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A Pilot Web Based Positive Parenting Intervention to Help Bipolar Parents to Improve Perceived Parenting Skills and Child Outcomes

  • Steven Jones (a1), Rachel Calam (a2), Matthew Sanders (a3), Peter J. Diggle (a1), Robert Dempsey (a2) and Vaneeta Sadhnani (a2)...

Background: Children of bipolar parents are at elevated risk for psychiatric disorders including bipolar disorder. Helping bipolar parents to optimize parenting skills may improve their children's mental health outcomes. Clear evidence exists for benefits of behavioural parenting programmes, including those for depressed mothers. However, no studies have explored web-based self-directed parenting interventions for bipolar parents. Aims: The aim of this research was to conduct a pilot study of a web-based parenting intervention based on the Triple P-Positive Parenting Programme. Method: Thirty-nine self-diagnosed bipolar parents were randomly allocated to the web-based intervention or a waiting list control condition. Parents reported on their index child (entry criterion age 4–10 years old). Perceived parenting behaviour and child behaviour problems (internalizing and externalizing) were assessed at inception and 10 weeks later (at course completion). Fifteen participants (4 control group and 11 intervention group) did not provide follow-up data. Results: Levels of child behaviour problems (parent rated; Strengths and Difficulties Questionnaire) were above clinical thresholds at baseline, and problematic perceived parenting (self-rated; Parenting Scale) was at similar levels to those in previous studies of children with clinically significant emotional and behavioural problems. Parents in the intervention group reported improvements in child behaviour problems and problematic perceived parenting compared to controls. Conclusions: A web-based positive parenting intervention may have benefits for bipolar parents and their children. Initial results support improvement in child behaviour and perceived parenting. A more definitive study addressing the limitations of the current work is now called for.

