Alaskan Families' Voice on Children's Behavioral Health - http://www.ayfn.org/

IN THIS ISSUE:

April Wellness Recovery Action Plan (WRAP) Class Announcement

Youth Invited To Present The Recovery Management Curriculum

Brain Injury Public Testimony

Wraparound Invite: You Are Invited!

Public Hearing-Sexual Assault & Child Abuse and Neglect

Audio Conference that Addresses Issues Affecting Work with Offenders with Cognitive Impairments

Impact of ‘Culture on Person/Family Centered Planning' Author Townsend at NYAPRS June Seminar

SFN Listserv: Resources for Military Families

Science and Service News Updates

Interesting New Web Sites

April Wellness Recovery Action Plan (WRAP) Class Announcement

The April class will begin on the 16^th and end on the 27^th:

• NAMI Alaska building, downstairs group room
• 144 West 15^th Avenue
• 5:30 - 7:30 PM, Monday through Friday (for two weeks)

REGISTRATION BY PHONE:  Aleen:  350-5509 or Sylvia:  333-4559

REGISTRATION BY FAX:  Use attached form here and fax to:  907-272-6213           

2007 WRAP CLASS POLICIES: 1)  PREREGISTRATION - Preregistration and a $10 book fee are required to enroll in a RECA WRAP class (book fee can be waived by Aleen if necessary).  Registration forms are attached to this e-mail.  Deadline for February 2007 class:  Thursday, April 12 at the RECA office; 2) MINIMUM NUMBER OF STUDENTS/CLASS CANCELLATIONS - We must have at least 13 preregistered students by above deadline, or the class will be cancelled.  If a cancellation is necessary, all preregistered students will be called on Friday.  Book fees will be returned, or can be held for the next class.  Book fees are NON REFUNDABLE if a student fails to attend the class for which he/she is registered, unless the student has cancelled by the deadline, or the class was cancelled by RECA.  SNACKS - RECA will provide healthy snacks only for the first day of class.  Students are encouraged to brown bag their evening meal or bring snacks to share with their classmates.  RECA will continue to provide bottled water for all class meetings.  For more info contact Recovery Education Centers of Alaska, Aleen M. Smith,  Executive Director, 1145 I Street, Anchorage, AK 99501-4320, Phone: 907-350-5509 Fax: 907-272-6213 or email aleenmarie1947@yahoo.com.

Youth Invited To Present The Recovery Management Curriculum

The youth who have completed the recovery management curriculum have been invited to the "research and Services in Support of Children and their families: in Portland Oregon May 30-June 3.  They will present the curriculum and their impressions of why it has helped them take care o themselves and truly take charge of their own recovery.  We can't take all 25 to Portland but we would like to take at least two.  The Youth Coordinator will go with them.    Can anyone donate some Alaska Airline miles to help us defray the cost?  If you can, would you call (907)770-4979, (888)770-4979 or email Fran ayfn@ayfn.org. Thank you.

Brain Injury Public Testimony

Have you, a family member, a friend, or a client experienced a brain injury?  Have you had a fall or an accident?  Possible signs and symptoms of an injury to the brain:  Headaches, Fatigue, Depression, Anxiety, Excessive sleepiness, Inattention, Difficulty concentrating, Emotional outbursts, Disturbed sleep, and Slowed thinking.

WE NEED TO HEAR FROM YOU - The Alaska Brain Injury Network invites you to share your story.  What services were available to you?  What services would have been helpful?  Together we can educate the Legislature, State Administration, the Public, and our Community.

• Wednesday, April 25, 2007 3:30pm-5:00pm

CALL 1 (800) 791-2345 Pass code 32295#

• Place:  Kodiak Fisheries Research Center

For more info, please visit their Web site at http://www.alaskabraininjury.net/.

Wraparound Invite: You Are Invited!

Come meet Karl and Kathy Dennis, nationally renowned experts in community-based care programs.

Karl will discuss: 

• What are wraparound services?
• How did the idea of wraparound services begin?
• What is the importance of utilizing wraparound services for our clients?
• How to most effectively meet your wraparound service goals.

 "Everything Is Normal Until Proven Otherwise," written about families the Dennis' have worked with over the years, along with commentary by the highly respected Dr. Lourie, will be on sale. This book is written for parents and professionals, providing wraparound guidance and the effectiveness of the process.

