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Undertaking family-focused interventions when a parent has a mental illness – possibilities and challenges
- Authors:
- YATES Scott, GATSOU Lina
- Journal article citation:
- Practice: Social Work in Action, 33(2), 2021, pp.103-118.
- Publisher:
- Taylor and Francis
Parental mental illness (PMI) is a public health issue associated with risks of negative outcomes for children and families. Effective whole family interventions with families with PMI are still not well implemented across mental health, social work and multi-agency workforces. This paper presents research with professionals trained in a new programme, the Think Family-Whole Family Programme, to strengthen family-focused work around PMI. It examines professionals’ practice and understanding of PMI and identifies enablers of effective practice. Findings indicate that professionals having appropriate knowledge of how PMI can affect families and the confidence to address it are important factors enabling effective work with them. They also had concerns around how to discuss mental health due to issues of stigma and management support of whole-family work. Results indicate potential for training to achieve positive outcomes in improving professionals’ knowledge and confidence and encouraging whole-family work around PMI. Possibilities and challenges for future work with families with PMI are discussed. (Edited publisher abstract)
Applying the readiness to change model to implementation of family intervention for serious mental illness
- Authors:
- SHERMAN Michelle D., CAROTHERS Richard A.
- Journal article citation:
- Community Mental Health Journal, 41(2), April 2005, pp.115-139.
- Publisher:
- Springer
Family intervention for serious mental illness is known to be highly efficacious in reducing patient relapse, improving social functioning, enhancing caregivers knowledge of mental illness, and ultimately reducing overall costs of care. However, very few families receive services. The reasons for this gap between empirical findings and program implementation are complex and not yet fully understood. Prochaska and DiClementes Readiness to Change Model provides a helpful structure for understanding key issues for the four relevant stakeholders (patients, family members, clinicians and administrators). Staging each stakeholder group and applying corresponding interventions (processes of change) are useful in a sites implementation of family services.
The heart of the matter 2: integration of ecosystemic family therapy practices with systems of care mental health services for children and families
- Author:
- COFFEY Ellen Pulleyblank
- Journal article citation:
- Family Process, 43(2), June 2004, pp.161-173.
- Publisher:
- Wiley
This article links the ideas inherent in systems of care with ecosystemic family therapy principles and practices. Based on a study of nine innovative systems of care pilot projects in Massachusetts, it describes how these innovative programs, and others like them, have been most successful in increasing access to services and providing for coordinated services. They have been less successful in accomplishing positive clinical and functional outcomes. Change in these systems is often described in terms of how services are provided. Not enough attention is given to the conversations that take place between families and case coordinators and how these conversations lead to long-term change. This article contends that the ways in which services are delivered in these systems of care fit well with ecosystemic family therapy principles and practices. Argues that family therapists, have an opportunity to link these two sets of ideas, which share common assumptions and values and increase the likelihood of positive clinical outcomes for children and families.
The ability of staff trained in family interventions to implement the approach in routine clinical practice
- Authors:
- BAILEY Rachel, BURBACH Frank R., LEA Susan J.
- Journal article citation:
- Journal of Mental Health, 12(2), April 2003, pp.131-141.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Despite the proliferation of training programmes for Family Interventions (FI) in psychosis, there are many reported difficulties in the implementation of these approaches in routine clinical settings. The aim was to examine the effectiveness of a team-based multi-professional training programme in FI for psychosis. Fifteen therapists who had completed a 1-year Family Intervention training course (FIRST) designed to establish local FI services completed questionnaires used in previous studies and participated in focus groups. All FIRST trained staff continued to work with families following completion of training and most (80%) reported little difficulty in implementing the approach. Organisational issues such as availability of time and integration with caseload or other responsibilities at work were identified as the main cause of difficulty in working with families, whilst the key enabling factors were related to the structure of the FI service - co-working, supervision, multi-disciplinary teams and its flexible approach. FIRST trained staff experienced fewer difficulties in implementing FI in routine clinical practice than has been reported in previous studies.
A family intervention in psychosis service integrating the systemic and family management approaches
- Authors:
- BURBACH Frank R., STANBRIDGE Roger I.
- Journal article citation:
- Journal of Family Therapy, 20(3), August 1998, pp.311-325.
- Publisher:
- Wiley
Describes a project to establish new family intervention services to support people with psychotic symptoms and their families. The new services are developed by training a whole team in each main population centre. Describes the multidisciplinary training course and the family intervention service, and discusses the way in which the 'family management' and 'family therapy' approaches are integrated.
