Treatment models that have been supported by evidence of effectiveness have required clinicians to adhere to fifteen principles in working with families of persons who have mental illness:
- Coordinate all elements of treatment and rehabilitation to ensure that everyone is working toward the same goals in a collaborative, supportive relationship.
- Pay attention to both the social and the clinical needs of the consumer.
- Provide optimum medication management.
- Listen to families' concerns and involve them as equal partners in the planning and delivery of treatment.
- Explore family members' expectations of the treatment program and expectations for the consumer.
- Assess the strengths and limitations of the family's ability to support the consumer.
- Help resolve family conflict by responding sensitively to emotional distress.
- Address feelings of loss.
- Provide relevant information for the consumer and his or her family at appropriate times.
- Provide an explicit crisis plan and professional response.
- Help improve communication among family members.
- Provide training for the family in structured problem-solving techniques.
- Encourage family members to expand their social support networks-for example, to participate in family support organizations such as NAMI.
- Be flexible in meeting the needs of the family.
- Provide the family with easy access to another professional in the event that the current work with the family ceases.
In addition, the following elements are essential to providing consumer and family benefits:
- The intervention should span at least nine months
- The intervention should include education about mental illness, family support, crisis intervention, and problem solving
- Families should participate in education and support programs
- Family members should be engaged in the treatment and rehabilitation of consumers who are mentally ill
- The information should be accompanied by skills training, ongoing guidance about management of mental illness, and emotional support for family members
Other Important Features
Psychoeducation can be provided in single-family and multi-family groups. For multi-family groups, practitioners invite five to six consumers and their families to participate in a psychoeducation group for at least six months. Additional meeting time promotes improved outcomes. Meetings are held every other week. The format is structured and pragmatic to assist people with developing skills for handling problems posed by mental illness. Over time practitioners, family members, and consumers form a partnership as they work toward recovery. Consumers and their supporters may decide to meet as a single family rather than in the multi-family group format.
Family psychoeducation involves:
- joining (developing an alliance)
- on-going education about the illness
- creating social supports
- developing coping skills
Family psychoeducation sessions focus on:
- exploring precipitants of previous acute episodes of illness
- review of prodromal signs and symptoms
- reactions of the family in supporting family members with an illness
- coping strategies and strengths that have been successful
- social supports in the community
- grief and mourning in relation to the illness and the development of a treatment plan