• Date: Wednesday, April 18
• Time: 10 am - 12 noon

Location:  North Star Behavioral Health 2530 Debarr Road, Anchorage, Alaska. Anchorage.  Parking: North Star does not have parking available. To park, enter the Alaska Regional Hospital parking lot (directly across the street from North Star).  Park at the west end of the parking lot. There will be a shuttle to North Star running from 9 a.m. to 1p.m.  For more information, please contact Kathleen Hargraves at (907) 465-8272. Pre-registration is not necessary.  THIS EVENT IS FREE.

Public Hearing-Sexual Assault & Child Abuse and Neglect

Anchorage Women's Commission announcing a public forum inviting public comment on two important public safety issues Sexual Assault and Child Abuse and Neglect  being hosted

• Tuesday April 17, 2007
• 11:30 AM - 1:00 PM

At the Department of Health and Human Services Building (4^th floor conference room) located at 825 L. street.  For more information you may contact Renee Aquilar at 343-6302.

The Anchorage Women's Commission invites public comment on two public safety issues in our community Sexual Assault and Child Abuse and Neglect. April is Sexual Assault Awareness Month and Child Abuse Prevention Month The Anchorage Women's Commission is inviting public comment on these issues of importance to women, children, and families. The Commission will review public testimony and offer recommendations for new strategies to address these public safety concerns. You may RSVP by telephone or e-mail any written comments to Renee Aguilar at 343-6302 or aguilarrp@muni.org

The Anchorage Women's Commission exists to advise the Mayor and Assembly on matters pertaining to the status of women. The Commission shall be particularly concerned with improving opportunities for women in the community. The Commission shall:

• Act as a clearinghouse and coordinating body for information relating to the status of women.
• Disseminate results of research and other information on women's issues.
• Analyze and set priorities for women's needs at the local level.
• Recommend legislative and administrative action on women's issues.
• Encourage women to utilize their capabilities and to assume leadership roles.

Audio Conference that Addresses Issues Affecting Work with Offenders with Cognitive Impairments

The Center for Human Development/UAA in partnership with the Alaska Mental Health Trust Authority cordially invites you to join a monthly audio conference to address issues affecting your work with offenders with cognitive impairments!

The April audio conference will be provided by panel headed up by Colleen Patrick-Riley with the Department of Corrections, State of Alaska. The panel will include Dee Dee Raymond with DOC, Matt Jones with Assets, Diana Ray and Max Gruner both with Hope Community Resources. They will be presenting "Department of Corrections and Community Service Providers Current Practices for Offenders with Cognitive Impairments, Gaps in Services and Future Needs. For more details, please open the attached flyer or click link here.  You will need the free Adobe Acrobat Reader to view or print these files. It is available for Macintosh or Windows here: http://www.adobe.com/products/acrobat/readstep2.html.

• When: Tuesday, April 17, 2007
• Time: 10am - 11:30am

Who should participate: Anyone interested in having a better understanding of offenders who experience traumatic brain injuries.

Registration Required: To ensure we have enough toll-free call in lines and to provide you the presentation materials in advance, will are requesting you pre-register. We also encourage you to email any specific presenter questions you may have regarding the topic. Please pre-register and send your questions to Julie Holden at anjeh1@uaa.alaska.edu no later than Thursday, April 13th. Your advance participation is greatly appreciated!

Save the following dates from 10am-11:30am for additional audio conferences!

• Tuesday, May 15, 2007

• Tuesday, June 19, 2007

Impact of ‘Culture on Person/Family Centered Planning' Author Townsend at NYAPRS June Seminar

NYAPRS Note:  Two extra items of note on this important piece by one of the nation's leaders in helping to extend the promise of recovery to all Americans with psychiatric disabilities, Wilma Townsend. One of the piece's key recommendations, the establishment of Centers of Excellence in cultural and linguistic competence, was adopted by the NYS Legislature and Governor Spitzer last week. Second, Wilma will be a featured speaker in NYAPRS' Executive Seminar on Transformation, to be held June 21-2 at the Crowne Plaza in Albany.  See http://www.nyaprs.org/PDF/NYAPRS_ST_brochure_final.pdf  for more details; register by June 1 to get best hotel and seminar rates!

Introduction

To understand the impact of culture on person/family centered planning one must first understand three major terms, namely person/family centered planning, culture, and recovery.  In person/family centered planning the consumer and provider together develops a plan outlining goals and interventions to assist the consumer's recovery.  For this plan to be person or family centered the individual who is receiving services and/or his or her family must be active participants, direct the process, and be the final decision maker(s).  The goal of person/family centered planning is to achieve outcomes identified and managed by the consumer and/or his or her family and facilitated by the provider. Research has shown that the best predictor of positive mental health outcomes is the consumer's perception that his or her needs are met. (Roth, 1999).