Family based interventions in psychosis - an overview of, and comparison between, family therapy and family management approaches
- Author:
- BURBACH Frank
- Journal article citation:
- Journal of Mental Health, 5(2), April 1996, pp.111-134.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
This paper aims to be of assistance to those who wish to work with families which include a person exhibiting psychotic symptoms. The distinctive contributions made within the field and are noted and the historical context for the split between the 'family therapy' and 'family management' approaches are summarised. The two approaches are compared in terms of their understanding of the issues of causation, lineality and circularity, acceptance of the concept of schizophrenia, and their emphasis on research or theory. It is suggested that future theoretical innovation is unlikely to be based on the unitary conceptualisation of the expressed emotion measures but is more likely to draw on systemic theories.
A Delphi survey to explore best practice for practitioners offering family intervention for psychosis to families with children
- Authors:
- THOMPSON Owen, et al
- Journal article citation:
- Journal of Family Therapy, 42(4), 2020, pp.560-587.
- Publisher:
- Wiley
Parents experiencing psychosis can face challenges in addition to those usually associated with being a parent, with their children at increased risk of negative outcomes. Although a strong evidence base has shown that family interventions for psychosis (FIp) can mitigate distress for adult relatives, techniques described in the systemic and parenting literature to facilitate the inclusion of children in family therapy are largely absent from the FIp literature and training. This study used a three‐round Delphi survey to investigate what experienced FIp clinicians consider to be best practice regarding the inclusion of children in parental FIp. Findings demonstrated support for including children, with high levels of consensus regarding methods of facilitating their involvement, as well as organisational factors that would support this. The results have important clinical implications given that many FIp practitioners work with families, following brief psychosis specific training, without exposure to the broader literature. (Edited publisher abstract)
The role of relationships and families in healing from trauma
- Authors:
- LOPEZ-ZERON Gabriela, BLOW Arian
- Journal article citation:
- Journal of Family Therapy, 39(4), 2017, pp.580-597.
- Publisher:
- Wiley
The effects of trauma and its treatment have a central role in health discussions in that trauma exposure is associated with an array of mental health issues, including depression, anxiety, and substance abuse. Treatment approaches are varied, but most empirically based protocols are individually focused, targeting intrapersonal difficulties. Although these protocols are critical, they do not directly address the relationship difficulties that may arise for survivors. In addition, limited empirical evidence supports using systemic approaches in trauma treatment. This article addresses this issue by summarising the most salient individual and relational evidence-based trauma protocols and by providing a description of common factors among these approaches, while also challenging the field to generate more research that emphasizes systemic interventions as a core consideration in treatment. A case study is included to illustrate the global relevance and benefit of systemic trauma approaches. Practitioner points: 1) Trauma should be treated as an event that affects everyone in the family and is nested in societal and cultural contexts; 2) Close relationships can maintain or exacerbate problems, but they can also be a powerful source of healing; 3) Systemic protocols that not only address intrapersonal difficulties, but also focus on survivors’ relationships are critical for healing in the aftermath of trauma. (Edited publisher abstract)
Family therapy with families of holocaust survivors
- Authors:
- QUADRIO Carolyn, et al
- Journal article citation:
- Journal of Aggression Maltreatment and Trauma, 25(6), 2016, pp.618-634.
- Publisher:
- Taylor and Francis
This is a clinical review of 7 families of Holocaust survivors who presented for treatment because of problems with an adolescent of the third generation. In 3 cases the problem was anorexia, and the remaining 4 had various clinical presentations, mostly related to separation-individuation issues. A common thread in the narratives that unfolded was that the trauma of the grandparent/survivors had been transmitted across subsequent generations to exercise significant influence on the children and grandchildren. Often, a more recent death or separation crisis had been the catalyst for these difficulties or a trigger that activated the Holocaust trauma. An outline of the therapeutic intervention is presented; it was based on a combination of systemic, structural, strategic, and psychodynamic approaches. It is suggested that open acknowledgment of the transgenerational issues played a critical role in moving families toward a more differentiated outcome. (Publisher abstract)
Bringing forth stories of blame and shame in dialogues with families affected by adolescent self-harm
- Authors:
- AMOSS Sarah, LYNCH Monica, BRATLEY Mary
- Journal article citation:
- Journal of Family Therapy, 38(2), 2016, pp.189-205.
- Publisher:
- Wiley
Feelings of blame and shame seemed to figure significantly in the interactional patterns of some families seen within the self-harm intervention family therapy (SHIFT) trial. Taking the SHIFT manual as a starting point, we elaborate the links between blame, shame, emotional regulation and adolescent self-harm, drawing on various theoretical models. The authors note the importance of attending to these emotional processes both in the family and the therapy team, arguing that these unhelpful patterns of interaction, emotion and meaning-making may also signal a motivation for change. Some ideas are offered about using blame and shame as platforms for understanding and intervention in the context of adolescent self-harm and illustrate the application of these ideas with case vignettes. (Edited publisher abstract)