PARENTAL SUPPORT FOR ADOLESCENTS WITH BIPOLAR DISORDER SYMPTOMS USING COGNITIVE BEHAVIORAL THERAPHY

Adolescents in their development experience symptoms of bipolar disorder that hinder adolescent development. This study presents a critical analysis of previous research findings in the context of developing intervention strategies for adolescents with bipolar disorder symptoms. We evaluated the effectiveness of cognitive-behavioral therapy applied to a group of adolescents with active parental support. This study utilized qualitative-descriptive methods to elucidate the positive impact of the therapy in improving psychological well-being and management of bipolar symptoms. Although the findings indicated the success of the therapy, the limitations of previous research became a focal point for this follow-up study. The results showed that parents' presence and participation played an important role in designing and reinforcing the therapy intervention. Emotional and educative support from parents provides a solid foundation to accelerate the adolescent's healing process. These findings provide insight into the importance of integrating family support in designing effective cognitive-behavioral therapy strategies to manage bipolar disorder symptoms in adolescents.


Introduction
Every human being has a phase of development that will be passed as the human develops itself.
The development experienced by humans is in the form of physical and psychological development which takes place systematically, progressively and continuously.(Rahmat 2018) While physical development is the growth and changes that occur in a person's body.The most obvious changes are changes in body shape and size.(Puspita, Calista, and Suyadi 2018) One of the stages of development is the adolescent development phase, in this phase of adolescent development it is an important phase in shaping the mentality of an adolescent because of the transition in each adolescent including physical development, external transformation, internal changes in emotional, cognitive and social development.(Devita Yeni 2019) In this period adolescents have a unique and special period that is not owned in development at other stages.(Fahrizqi, Aguss, and Yuliandra 2021) In its development, adolescence is inseparable from the mental development it faces so that there is upheaval in adolescents such as disturbed mental health.Physical changes accompanied by psychological changes in adolescents make adolescents in their development experience mental health problems, especially for adolescents who are isolated from the role of parents, friends, schools and their environment and this happens quickly(Ida Ayu Gita Prameswari 2020) One of the mental health felt by adolescents is the symptoms of bipolar disorder experienced by adolescents in their development.
Riskerdas found that more than 19 million Indonesians aged 15 years experienced mental disorders with an age range of 15 years.(Riskesdas 2018) Bipolar disorder can be defined as a disorder of mood changes in a person, another definition of Bipolar Disorder is a disorder in the brain that causes abnormal changes in mood energy, and activity levels.(Clinic 2022)) In mental health disorders such as bipolar disorder, it causes emotional instability in adolescents (Astriliana and Kustanti 2023) and even the worst thing caused by this mood change is suicidal feelings in adolescents who are already with symptoms or who have gone through expert diagnosis.(Astawa and Trisnowati 2023) So that mental health, especially in the case of bipolar disorder, cannot be considered a common thing, it needs preventive handling and study as a form of support for adolescent development.
In handling mental health cases that continue to grow, many things can be done to overcome bipolar symptoms in adolescents.Such as the use of Cognitive Behavioral Theraphy (CBT) in dealing with psychological symptoms, CBT itself focuses on reconstructing cognitions that are considered Copyright@ Hak Cipta Dilindungi Undang-Undang I 29 problematic in a person by seeing more positive opportunities for a person in the future than the past.(Aini 2019) CBT emphasizes aspects of collaboration and active participation from clients (Turner, Turner, and Swearer 2010) meaning that someone in overcoming their problems needs cooperation and interaction that occurs between clients and experts and then does not rule out the possibility of also needing support from close people such as parents of adolescents.
Parents play an important role in the development experienced by adolescents because of the social support of family, friends and closest people as social support needed by adolescents.(Astriliana and Kustanti 2023)the family becomes the closest group as supportive of adolescent development in the search for identity and confusion experienced by adolescents at their stage of development.
In research conducted (Simbolon 2022) the results of his research show that the application of cognitive behavioral therapy in overcoming bipolar symptoms in adolescents shows a gradual development in 4 adolescents who experience symptoms of bipolar disorder with 2 cycles of meetings where each meeting continues to progress, this is supported by the intention of adolescents who want to try to change in overcoming the problems they face and also the use of methods used is proven effective.
However, this study still has shortcomings and needs a more in-depth study, especially the role of parents in the sustainability of handling bipolar symptoms that occur in adolescents in previous studies has not been raised how the role of the closest person in helping adolescent development is only still focused on the application of cognitive behavioral therapy.
Researchers are interested in exploring the influence of parents in the application of cognitive behavioral therapy in interventions against bipolar symptom disorders in adolescents.The role of parents in adolescent development is considered indispensable in shaping, processing, evaluating the development that occurs in each teenager, actually people who want to get out of problems such as bipolar disorder symptoms must be supported by social and environmental in order to be free from the problems they face.
Based on the above objectives, the researcher wants to deepen the important role of parents in the sustainability of the research that has been conducted.Through in-depth understanding and involvement from parents, it is hoped that this article can provide readers with insights and guidance on how to support adolescents' mental health, create strong family bonds, and help children reach their full potential on the journey to adulthood.