We define culture as a common heritage or set of beliefs, norms, and values.  It refers to the shared, and largely learned, attributes of a group of people (DHHS, 2001).  "Cultural Identity" refers to the culture with which someone identifies and to which he or she looks for standards of behavior (Cooper & Denner, 1998).  In short, culture is the way in which persons see and identify themselves. 

Recovery refers to the process through which people living with a disease or a disability are able to live, work, learn, and participate fully in their community.  For some individuals, recovery is the ability to live a fulfilling and productive life despite a disability.  For others, recovery implies the reduction or complete remission of symptoms of a disease or disability.  Science has shown that having hope plays an integral role in an individual's recovery.  (President's New Freedom Commission on Mental Health, 2003)   Recovery is about giving the overarching message that with hope, the restoration of a meaningful life is possible... Instead of focusing primarily on the relief from symptoms as the medical model dictates, recovery casts a much wider spotlight on restoration of self-esteem and identity and on attaining meaningful roles in society. (Deegan, 1997, 1988)

Person/family centered planning entails individuals and/or families actively participating in the treatment process.  Providers must recognize and be able to work with them within the norms and values of their individual and collective cultures. Culture influences outcomes (Humphrey, 2003) which then impact the process of recovery for that consumer and/or his or her family.  The individual's culture will impact the treatment goals, interventions, and processes used to achieve these goals.  Providers and administrators should understand that culture and recovery are interwoven.  Just as culture directs how individuals perceive and attend to illness and wellness, culture also influences perceptions of recovery.  Culture permeates all aspects of an individual's life and providers must acknowledge this through the assessment, treatment, and service delivery processes. Administrators must ensure that person/family centered planning, concepts of recovery, and cultural competence are integrated throughout the treatment system.

Failure to incorporate person/family centered planning, the concepts of recovery, and cultural competence as the lynchpins of all mental health services will perpetuate a cycle consisting of the provision of costly services over long periods of time.  Such results are perceived as negative outcomes by consumers and funders alike. 

Barriers - Perceived and Otherwise

By the year 2025, nonwhite racial and ethnic populations will comprise 40% of the population of the United States (Bureau of the Census, 2001).  In spite of this, health disparities impacting people of color today are alarming and are apparent not only in publicly-funded services, but in the private sector as well. (Daniels & Adams, 2003)

Although the majority of providers are well intentioned and attempt to provide care in an ethical manner, they are limited.  In other words, they don't know what they don't know.  Systems (and the clinicians who work within them) traditionally operate from a paternalistic point of view, taking responsibility for people and their lives (Deegan, 1993) and teaching consumers to depend on these systems and their clinicians in a negative cycle that acts to impede rather than foster recovery.  

The cycle is confounded by the need to provide services that are culturally appropriate.  Although the provision of culturally competent/appropriate services and the recognition of cultural differences that would warrant such services is not evidence-based practice, it is believed that for any practice to be deemed evidence-based, it should be culturally appropriate/competent and should respond to the unique needs of the consumer and/or family receiving the services. (Stanhope, Solomon, Pernell-Arnold, Sands & Bourjolly, 2005)

For providers whose consumers are homogeneous and made up of the dominant culture, (i.e. people of European ancestry), there may be less of an issue of cultural appropriateness as the majority of the service delivery systems today were created to serve the dominant culture.  If directors of programs were surveyed regarding their service delivery to groups of consumers of color/different races/different cultures as to whether or not their programs respond to the needs of those consumers, most of the time, they will answer in the affirmative.  (Humphrey, 2003, 2004) 

Cultural competency is an add-on that program administrators find difficult to define, hard to implement, and often impossible to obtain reimbursement for except in cases of programs that have been created to meet the needs of specific groups of consumers.   Sadly, these are few and far between.  The following are points that may assist in the identification of some of the barriers and suggestions for addressing them.  This list is by no means exhaustive and the study of these factors should be on-going.  

