Strategies for Success

The Quarterback Model

You are not just a parent. You are the CEO of a small, chaotic non-profit organization called “Your Child’s Health.”

Your job is to:

  • Coordinate the care team (psychiatrist, therapist, school, pediatrician)
  • Track medications and side effects
  • Translate medical jargon for teachers and family
  • Advocate when systems fail

This is case management. And you are now a professional.

Building the Care Team

Your teen needs a team, not a single provider. Here’s who should be on it:

The Core Team

  1. Psychiatrist (Medication management)
  2. Therapist (Weekly DBT/CBT for mood regulation, coping skills)
  3. School Counselor or IEP Coordinator (Academic accommodations)
  4. Pediatrician (Physical health, blood work, growth monitoring)

The Extended Team (If Needed)

  1. Neuropsychologist (Testing for ADHD/Autism if not yet diagnosed)
  2. Occupational Therapist (Sensory integration for autistic teens)
  3. Social Worker (Connecting to community resources, insurance navigation)
  4. Crisis Team Contact (Mobile crisis unit, hospital liaison)

The Coordinator: YOU

The Problem: These providers don’t talk to each other. The psychiatrist doesn’t know what the therapist is seeing. The school doesn’t know about the new medication.

The Solution: You become the information hub.

Protocol: The Care Team Meeting Agenda

Frequency: Quarterly (every 3 months), or after major changes (new med, hospitalization, IEP update)

Attendees: Psychiatrist, therapist, school counselor, you, your teen (if appropriate)

Format: 30-minute meeting (can be virtual)

Pre-Meeting Prep (What to Bring)

Meeting Agenda Template

1. Check-In (5 min) - “How is [Teen] doing overall?” - Each provider gives 1-minute summary

2. Data Review (10 min) - Share mood chart - Discuss patterns (e.g., “Mood dips every Monday morning—school-related?”) - Review medication compliance and side effects

3. Problem-Solving (10 min) - Identify biggest current challenge (sleep? school? rage episodes?) - Brainstorm adjustments (med change? therapy focus shift? school accommodation?)

4. Action Items (5 min) - WHO will do WHAT by WHEN? - Example: “Dr. Smith will increase Lamictal to 100mg by next week” - Example: “School will implement ‘break card’ by Monday” - Example: “Therapist will work on sleep hygiene for next 4 sessions”

Sample Questions to Ask

  • To Psychiatrist: “Should we add/adjust meds based on recent mood data?”
  • To Therapist: “What coping skills is [Teen] actually using at home?”
  • To School: “Can we add [specific accommodation] to the IEP?”
  • To Everyone: “Are we all on the same page about the crisis plan?”

Technology Tools: Outsourcing Your Brain

You cannot remember everything. Use apps and systems.

Mood Tracking

  • App: Daylio, eMoods, or simple Google Sheet
  • What to Track: Sleep hours, mood (1-10 scale), incidents (rage, crying, self-harm)
  • Frequency: Daily (set phone reminder for 8 PM)
  • Why: Patterns emerge over weeks. You’ll spot triggers psychiatrist would miss.

Medication Management

  • App: Medisafe, Round Health
  • Features: Reminders, refill alerts, side effect logs
  • Why: Teens forget. Parents forget. Apps don’t.

School Communication

  • System: Shared Google Doc with school counselor
  • Update: Weekly (Fridays) - Brief summary of teen’s week at home
  • Why: School sees half the picture. You see the other half. Share it.

Crisis Contacts (Phone + Paper)

Create a Crisis Card (size of credit card, laminated, in wallet):

Crisis Card Template

Give copies to: School nurse, grandparents, babysitters, teen (to carry)

School Accommodations: The IEP Cheat Sheet

Your teen’s IEP should address all three conditions (Bipolar, ADHD, Autism). Most schools only address one. Push back.

Executive Function Support (ADHD)

Sensory/Social Support (Autism)

For full IEP sample language, see Appendix C.

Communication Protocols

Parent → Psychiatrist

When to Contact: - Urgent (call/page): Suicidal ideation, violence, psychosis - Soon (call within 24h): New side effect, 3+ days no sleep - Routine (email/portal): Questions about dosing, refills

What to Include: - Brief summary: “Leo hasn’t slept in 3 days, very irritable, talking fast” - Current dose: “On 900mg Lithium, 100mg Lamictal” - Request: “Should we increase mood stabilizer or bring him in?”

Parent → School

Weekly Update Template (Email):

Subject: [Teen Name] Weekly Update - [Date]

Hi [Counselor Name],

Quick update on [Teen]:

  • Mood: Stable this week / Had depressive dip Tue-Thu / Hypomanic energy Mon-Wed
  • Sleep: Getting 7hrs average / Only 4hrs last 3 nights
  • Medications: No changes / Started new dose [X] on [date]
  • Concerns: None / Watch for [specific behavior]

Let me know if you see anything concerning on your end. Thanks!

Parent → Extended Family (Boundaries)

Script:

“We appreciate your concern about [Teen]. We’re working with a team of doctors and following their treatment plan. If you’d like to help, here’s what would be most useful: [specific ask, e.g., ‘Take sibling for afternoon once a week,’ ‘Don’t comment on Teen’s appearance/behavior’]. If that doesn’t work for you, we understand, but we won’t be discussing the treatment plan further.”

Self-Advocacy: Teaching Your Teen

Eventually, your teen needs to manage their own care. Start now (age-appropriately).

Ages 13-14: Awareness

  • Teach: Names of medications, why they take them
  • Practice: “Can you tell Dr. Smith how you’ve been sleeping?”
  • Goal: Teen can describe symptoms to doctor (with you there)

Ages 15-16: Participation

  • Teach: Side effects to watch for, when to ask for help
  • Practice: Teen calls/texts you when feeling “off”
  • Goal: Teen actively participates in doctor visits (not just you talking)

Ages 17-18: Transition Prep

  • Teach: How to refill prescriptions, schedule appointments, use insurance
  • Practice: Teen makes one appointment on their own (you supervise)
  • Goal: Teen can manage care with minimal parent involvement (ready for college/adulthood)

The Takeaway

Success in managing the “Double Diagnosis” requires: 1. A coordinated care team (quarterly meetings, shared information) 2. Technology tools (mood tracking, med reminders, crisis cards) 3. School advocacy (IEPs that address ALL conditions) 4. Clear communication (protocols for when/how to contact providers) 5. Self-advocacy training (age-appropriate independence building)

You are the Quarterback. The plays are complex. The team doesn’t always coordinate. But YOU keep the game moving forward.

And that makes all the difference.