1. Working with Families and Carers Gemma Stacey

2. Group discussion  In the care that you have observed how have families and carers : Helped ? Hindered ?

3. Why work with families?  Carers should be acknowledged as full partners in the caring process.  They hold a deep knowledge of those they are in the relationship with. Shared learning between SU’s, carers and professionals  They are a valuable resource Help recognise early warning signs Provide natural sources of emotional support  Carers often feel neglected and dismissed  It is required as part of the Care programme Approach

4. How might families feel?  Scared, sad, guilty, angry  Bewildered- no previous experience of mental health problems or services  Hopeless/ powerless  Isolated as a result of stigma  The consequence of this may be the development of their own mental health problems.

5. Expressed emotion  High EE Hostility Emotional over involvement Critical comments  Low EE Warmth Positive coping strategies

6. Impact on the service user  Loose relationships  Places strain on relationship  Feel blamed  Greif and loss for role and relationships  Feel like a burden  Socially and developmentally held back

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8. Types of resources that would be useful  If you had a loved one who was experiencing mental health problems what help would want? Social Supportive Educational Problem solving Practical  This can be provided by voluntary and statutory services.

9. Aims of working with families  Help families to support SU’s in their journey to recovery  Facilitate an increased understanding of the SU’s experience of mental health problems  Facilitate ways of coping and adapting  Identifying and solving problems  Gaining support  Opening lines of communication  Improve quality of life  Increase service users independence and self maintenance

10. Getting started  Confidentiality Fear about breaching patient confidentiality has frequently created a barrier to effective involvement difficulties may occur for the carer and worker if the person interprets actions as a breach of trust & confidentiality

11. Getting Started  Engaging families Offer positive, pleasant and consistent contact Show appropriate care and concern for the family situation May need to speak to family members individually Be persistent but at a pace the family will allow Finding a convenient time to meet Who, what, why, when, where?

12. Hints and Tips  Avoid jargon  Acknowledge expertise  Facilitating equal contribution  Listen to all views  Acknowledge loss and focus on strengths

13. Hints and Tips  Encouraging everyone to talk to the person not about them  Giving the recipient the opportunity to respond to how a comment makes them feel  Attempt to explore emotions underlying critical comments  Staff role modelling these things, demonstrating understanding and acceptance

14. Problem solving  Specify in detail what the problem is.  Get everyone’s view of the problem, particularly the SU.  Elicit possible solutions.  Look at the pros and cons of each possible solution.  Compromise and agree on a desirable solution.  Anticipate any obstacles.  Identify clearly action, timeline and responsibilities