Issues and Road Blocks to Consider

Training -

• Clinicians/providers of services lack a systematic definition of cultural competence and why it is important to understand consumers in this context.
• Clinicians/service providers lack a systematic definition of recovery, the difference between a treatment plan and a recovery plan and how to be a recovery facilitator rather than a case manager.
• Clinicians/service providers need information about where to get the right type of training for the consumers they serve.
• If clinicians/service providers do get training they rarely have "coaching" post-training to make certain this is integrated into the way they serve their consumers.

Health Disparities -

• Most disparities are based on the long history of racism and oppression in the United States.
• They may also be based on a perceived lack of resources, education, and ability to make good, healthy and safe decisions by the provider community.
• Additionally, there may be a very real (and valid) lack of trust for the system (i.e. Tuskegee Syphilis Experiment) by the consumer. (SGR, DHHS, 1999; Cooper-Patrick et al., 1999)

History of treatment of consumers of MH and Addictions Treatment -

• There are consequences for the consumer/person in recovery trying to control his or her destiny.
• Consumers have been disenfranchised for a long period of time. This disenfranchisement, standard practice in many settings, is viewed as the way to do business by both provider and consumer alike.
• Providers and administrators have not traditionally viewed recovery as possible.
• Consumers of Mental Health and Addictions Treatment have treatment done to them or for them, but seldom with them. They are rarely viewed as the experts in their own treatment.
• One size is supposed to fit all. If it does not, the consumer is labeled as resistant, in denial, a "frequent flyer" or "high utilizer" and is shunned both within and outside the service system.
• Consumers are often misdiagnosed as a result of spiritual beliefs and questions beyond the traditional "are you hearing voices?" are seldom asked.
• Race and ethnicity are relegated to a question or two and are seldom viewed as important aspects to consider when deciding upon a course of treatment for the consumer.
• Support networks, especially family, spiritual and social systems in consumer communities of color, often positive forces in the consumer's life, are frequently minimized or ignored altogether.
• The treatment delivery system does not empower the consumer to make decisions and choices about treatment for him/herself.
• Treatment delivery systems need information and they need to acknowledge that racism and oppression impacts communities of color and as such, the consumers of MH and Addictions Treatment. Treatment systems need to take a hard look at how they may be contributing to that oppression and how they might be viewed by the consumer as an extension of a system that has failed them.
• Stigma, how mental health and addiction may be viewed in the consumer's culture, and the language that is used both in and out of treatment play significant roles in keeping consumers and potential consumers of services feeling powerless, hopeless and/or from accessing services altogether. (SGR, DHHS, 1999; Sussman et al, 1987)

Program Assessment and Administration -

• Culture and the provision of culturally appropriate assessments, treatment and services are usually afterthoughts that may consist of a few signs in Spanish, some magazines in the waiting room and/or some pictures on the wall.
• Program services seldom have strategic plans for the delivery of services that are culturally relevant to the population they serve.

Financial Systems -

• Providers may believe that there is no way for culturally appropriate services to be paid for and that funding sources do not have standards by which to evaluate alternative or culturally-appropriate interventions.
• Providers do not speak the language of the payers and cannot describe their interventions in a way that will generate payment.
• There may be no one at the funding level holding service delivery systems accountable.
• Providers are not trained to negotiate payment for services that may be outside the norm of so-called traditional types of service.

Hope for the Future - Breaking Down the Barriers

Supporting Consumers/People in Recovery -

• Consumers should see evidence at the outset that they are welcome by a treatment provider and that evidence should be more than just magazines and signs. As much as possible, the staff make-up should be representative of the consumer population.
• Consumers should be able to clearly identify the provider organization as recovery focused. They should be able to identify that the services understand their concept of illness and recovery and it is manifested at the outset of treatment through discussions with the consumer about recovery and wellness and not just about the illness.
• Consumers should have an active role in setting the agenda for treatment, should sit on advisory and executive boards and committees and should know that their voices will be heard.
• Consumers of services should expect that they will be treated in a holistic manner, that their cultures will be honored and respected, that the information they share will be incorporated into a recovery plan that they themselves author, and that they will be able to be open about themselves as cultural/spiritual beings. This connection should be recognized and used as a strength in the consumer's recovery process.
• Consumers should be taught to expect that they will be able to receive services that will respond to their cultural/spiritual needs and in the manner in which they understand illness and recovery. If this is not in programs created specifically around their understanding, then it should be through interventions designed for them within the context of the larger program structure.

