Expert: Ivan Goldberg, M.D. - 1/21/2011

Question
my daughter has a long history of being bipolar and i have had her in treatment for years without success. she never takes responsibility for what she has done that had put her in jail or in trouble or her angry rants in which she is violent and loud and extremely hurtful to those helping her without remorse, my question is how do i handle her manipulative behavior i cant live with her so it would mean her being homeless. her continuous rants and verbal assaults can continue for 12 or more hours, she would put a cop to shame for her interrrogations. she is highly intelligent and can twist everything  around . she has been on multiple drugs no success. her mood swings are drastic and violent .

Answer
Hi, Ann . . .

There is no way that I am allowed to give you personal advice but I can tell you what I tell the parents of my patients. There are some basic ground rules that must be established by a parent who allows a mentally ill child into their home you. They include:

1. The parent and child will be involved in "family therapy" sessions on a weekly schedule. If the child misses two consecutive sessions (s)he will be be removed from the house.

2. In addition to whatever other therapies the child participates in, the child will be involved in a "dialectical behavior therapy" (DBT) program.

3. The parent(s) will attend meetings of the local chapter of the Depressive and Bipolar Support Alliance (See: http://www.dbsalliance.org/site/PageServer?pagename=support_findsupportlanding)

4. Any physical assault against the parent (hitting, pushing, spitting, etc.) will be immediately followed by a call to 9-1-1 and the  child  being arrested for assault. If the child is jailed by the police, the parent will not bail them out of jail.

5. Any destruction of property will also result in a call to 9-1-1.

It should be assumed by the parent that the mentally ill child will "test" these rules to see if the parent is serious abut enforcing them. If the parent does not enforce the rules, the situation is impossible and the child will never learn that behavior has consequences.

Best regards . . .

Ivan
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