Corresponding author
Requests for reprints to Steven Jones, Spectrum Centre for Mental Health Research, School of Health and Medicine, Lancaster University, Lancaster LA1 4YT, UK. E-mail:
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Alloy, L. B., Abramson, L. Y., Gibb, B. E., Crossfield, A. G., Pieracci, A. M., Spasojevic, J., et al. (2004). Developmental antecedents of cognitive vulnerability to depression: review of findings from the cognitive vulnerability to depression project. Journal of Cognitive Psychotherapy, 18, 115133.
Arnold, D. S., O'Leary, S. G., Wolff, L. S. and Acker, M. M. (1993). The Parenting Scale: a measure of dysfunctional parenting in discipline situations. Psychological Assessment, 5, 137144.
Backer, C. (2011). “It's Like Being on the Other Side of the World with Mummy”: a qualitative study exploring children's experiences of living with a parent with Bipolar Disorder. Unpublished Clinical Psychology Thesis, The University of Manchester.
Bauer, M. S., Crits-Christoph, P., Ball, W. A., Dewees, E., McAllister, T., Alahi, P., et al. (1991). Independent assessment of manic and depressive symptoms by self rating. Archives of General Psychiatry, 48, 807812.
Bentall, R. and Jones, S. H. (2006). The Psychology of Bipolar Disorder: new developments and research strategies. New York: Oxford University Press.
Birmaher, B., Axelson, D., Monk, K., Kalas, C., Goldstein, B., Hickey, M. B., et al. (2009). Lifetime psychiatric disorders in school-aged offspring of parents with bipolar disorder: the Pittsburgh bipolar offspring study. Archives of General Psychiatry, 66, 287296.
Butzlaff, R. L. and Hooley, J. M. (1998). Expressed emotion and psychiatric relapse: a meta-analysis. Archives of General Psychiatry, 55, 547552.
Calam, R., Sanders, M. R., Miller, C., Sadhnani, V. and Carmont, S. A. (2008). Can technology and the media help reduce dysfunctional parenting and increase engagement with preventative parenting interventions? Child Maltreatment, 13, 347361.
Darzi, A. (2008). High Quality Care For All: next stage review final report. London: DoH.
Department of Health (2009). New Horizons: a shared vision for mental health. London: DoH.
Department of Health (2011). No Health Without Mental Health: a cross-government mental health outcomes strategy. London: DoH.
Duffy, A., Alda, M., Crawford, L., Milin, R. and Grof, P. (2007). The early manifestations of bipolar disorder: a longitudinal prospective study of the offspring of bipolar parents. Bipolar Disorders, 9, 828838.
Gellatly, G., Bower, P., Hennessey, S., Richards, D., Gilbody, S. and Lovell, K. (2007). What makes self-help interventions effective in the management of depressive symptoms? Meta-analysis and meta-regression. Psychological Medicine, 37, 12171228.
Goodman, R. (2001). Psychometric properties of the Strengths and Difficulties Questionnaire. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 13371345.
Goodman, R., Ford, T., Simmons, H., Gatward, R. and Meltzer, H. (2000). Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. British Journal of Psychiatry, 177, 534539.
Goodwin, F. K. and Jamison, K. R. (2007). Manic-Depressive Illness. New York: Oxford University Press.
Hillegers, M. H., Reichart, C. G., Wals, M., Verhulst, F. C., Ormel, J. and Nolen, W. A. (2005). Five-year prospective outcome of psychopathology in the adolescent offspring of bipolar parents. Bipolar Disorders, 7, 344350.
Hirschfeld, R. M., Calabrese, J. R., Weissman, M. M., Reed, M., Davies, M. A., Frye, M. A., et al. (2003). Screening for bipolar disorder in the community. Journal of Clinical Psychiatry, 64, 5359.
Hirschfeld, R. M., Williams, J. B., Spitzer, R. L., Calabrese, J. R., Flynn, L., Keck, P. E. Jr., et al. (2000). Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire. American Journal of Psychiatry, 157, 18731875.
Inoff-Germain, G., Nottelmann, E. D. and Radke-Yarrow, M. (1992). Evaluative communications between affectively ill and well mothers and their children. Journal of Abnormal Child Psychology, 20, 189212.
Jones, S. and Bentall, R. P. (2008). A review of potential cognitive and environmental risk markers in children of bipolar parents. Clinical Psychology Review, 28, 10831095.
Jones, S., Tai, S., Evershed, K., Knowles, R. and Bentall, R. (2006). Early detection of bipolar disorder: a pilot familial high-risk study of parents with bipolar disorder and their adolescent children. Bipolar Disorders, 8, 362372.
Kazdin, A. E. and Blase, S. L. (2011). Rebooting psychotherapy research and practice to reduce the burden of mental illness. Perspectives on Psychological Science, 6, 2137.
Lobban, F., Taylor, K., Murray, C. and Jones, S. (2012). Bipolar disorder is a two-edged sword: a qualitative study to understand the positive edge. Journal of Affective Disorders, 141, 204212.
Markie-Dadds, C., Sanders, M. and Turner, K. M. T. (1999). Every Parent's Self Help Workbook. Brisbane, Australia: Families International Publishing.
Metzler, C. W., Sanders, M. R., Rusby, J. C. and Crowley, R. N. (2012). Using consumer preference information to increase the reach and impact of media-based parenting interventions in a public health approach to parenting support. Behavior Therapy, 43, 257270.
Miklowitz, D. J., Axelson, D. A., Birmaher, B., George, E. L., Taylor, D. O., Schneck, C. D., et al. (2008). Family-focused treatment for adolescents with bipolar disorder: results of a 2-year randomized trial. Archives of General Psychiatry, 65, 10531061.
Miklowitz, D. J., Otto, M., Frank, E., Reilly-Harrington, N., Wisniewski, S., Kogan, J., et al. (2007). Psychosocial treatments for bipolar depression: a 1-year randomized trial from the Systematic Treatment Enhancement programme. Archives of General Psychiatry, 64, 419427.
Murphy, R. (2011). A Qualitative Investigation of the Experience of Parenting with Bipolar Disorder. Unpublished Clinical Psychology Degree Thesis, University of Manchester.
Phelan, R., Lee, L., Howe, D. and Walter, G. (2006). Parenting and mental illness: a pilot group programme for parents. Australasian Psychiatry, 14, 399402.
Radloff, L. S. (1991). The use of the Centre for Epidemiologic Studies Depression Scale in adolescents and young adults. Journal of Youth and Adolescence, 20, 149166.
Sanders, M. (2008). Triple P-Positive Parenting Program as a public health approach to strengthening parenting. Journal of Family Psychology, 22, 506517.
Sanders, M., Bor, W. and Morawska, A. (2007). Maintenance of treatment gains: a comparison of enhanced, standard, and self-directed Triple P-Positive Parenting Program. Journal of Abnormal Child Psychology, 35, 983998.
Sanders, M., Calam, R., Durand, M., Liversidge, T. and Carmont, S. A. (2008). Does self-directed and web-based support for parents enhance the effects of viewing a reality television series based on the Triple P-Positive Parenting Programme? Journal of Child Psychology and Psychiatry, 49, 924932.
Sanders, M. and McFarland, M. (2000). Treatment of depressed mothers with disruptive children: a controlled evaluation of cognitive behavioral family intervention. Behavior Therapy, 31, 89112.
Stewart-Brown, S., Patterson, J., Mockford, C., Barlow, J., Klimes, I. and Pyper, C. (2004). Impact of a general practice based group parenting programme: quantitative and qualitative results from a controlled trial at 12 months. Archives of Disease in Childhood, 89, 519525.
Twiss, J., Jones, S. and Anderson, I. (2008). Validation of the Mood Disorder Questionnaire for screening for bipolar disorder in a UK sample. Journal of Affective Disorders, 110, 180184.
Vance, Y., Jones, S., Espie, J., Bentall, R. and Tai, S. (2007). Parental communication style and family relationships in children of bipolar parents. British Journal of Clinical Psychology, 47, 355359.
Vostanis, P., Anderson, L. and Window, S. (2006). Evaluation of a family support service: short-term outcome. Clinical Child Psychology and Psychiatry, 11, 513528.
Zimmerman, M., Galione, J. N., Ruggero, C. J., Chelminski, I., Young, D., Dalrymple, K., et al. (2010). Screening for bipolar disorder and finding borderline personality disorder. Journal of Clinical Psychiatry, 71, 12121217.
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Behavioural and Cognitive Psychotherapy
  • ISSN: 1352-4658
  • EISSN: 1469-1833
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