Training -

• Clinicians should understand and incorporate into practice the U.S. Department of Health and Human Services Office of Minority Health's National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health Care.
• Clinicians should understand the need to respect and be open to the ways of other races or cultures even if they differ significantly from their own. (A level of comfort with one's own worldview helps to promote the acceptance of another's.)
• Clinicians should understand that performance evaluations are tied to delivery of culturally appropriate services just as for other indicators and the indicators should be equally weighted.
• Clinicians must receive training on how to conduct person centered planning such as "Facilitating Consumer Recovery through Best Practices: Clinical and Consumer Training on the Emerging Best Practices Model by Developing a Recovery Management Plan." This training integrates person center planning, recovery, and cultural competence.
• Clinicians must overcome the need to do for and to consumers who come for services and should acknowledge the consumer as the expert in his or her own recovery process. Especially when it comes to culture and the provision of services that are appropriate and competent, the clinician should be the learner in the process.

Program Administration -

• Administrators/Directors of programs should insure that CLAS Standards are part of every staff member's orientation and that the guidelines are incorporated into their employee's performance evaluations in a meaningful manner.
• Administrators, directors and managers should be familiar with CLAS Standards and Guidelines and should be well trained in them so that they might in turn adequately train their staff and provide on-going coaching until the provision of culturally appropriate services becomes integrated into staff practice.
• Administrators, directors and managers should create performance evaluations that reflect the program's commitment to the provision of services that are culturally appropriate and should hold staff accountable to these standards.
• Administrators, directors and managers should ensure that assessment tools, programs and treatment modalities that are used by their organizations include culturalogical questions, components and treatment best practices related to issues of race and culture. Assessments tools should include questions related to spirituality. Rich clinical information is often lost because such questions go unasked. Once the assessments tools, components and modalities are developed, clinicians should be trained on how to ask the questions and how to implement the modalities. Adequate coaching should be part of this training.
• Administrators, directors and managers should design interventions based on the population who come to them seeking assistance. If knowledge of what types of interventions might be desirable to the consumers is needed, ask the consumers!

Policy Makers/Funders -

• Creating Centers of Excellence for programs that excel in the area of the provision of culturally appropriate services to consumers is a value-added strategy to encourage programs to respond to this need. Programs who earn this designation are held up as models to others and provide powerful examples of how to provide culturally- appropriate services.
• In conjunction with the consumers themselves, create outcome measures for culturally appropriate services then tie funding to outcomes - no outcomes, no funding.
• Train monitors of programs at the funding level with the same type of training in the provision of culturally-appropriate services that the providers receive. In this way, when they evaluate programs they are able to do so in an informed manner. Make the demonstration that programs are providing culturally appropriate services just as important as any other indicator.
• Make the creation of a strategic plan for provision of culturally-appropriate services a mandate for both initial and continued funding. Use that plan when monitoring for compliance.

Conclusion

The field of behavioral health has grown and developed over the years and these changes have impacted the manner in which services are provided.  In some ways, the growth has been slow (i.e. closing of some state hospitals, restraint and seclusion policies, etc.) but there have also been much-needed advancements.   Work being done in states such as Ohio, Connecticut, Michigan and others regarding the creation of systems of care that are recovery-oriented creates hope for consumers, programs and policy-makers alike.  As these advancements continue, the quality of life/recovery may be improved for consumers, outcomes will be improved for programs, and consumers will spend less time in treatment saving scarce resources. 

While all of this work has been encouraging, further steps need to be taken.  As stated previously, one size does not and should not fit all.  While some ethnocentrists might prefer to think of the U.S. in terms of what is referred to as a melting pot, there are those who choose not to be part of that and who find comfort in cultural ways that may be quite outside of the pot.  Treatment systems created around the melting pot premise negate consumer/family individuality and that which makes them special and unique.  Consumers come to treatment with narratives and wonderfully rich stories of family and home and often those stories detail for providers who the person is as a cultural/spiritual being.  Sometimes, the stories speak of rich heritages and traditions that allow the consumer to feel connected to something larger than him/her.  Sometimes, the stories are painful and narrate internalized racism and long histories of oppression.  If providers do not recognize these stories as tools to use when assisting the consumer on his or her recovery road, they are missing a great deal.   Person Centered Planning gives us that opportunity, the skill and the knowledge necessary to gather and utilize this richness to assist people in their recovery. 

