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

2. 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”…)

3. Pyramid of Family Care (Mottaghipour & Bickerton, 2005)

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

5. …, 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

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

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

8. 3. Psychoeducation
Coping strategies
Problem-solving
Groups or single

9. 4. Consultation
Professional help
Peer engagement
Referrals

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

11. Confidentiality

12. The Challenge

13. The Consequence

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

15. 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.”

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

17. What To Do?

18. Provider Issues

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

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

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

22. 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

23. Family Education

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

25. Who is this woman?

27. Our guest presenter