Methods
In this study using a descriptive qualitative research design using a case study approach that occurs in adolescents with bipolar symptoms and parents, data collection was obtained through interviews and observations of previous research, data sources were obtained from 4 adolescents (2 males and 2 females) ranging in age between 14-21 years and 4 parents in each parent representing adolescents.The focus of this study is the role of parents in supporting adolescents with bipolar disorder symptoms using cognitive behavioral therapy.

Result
The application of cognitive behavioral therapy as a form of assistance provided to adolescents has a significant impact on adolescents, at this stage adolescents have the awareness to change for the better, with the help and support provided.There are some interesting findings from the relationship between the role of parents that help the process of forming mental health in adolescents.In the study (Simbolon 2022), there were several conditions of special findings that occurred in the behavior of adolescents with bipolar symptoms studied, including: (1) Lack of interest and motivation (2) Changeable self-confidence (3) Impatience and tendency to be temperamental Then in this study emphasizes the interaction between counselors and adolescents, still adrift in cognitive behavioral therapy procedures.Every meeting conducted by adolescents has the opportunity to get to know themselves and the problems they face.However, there are some differences in the success of therapy between adolescents with parental support.Parents have an important role in the next stage after the application of cognitive behavioral therapy provided, namely: recognizing mental health in adolescents, open communication between adolescents and parents, school education participation, and professional search assistance.

Parents and Adolescent Mental Health
In some cases, the understanding of mental health education is not fully understood and recognized Parents should also know how important mental health education can be for adolescents as a form of parental support in adolescent development.Mental health can be applied in all types of social life, one of which is the family environment.The application of mental health in adolescents in the family is very important to achieve a harmonious atmosphere between family members.If family interpersonal sentences, for example, between husband and wife, parents, children, or between siblings are not harmonious, then the family will create a psychological climate that is not conducive and uncomfortable.
(Rohmah Intan Ningrum, Mizam Ari K 2023) From some of the bipolar symptoms found, teenage parents think that this is something that often happens in adolescence.So that there is no special education pattern given by parents to adolescents.
Providing positive and appropriate parenting to adolescents requires empathy, sensitivity, acceptance, and responsiveness to children.Parenting is an important component in children's psychological development and behavior.(Csomortáni, Z. 2013) On the one hand, it is not only parents who need an introduction to mental health but adolescents also need relevant psychoeducation in the treatment that can be done, especially in cognitive behavioral therapy which emphasizes adolescents who want to change from within themselves.
Parents serve as a key pillar in shaping an environment that supports children's emotional development, as well as being a key source of support when facing mental health challenges.By recognizing and understanding their child's mental health condition, parents can respond appropriately, providing the necessary emotional support.In addition, parental involvement in educating children about mental health can create better awareness, reduce stigma, and help children build emotional resilience to deal with life's stresses.Therefore, the role of parents is not just to physically support their children, but also to play a central role in creating a solid mental health foundation for their children.Permissive parenting is characterized by parents giving full freedom to children to act.(Ayun 2017) With these various parenting patterns, it not only has an impact on communication behavior, but also long-term impacts for each family member.(Koerner, A. S., Schrodt, P., & Fitzpatrick 2017) To maintain mental health, especially in conditions with bipolar disorder symptoms in adolescents, binding values are needed in family communication patterns, namely: Togetherness in forming a sense of family commitment in overcoming adolescent development problems, the importance of openness between fellow family members in this way can provide a solution to every problem can be done openly, decision making that is done together in building adolescent self-confidence, self-will that must be fulfilled in adolescents given by parents such as wanting to be considered an adult, then warm communication that is intertwined so that with warm communication will make adolescents feel that all problems are not charged and borne alone by them but there is a parental role that gives them a sense of comfort.(Yoanita 2022) ISSN:2548-4044 Psikoislamedia Jurnal Psikologi Volume 09 Nomor 01, 2024 Copyright@ Hak Cipta Dilindungi Undang-Undang I 33

