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 Bipolar Disorder and the long-term implications of diagnosis, a comprehensive assessment will be completed on all referrals.

Assessment
The assessment process is in 3 parts.

Part A
This part of the assessment occurs in the client’s community.  Clients who function within normal range of intellect will receive an extensive standardized diagnostic interview/questionnaire known as the WASH-U-KSAD. (If intellectual functioning is in question, a psychological assessment completed in your community prior to assessment is suggested).  The Washu interview will be completed with the child/ youth and his or her guardian by a Community Behaviour Intervention Consultant (CBIC) trained to conduct the interview.  The results of the interview will be shared with the clinical team.   

This standardized interview is a validated evidence based tool used in assessing Early Onset Bipolar Disorder.

Part B
The assessment interview is then scored and reviewed by other staff members of the clinic team (psychology, psychiatry).  A psychiatric/clinic assessment is then booked and completed with the client and guardian at CPRI.  The psychiatrist and clinic team may make recommendations and give a diagnostic impression and diagnosis.  Further assessments may be required.

Part C
Clients who are not diagnosed with Bipolar Disorder will receive a comprehensive assessment summary.  The clinic staff will consult to the case manager/physician about the assessment results if requested.  The client may be referred for other services within CPRI if appropriate.

Clinic Entry
Clients diagnosed with Bipolar Disorder will receive 8-10 intensive group sessions in the clinic.  This includes concurrent parent/client groups. These sessions are based on a cognitive behavioural therapy model with a psycho-educational component.  Psychiatric follow-up will occur while client/family is attending treatment groups.  Sibling sessions will occur during this time.  During this time, clinic staff will be available to consult about the clients’ progress and ongoing treatment needs to the clients community.

* If numbers predict, treatment groups can occur in the client’s community.

Treatment Transition
Once clients have completed the clinic 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 client in their community. 

This would include review of clinic sessions, staff training, implementation of management strategies for school and home and an educational workshop to the community.  Transition planning is to support the child/youth in his home community. 

Booster sessions are offered to children/youth and there guardians at intervals after clinic treatment has ended.

Consultation
Clinic staff are available to consult with communities as needed.  Clinic psychiatrist can be available to consult to community physician.

Consultation does not include direct client contact.

Parent Resource Group
All parents with children diagnosed with Bipolar Disorder are invited to attend a “staff supported” parent support group.  This group has been running since 2000. 

Parents can access the group via videoconference or teleconferencing from the home community if requested.

Clinic staff can assist communities/families to organize groups in their community.

Outcome/Evaluation
To track treatment progress, 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.