If we want people to tell us stories about their lives, why don't we just ask them? (Davidson, 2003, pg. 64)

SFN Listserv: Resources for Military Families

This week's listserv presents three resources related to helping military families deal with the particular challenges they face

The first resource is "Operation Healthy Reunions," a website and program of Mental Health America (as are the resources below). The website's homepage reads: "Mental Health America is proud to champion Operation Healthy Reunions, a first-of-its-kind program that provides education and helps to bust the stigma of mental health issues among soldiers, their families, and medical staff to ensure that a greater number of military families receive the prompt and high-quality care they deserve. In partnership with the leading military organizations, Mental Health America distributes educational materials on such topics as reuniting with your spouse and children, adjusting after war, depression, and post-traumatic stress disorder (PTSD)." The website address is: http://www.mentalhealthamerica.net/reunions/.

The second resource is an article called "Bereavement and Grief: Information for Military Families and Communities." This article is intended to assist families and children in dealing with the grief associated with losing a family member in the military. According to the introduction, "The death of a loved one is always difficult. When the death results from a war or a disaster, it can be even more troubling given the sudden and potentially violent nature of the event. After the death of someone you love, you experience bereavement, which literally means, 'to be deprived by death.' You may experience a wide range of emotions, including:  Denial, Disbelief, Confusion, Shock, Sadness, Yearning, Anger, Humiliation, Despair, Guilt.  These feelings are common reactions to loss. Many people also report physical symptoms of acute grief - stomach pain, loss of appetite, intestinal upsets, sleep disturbances or loss of energy. Of all life's stresses, mourning can seriously test your natural defense systems. Existing illnesses can worsen or new conditions may develop. Profound emotional reactions can include anxiety attacks, chronic fatigue, depression and thoughts of suicide." The article can be accessed at the following link:  http://www.mentalhealthamerica.net/go/information/get-info/grief-and-bereavement.

The final resource is specifically intended for children: "Helping Children Cope With Loss." The article begins, "Helping a child cope with loss is perhaps one of the most important roles an adult can play. In effect, you are helping that child develop skills that can last a lifetime. The death of a loved one is always difficult. For children, the death of a loved one can affect their sense of security. Like adults, children express loss by grieving. Yet children may not demonstrate the grief in the same manner as adults. Pre-schoolers usually see death as temporary; between the ages of 5 and 9, children begin to experience grief more like adults. NMHA provides the following information for parents, educators and others who may help a child overcome loss." This article can be accessed at the following website: http://www.mentalhealthamerica.net/go/information/get-info/grief-and-bereavement/helping-children-cope-with-loss/helping-children-cope-with-loss.

If you would like to request or send information about these or any other topics of interest to members of the listserv, or if you would like to circulate information about your Network, please email shelspear@verizon.net.

Science and Service News Updates

NIMH: Intensive Psychotherapy More Effective Than Brief Therapy for Treating Bipolar Depression - Patients taking medications to treat bipolar disorder are more likely to get well faster and stay well if they receive intensive psychotherapy, according to results from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), funded by the National Institutes of Health's (NIH) National Institute of Mental Health (NIMH). The results are published in the April 2007 issue of the Archives of General Psychiatry.

• Press Release: http://www.nimh.nih.gov/press/stepbd-psychotherapy.cfm
• Questions and Answers about the STEP-BD Depression Psychosocial Treatment Trial: http://www.nimh.nih.gov/healthinformation/step-bd-psychotherapy-qa.cfm
• Additional information about the STEP-BD trial: http://www.nimh.nih.gov/healthinformation/stepbd.cfm

NIMH: Study Sheds Light on Medication Treatment Options for Bipolar Disorder - For depressed people with bipolar disorder who are taking a mood stabilizer, adding an antidepressant medication is no more effective than a placebo (sugar pill), according to results published online on March 28, 2007 in the New England Journal of Medicine. The results are part of the large-scale, multi-site Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), a $26.8 million clinical trial funded by the NIMH.

• Press release: http://www.nimh.nih.gov/press/stepbd-medication.cfm
• Questions and Answers About the STEP-BD Acute Depression Medication Trial: http://www.nimh.nih.gov/healthinformation/step-bd_medication_qa.cfm
• Additional information about the STEP-BD trial: http://www.nimh.nih.gov/healthinformation/stepbd.cfm

Recent news release about medication for preschoolers with ADHD http://www.nimh.nih.gov/press/preschooladhd.cfm.

Interesting New Web Sites

http://www.coping.org/ : Home of the Tools for Coping Series - onsite manuals for coping with a variety of life's stressors, authored by: James J. Messina, Ph.D., & Constance M. Messina, Ph.D.