars Tell You How They Beat America's #1 Fear" is due out in May and can be preordered on amazon.com.

An Interview with Dr. Maureen Duffy

When did you first meet Tom Wootton and why did you want to join Bipolar Advantage?

I met Tom at a support group meeting for people with chronic mental illnesses in Fort Lauderdale, Florida in March of 2006. Tom was on tour giving talks and promoting his new book The Bipolar Advantage. A story about Tom and how he came to write his book appeared in my local newspaper, The Miami Herald. I was intrigued from the moment I read the newspaper article and decided that I wanted to meet Tom and hear his story in person. I was the Chair of the Counseling Program at Barry University and had long been interested in strength and resource-based treatment approaches to what is ruefully called "serious mental illness." So my husband, Pat, and I drove up to Fort Lauderdale to hear Tom. Tom did not disappoint. He was funny, hilarious at times, and inspiring as he told his own story.

I read the book, liked the ideas that Tom was making, and we began communicating via email. I think I was one of the first professionals to write a review and endorsement of Tom's book. As Tom began to create a vision for The Bipolar Advantage Program, we talked a lot about the importance of relationships in making or breaking recovery. Since family therapy is my specialty, I began to put together a relationship training and skills building program for people with bipolar and their families.

What area or subject is the most difficult for family members or for people with bipolar or depression?

For family members, I think there are a few areas and they seem to revolve around how to handle anxiety and fear. Family members are often very anxious about their loved one with bipolar or depression and they respond, understandably at one level, by increasing their surveillance of the person, thinking that if something bad happens they will see the early warning signs and be able to do something about the situation or get help quickly. In spite of what might be well intended, trying to control the person with bipolar or depression almost always backfires!

No one appreciates being watched all the time and people with bipolar or depression understandably may become resentful. If a family member is constantly watching for signs of relapse then the message that gets telescoped to the person with bipolar or depression is that all they are or all they can become is something to do with mental illness. In those circumstances, for both the family member and person with bipolar or depression, life becomes narrower and narrower, revolving around trying to keep the signs and symptoms of their mood disorder away. I am convinced that Tom's concept of acceptance is critical to changing this destructive relationship pattern. Accepting bipolar or depression, for both the person and family members, means no one has to fight it anymore. What an incredible relief! Life suddenly becomes enlarged and both the person and the family members can stop spending so much time playing hide and seek about bipolar and depression and move on to doing other things with their lives.

What were some of the best surprises or greatest breakthroughs that came out of the Relationship Workshops?

Because these are relationship training and skills-building educational programs, we encourage people with bipolar or depression to bring along family members, if they are comfortable in doing so. It doesn't make a lot of sense to have relationship workshops and not encourage people to bring partners, spouses, or other family members. In a lot of treatment approaches, family members are separated from the person who has the condition and family programs are conducted separately. In our Relationship Workshops, the person with bipolar or depression and family members really benefitted from hearing each other's perspectives and from learning relationship skills that they could take home and put to use right away.

The participants in our Relationship Workshops named a few really important ideas that they took home with them. A key idea that many mentioned was that improving their relationships had to start with them. It's common to think that your relationship can only change if the other person changes-we've all thought that at one time or another-or at least wished it. So we spent a lot of time challenging that idea and thinking about what it might mean to start relationship change with ourselves! Another idea that people said they took home was the importance of accepting themselves with their bipolar or depression and not seeing themselves as defective. These are life-changing ways of thinking that, if adopted, can only lead to positive developments in one's life. I was really heartened to see that some participants said the Relationship Workshops helped them to realize that they were already doing a lot of things right!

The feedback from the participants was incredibly positive. I enjoyed immensely doing the workshops and interacting with everyone. I was surprised a little by how incredibly attentive and involved the participants were and how many notes some people took. I've taught college for many years and I have to say I don't often see the level of attention and engagement that I saw in the Relationship Workshops. I'm looking forward to our next series!

Wellness

Regular Acupressure Treatments May Help Relieve Symptoms of Anxiety, Bipolar conditions, Depression, and Panic Attacks.

