A case study exploration of placement in a therapeutic day school as an educational intervention package for children and adolescents with bipolar disorders

摘要

The number of children and adolescents diagnosed with bipolar disorders has increased dramatically since the mid-1990s, while the treatment literature has failed to keep pace. Few studies have explored any aspect of the educational functioning of this population, and no empirically supported educational interventions have been identified. As a result, school psychologists have little guidance regarding how to effectively serve these students.In this study, case study methodology was utilized to explore the effectiveness of placement in a therapeutic day school as an educational intervention package for eleven (n=11) children and adolescents diagnosed with bipolar disorders. Both quantitative and qualitative data were utilized, and within- and cross-case analyses were conducted. Academic performance was examined in the areas of reading, mathematics, writing, science, and social studies. Behavioral/social-emotional performance was explored in the areas of on task/work completion, compliant (i.e., following instructions), and physically aggressive behaviors, as well as social skills and coping skills. Results indicated that a majority of students with bipolar disorders at least sustained performance in areas of relative academic and behavioral/social-emotional strength, improved performance in areas of relative academic and behavioral/social-emotional weakness, achieved positive immediate educational outcomes (e.g., upper levels of schoolu27s behavior modification level system, re-integration into home schools), and ameliorated referral concerns.Interestingly, all students in this study exhibited relative weaknesses in social and coping skills. Nearly all students demonstrated a relative weakness in mathematics. Another important finding of this study was the identification of two distinct patterns of physically aggressive behavior: a u22spikeu22 pattern and a u22low levelsu22 pattern. All students exhibited one of these two patterns, either in full or emerging form.In general, placement in a therapeutic day school was determined to be an effective educational intervention package for students with bipolar disorders. However, degrees, rates, and patterns of success were variable. Future studies should attempt to parse out the treatments that comprised this studyu27s intervention package in an effort to find effective treatments for children and adolescents with bipolar disorders.