Family Education Confidentiality Provider Issues PSRT 4271 The Family Role in Rehabilitation Week 8

The Role of the Family (Spaniol, Zipple & Lockwood, 1992) SMI triggers major changes  caregiving problems Meds management, specific behaviors, education and work deficits, hygiene issues Professionals also as unprepared Few are trained about families with SMI Recovery for years (“no finish line”…)

Pyramid of Family Care (Mottaghipour & Bickerton, 2005)

Premise After Maslow’s Hierarchy of Needs Basic needs first. Higher needs later.

…, 2 Most families don’t need higher level attention Factors Family related Illness related Baseline clinician skills and qualities Empathic listening, therapeutic alliance, grief and loss awareness, client assessment, mental illness knowledge, time management, high ethical standards

1. Connection and Assessment Introduce and explain Document contact details Assess needs Ensure safety (for all) Assess further Explain “The System” Make a plan

2. General Education Illness information Services resources Rights Support links Referrals

3. Psychoeducation Coping strategies Problem-solving Groups or single

4. Consultation Professional help Peer engagement Referrals

5. Family Therapy To create change in family system ST, LT (Required only by a few)

Confidentiality

The Challenge

The Consequence

For instance… Up to two-thirds of providers know that they can receive information without consent.

For instance… “I pretty much ask all my clients at one point in time about their families, if they had contact, and if they said no, then pretty much, I drop it.”

Unintended Consequences Infringing one’s “rights” to preserve them. Increase isolation, discourage intervention, reinforce stigma

What To Do?

Provider Issues

Convergence (Spaniol, Zipple & Lockwood, 1992) Helplessness, anger, despair, anxiety Few models Limited data about illnesses, etc.

Divergence (Spaniol, Zipple & Lockwood, 1992) Insufficient skills, support, validation for families Legacy thinking about pathological families Time Funding

Know The Family’s Evolution (Spaniol, Zipple & Lockwood, 1992) Coping Caregiving Supporting others Educating others Advocating

Supporting Family Roles (Spaniol, Zipple & Lockwood, 1992) Clarify roles Work as a team Be a teacher Include families Accommodate the intensity Meet local groups Acknowledge diverse beliefs Elevate family strengths Develop own supports Acknowledge limitations

Family Education

Convention Anecdote Lisa Dixon asks 200 USPRA members… Heard? Taken? Taught? Led?

Who is this woman?

Our guest presenter