Education and School Participation
Schools have an important role in fostering and developing social emotional and mental health in adolescents.Adolescents in their development are also inseparable from the educational process they carry out at school, schools become an environment that shapes physical and emotional development in adolescents because of the social interaction between fellow adolescents in it making adolescents have to mingle and be able to establish good social relationships, if adolescents cannot establish good relationships and emotions it will affect behavior in learning.(Puspita et al. 2018) In the formation of adolescent character, it is inseparable from conversational interactions, namely with parents, teachers, friends and also around the environment.Character is also obtained through the results of the learning process in a direct way or through observations made to others, for example in a school environment.(SustaniaRahmawati , Arbaiyah Yusuf 2023) The role of parents that can be carried out in supporting adolescent education in developing character and mental health in adolescents is to provide basic education services in the family, then provide proper education to adolescents such as schools, teaching religious education to instill a religious spirit in adolescents, teaching social education to foster sensitivity and connection between adolescents and their social and fostering good morals to form manners and manners.(Ruli 2020) Gunarso states that parenting is how parents interact, act, educate, guide their children through activities both individually and involving other people or also known as a series of activities as an effort to direct in shaping children's character and morals.(Fitria, E., & Syaehotin 2022) In building a good education and also schools as a healthy adolescent environment needed in their development, parents and schools need to synergize with each other in adolescent development by providing education and monitoring adolescent learning evaluations along with the obstacles faced by adolescents when in the family and at school.In a healthy school environment, it will certainly provide mental health to adolescents while being supported by educators who are alert to adolescent mental health problems, if parents and teachers.

Professional Assistance
In some cases that occur, many communities such as in Indonesia in handling mental health, especially in adolescents, still use traditional methods in handling adolescent mental health (Maya 2021) instead of seeking help from professionals such as counseling services, psychiatrists and psychologists in ISSN:2548-4044 Psikoislamedia Jurnal Psikologi Volume 09 Nomor 01, 2024 Copyright@ Hak Cipta Dilindungi Undang-Undang I 34 overcoming mental health problems of bipolar disorder symptoms in adolescents.Many parents consider this a trivial matter considering that the development of adolescents is still unstable and will recover by itself so that it seems that parents feel that parents can completely solve their children's problems on their own.
This illustrates that education on the importance of professional services has not been fully implemented in the educational and family environment, so it seems that education and the family environment in adolescent development are limited to formality and seem to be ignored.If this continues, it will lead to more severe mental health in adolescents with symptoms that hinder the development process.Therefore, proper handling is needed if parents and teachers at school have developmental problems in adolescents.
Parents and school environments that are positive in providing space for the development of adolescents free from mental health are characterized by the acceptance of professional experts such as psychologists, psychiatrists and counselors in assisting and evaluating ongoing education.(Nurfadilah, Rahmadani, and Ulum 2021) The provision of experts is very important in assisting adolescent development such as the problem of bipolar disorder symptoms in adolescent development.

Conclusion
The conclusion of the study on the role of parents in supporting adolescents' mental health by parents towards adolescent development.Parents who often consider adolescents with bipolar ISSN:2548-4044 Psikoislamedia Jurnal Psikologi Volume 09 Nomor 01, 2024 Copyright@ Hak Cipta Dilindungi Undang-Undang I 31 symptoms are a common process that occurs in adolescents.So that many parents ignore the function of the role of the family towards the support that parents should provide to adolescents.The family has functions, including Maintanance, namely the family provides care and nurturing to adolescents and then Socialization, namely education and inheritance of social values so that children are accepted by society.(UtomoMurdianto 2003)

ISSN
a form of communication relationship between father and mother as a communicator point and the child becomes a communicant.(Rahmawati2018) Communication that is maintained in the family provides adolescent emotional development is influenced by the interaction patterns and communication patterns provided by the family can encourage child development.The family is the fulcrum of character building and mental health in children because in fact from the stages of children, adolescents and adults, children grow up in their own family environment and get a lot of education and knowledge from their families, therefore the family is the most important place in the formation of children's mental health.(Rahmah 2018) Each family has its own communication pattern that is carried out by the father and mother in educating adolescents.By knowing the communication pattern of a family, a basic process can be identified to reach a mutual agreement in the family.The three types of parenting according to Baumrind are almost the same as the types of parenting according to Hurlock, as well as Hardy & Heyes, namely: (a) authoritarian parenting, (b) democratic parenting, (c) permissive parenting.Authoritarian parenting is characterized by parents making all decisions, children must submit, obey and not ask questions.Democratic parenting is characterized by parents encouraging children to talk about what they want.
highlights the importance of parents' positive involvement and role in shaping children's emotional wellbeing during adolescence.Parents are not only figures who provide physical support, but also key pillars in helping children overcome mental health challenges.Open and compassionate communication, education about mental health, and modeling healthy behaviors are key elements that emerged from this study.Parents who listen without punishment and provide emotional support create an environment where teens feel comfortable to talk about their feelings.Mental health education provides a foundation of knowledge and skills for children to cope with stress and pressure.Modeling healthy behaviors involves parents serving as positive examples of managing stress, maintaining life balance, and coping with conflict, forming life habits that support children's mental health.Healthy boundaries, consistency in upbringing, and participation in children's school life create a stable environment and provide children with clear boundaries.In addition, seeking professional help ISSN:2548-4044 Psikoislamedia Jurnal Psikologi Volume 09 Nomor 01, 2024