What exactly is Acupressure?

Acupressure, an ancient therapeutic treatment, requires practitioners to massage specific points on clients' bodies in an effort to enhance blood circulation, release muscle tension, and revitalize the body's innate healing energy. In Traditional Chinese Medicine, this healing energy is called "chi" in India it is called "Prana", in the U.S. it is called Spirit or Soul. From the beginning of the practice of Acupressure, Chinese practitioners became aware that Acupressure not only had the ability to heal physical ailments, but also had the ability to help their clients balance their emotional ailments. Moreover, many contemporary practitioners have observed that Acupressure, as well as general massage therapy, when scientifically tested does help relieve symptoms of anxiety, as well as other emotional disorders (Moyer, Rounds, & Hannum, 2004). Although Acupuncture is probably more familiar to many, acupressure actually precedes acupuncture by several hundred years. Additionally acupressure, rather than requiring the use of thin needles, calls for practitioners to work with their fingers, hands, and sometimes feet to activate key points along what practitioners of Traditional Chinese Medicine identified as "meridians".

Unlike acupuncture, simple acupressure procedures can be easily taught to clients allowing them to maintain levels of well-being between professional acupressure sessions. Further, current scientific research conducted regarding the benefits of acupressure support practitioners' anecdotal reports that regular acupressure sessions are able to help clients control their symptoms of anxiety, bipolar disorder, depression, and panic attacks.

How is Acupressure Used?

Following is a list of some simple acupressure techniques that are both effective and easy for clients to apply between professional sessions:

Techniques to relieve symptoms of depression/anxiety:

1. Locate the breast bone and follow it down about 1/3 of the way. There will be a small valley in the bone. Apply the forefinger and index finger to this spot. While breathing deeply, and with eyes closed, apply gentle pressure for 2 minutes. This point is Conception Vessel (CV) 17. After applying pressure, gently thump the same breast bone area in a sequence of threes-thump-thump-thump and pause; then thump-thump-thump and pause; then one last time; thump-thump-thump and stop. This thumping stimulates the immune system and helps to control symptoms of depression.

2. Move the index and forefingers to the intercostals space just above the nipples. Breathing deeply, with eyes closed, hold or gently rub this spot for 2 minutes. This point is stomach 16, or the "Breast Window". Another way to determine the correct spot is to check that the index and forefingers are directly below the ear lobes. This motion also quells symptoms of depression and anxiety.

Techniques to relieve symptoms of Bipolar conditions:

Locate the point in the middle of the palm of either hand between the middle and ring fingers. Use the thumb to massage this point for 2 minutes. Breathe deeply with eyes closed. This point is Pericardium 8, or the "Labor Palace".

Locate the point on the sole of the foot just at the base of the ball of the foot and between the 1st and 2nd toes. Use the thumb to press or massage this point for 2 minutes, while breathing deeply, and eyes closed. This point is Kidney 1, or the "Bubbling Spring".

Techniques to relieve symptoms of panic attacks:

Locate the bottom center of the breast bone. Then place the middle 3 fingers onto the Xyphoid process pressing until a slight discomfort is felt. Keep finger tips here, eyes closed, breathe deeply while pressing for 2 minutes. This point is Conception Vessel 14.

These techniques are just a small sample of the benefits of receiving regular acupressure. Full hour-long acupressure sessions can enhance the body's immune system, and encourage clients' emotions to achieve and maintain balance.Karen Randolph, EdD is a Certified Massage Therapist living in the Bay Area. Please visit her website for more information.

Collaborating with BPA:

When your organization partners with Bipolar Advantage you can be assured of successful outcomes, with strong endorsements from participants and organizers alike. For Organizations looking for more information on partnering with Bipolar Advantage, this page will provide an introduction to the services we offer.

CEU units

CEU units Certified by the State of California Board of Behavioral Health (PCE #4050) for MFT and LCSW. We encourage therapists to attend our workshops. Therapists will learn from experts, consumers and each other in an interactive environment. Our workshops will open your eyes and expand your education.