1. Engaging Families to Improve Co-Occurring Outcomes
Presented by
Jill S. Perry, MS, NCC, LPC, CAADC, SAP
June 8, 2018

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3. What does COD Look Like?
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4. Review

5. Stigma

6. Stigma Where does it come from?
Labels that follow people through their life
Labels that can limit a person’s identity
HOW DO WE CONTRIBUTE?

7. 5 Rules to Eliminate Stigma
1) Don’t label people who have a mental illness or addiction
2) Don’t be afraid of people with mental illness or addiction
3) Don’t use disrespectful terms for people with mental illness or addiction
4) Don’t be insensitive or blame people with mental illness or addiction
5) Be a role model

8. Employ a Recovery Perspective with INDIVIDUALS and FAMILIES There are two main features of the recovery perspective: It acknowledges that recovery is a long- term process of internal change 2. it recognizes that these internal changes proceed through various stages.
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9. What is a Family?
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15. What Does Family Look Like?
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34. Other Ways to Look at Family
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41. How do Families work?
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42. Family Systems Theory
When there is a change in any individual member of the family, others in the family system are impacted.
Families are seen as organisms that continuously change and reconstitute themselves.
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44. Family Systems Theory—8 concepts
Triangles
3-person relationship system: building block of larger emotions systems
Smallest stable relationship system
2-person system is unstable because it can only tolerate little tension before involving a 3rd person
If tension is too high for 1 triangle to contain, it spreads to a series of “interlocking” triangles
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45. Triangles More stable than a dyad but creates an “odd man out”
Although there is more stability for tension, there is also more conflict generated when the “outside” person tries to change his place
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46. Martha & Michael (A)

47. Amy (B)

48. Differentiation of Self
Families and other social groups affect how people think, feel, and act
Individuals vary in their susceptibility to a “groupthink”
Groups vary in the amount of pressure they exert for conformity.
The basic building blocks of a “self” are inborn, but an individual’s family relationships during childhood and adolescence primarily determine how much “self” is developed.
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49. Differentiation of Self
People with a poorly differentiated “self” depend so heavily on the acceptance and approval of others
Bullies & Chameleons
People with well-differentiated “self” recognize realistic dependence on others but can still make their own decisions
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50. Martha, Michael & Amy ©

51. Nuclear Family Emotional Process
Marital Conflict—As family tension increases, each spouse externalizes his or her anxiety into the marital relationship
Dysfunction in One Spouse—One spouse pressures the other to think and act in certain ways and the other yields to the pressure. Both act to preserve harmony but often one does more than the other. As family tension arises, the subordinate spouse may have increased anxiety which can lead to dysfunction
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52. Nuclear Family Emotional Process
Impairment of One or More Children—Spouses focus their anxieties on one or more of the children. The more the parents focus on the child, the more the child focuses on them becoming more reactive with his/her attitudes, needs and expectations.
Emotional Distance—People distance from each other to reduce intensity but risk becoming too isolated. The more anxiety one person or one relationship absorbs, the less other people must absorb. Some family members maintain their functioning at the expense of others.
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53. Martha, Michael & Amy (D)

54. Martha, Michael, Amy & Marie €

55. Family Projection Process
The primary way parents transmit their emotional problems to a child
Heightened needs for attention & approval
Difficulty dealing with expectations
Tendency to blame oneself or others
Feeling responsible for the happiness of others
Acting impulsively to relieve the anxiety of the moment rather than tolerating anxiety and acting thoughtfully
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56. Family Projection Process
3 Steps to Projection Process:
The parent focuses on a child out of fear that something is wrong with the child
The parent interprets the child’s behavior as confirming the fear
The parent treats the child as if something is really wrong with the child.

57. Martha, Michael & Amy (F)

58. Martha, Michael, Amy & Marie (G)

59. Multigenerational Transmission Process
Small differences in the levels of differentiation lead to marked differences in differentiation among members of a multigenerational family.

60. Martha, Michael, Amy & Marie (H)

61. Emotional Cutoff
A way to manage unresolved emotional issues with family members by reducing or totally cutting off emotional contact with them
Geographic
Avoiding sensitive issues
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62. Martha & Michael (I)

63. Sibling Position

64. Martha & Michael (J)

65. Societal Emotional Process
Systems theory applies to nonfamily groups
Work
Social organizations
Friendships
 People often act to relieve the anxiety of the moment rather than act on principle and a long-term view
Similarities in families and justice system

66. Cultural Issues
Refers to all aspects of society that influence beliefs, opinions, and choices
Advertising
Media
Public Relations
Economic Globalization
Religion
Politics
Language
Education
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67. Cultural Issues
Shared knowledge, behavioral norms, values and beliefs that help people to live in families, group and communities.
Can define groups within parameters:
Religion
Occupation (blue collar, military)
Region
Other (LGBTQ, sports team)
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