Monday, June 9, 2008

NYT: Clinic Treats Mental Illness by Enlisting the Family

From the New York Times:

It was hard to tell just who was the patient, as the Cunanan siblings — Jennifer, Adrian and Anthony — sat in a row on three chairs in a sparsely decorated therapist’s office at Beth Israel Medical Center in Manhattan.

It was Jennifer Cunanan, 27, who did most of the talking, describing life with Adrian, 30, a computer consultant who has bipolar disorder and who went through a severe manic episode in March. He would go two days without sleeping, she said, then become so frazzled that he depended on his family to carry out life’s daily chores, like shopping and cleaning.

“All of us would like someone to sweep up after us,” Ms. Cunanan said, half understanding, half resentful, as her brother listened, his eyelids drooping from exhaustion.

Adrian’s brother and sister, as well as the woman he is dating, are critical components of his therapy at Beth Israel, where a fledgling clinic aggressively treats people with bipolar disorder by involving their family members. The clinic, the Family Center for Bipolar Disorder, was set to be formally dedicated on Wednesday, though it has evaluated some 60 families since 2006, in a program that doctors say is unique in the city and based on a model developed at the University of Colorado.

Family-focused therapy, as it is called, breaks the image of the psychiatrist sitting in his chair, alone in a room with the patient, as well as the traditional wisdom that patient confidentiality is sacrosanct. In family therapy, the family might be treated as part of the problem; in contrast, in family-focused therapy the point is not to treat relatives, but to enlist their help in managing the patient’s illness.

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