Well, it's a start...

First, let me say this...treatment for bipolar disorder should include both a therapist and a psychiatrist. The psychiatrist to make a medical diagnosis if appropriate and to manage medications, the therapist to deal with psychological issues. Second, a licensed social worker can be an excellent therapist. Sure, we would rather them see Psy.D.'s. I can tell you that in my state, I have seen ads for therapists that would accept either Psy. D's or LSW's. While I don't think they are quite equivalent degrees, it's obvious that they are considered able to do the same work, at least in some places. Also I have personally been treated in three different "free" settings, and I have to say that the care is at least as good if not better than what I received when I had insurance. I think that these clinics probably have more experience when it comes to extremely troubled patients. By the time you get that bad, you've probably trashed your life and your other healthcare options, so I wouldn't worry too much about the quality of care at a free facility.

I guess I would rather that your stepdaughter be seen sooner by the MD (it is a psychiatrist, yes?), but perhaps the interim sessions will establish a trust between the her and the therapist, and hopefully your stepdaughter will be more willing to hear what the doctors say and take it to heart. I bet if she went to see a doctor tomorrow, she would balk at any sort of treatment; after a month of therapy, who knows?

Will ADHD drugs help her if she is bipolar? I'm out on a limb here, but from what I know of ADHD treatment, I do not think it would be helpful to a bipolar patient. Giving "upper" type drugs to someone who is manic is a bad idea, I think. That's the sort of thing time will tell. If she takes the ADHD treatment and gets better, then maybe she's not bipolar after all. If she gets worse, them maybe her therapist can help her see that.

All in all, I think there is a ray of hope here...at least she has made some sort of positive step to help herself, with some sort of support from her mom, and that should be encouraged. Keep your fingers crossed!

DJ