Family Psychoeducation -- Introductory Video

Uploaded by SAMHSA on 29.03.2012

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Family Psychoeducation, Introductory Video
>> Ian was always a challenge.
I mean, we never knew what the matter with him was.
>> I was shocked.
I was in shock, because that isn't the kind of thing that can happen in my family.
Schizophrenia to me was so horrible that that would be the last thing on the list
you'd ever want to have.
>> I mean, it's just awful.
You just have dreams for your kids.
You want them to be happy and healthy, and you find out
that there's really something very wrong, I mean.
>> I've been having this problem since I was 5 and I'm almost 20,
so I can see that it's gonna never go away.
I might have this for the rest of my life.
>> When I had cancer, she was right there with me,
but when it comes to my mental illness, she doesn't understand.
>> I just felt like if he killed himself, it would have been because I didn't
protect him, and I didn't...
The weight of keeping him healthy was on my shoulders.
>> With all those suicide attempts and everything else,
they never thought I'd pull through.
I mean, after playing games with guns and medication,
they just thought it was all over with.
>> My life before the multi-family group was pretty hectic.
I was just out of the hospital in 1991 after going through a manic episode
because of my bipolar disorder, and I was really struggling.
I had gone through day treatment programs, drug rehabilitation programs,
and nothing quite clicked.
I just had a rough time.
>> Family Psychoeducation, a new approach to treating severe illnesses
like schizophrenia.
>> By honoring families and letting them know we are truly interested in them as
people, that sets a relationship that kind of invites hope and belief,
not only in the family, but I think also in the therapist.
>> It's a unique collaboration between consumers,
their families, support systems, and clinicians.
>> We tell people right from the very first joining that this is an opportunity
for people to put their heads together and work on managing symptoms,
but also recognizing you for who you are as a person
and really applauding your strengths.
>> Psychoeducation happens primarily in a group format.
Two clinicians bring together consumers and family members,
typically meeting bi-weekly over an 18-month period.
>> We tell families that spending time together with other families and
individuals who struggle with schizophrenia will help them become aware
of the solutions that are inherently involved in their lives.
>> Uh, my psychology class has been going well...
>> Problem-solving is the heart of family psychoeducation,
producing solutions to move life forward.
>> I finally got my license after 3 tries.
>> Ya-hoo! [laughter]
>> After sharing progress and current struggles,
members then identify the most acute problem to work on.
>> I, right now I'm struggling with going back to work,
being a homemaker, taking on my mom's responsibilities,
taking care of...
>> Judy is feeling overwhelmed.
She is starting to experience symptoms that make it difficult for her to think,
keep things in balance.
>> When you say "struggling," Judy, what do you mean by that?
>> Mmm, I can feel myself having symptoms, and I feel like I'm cycling,
and... I just feel really overwhelmed.
>> Would you be OK with our problem-solving that this week?
>> Yeah.
>> OK.
Clearly define what the problem is that we're trying to problem-solve.
Do you have a sense in your mind, Judy, of how you would define the problem?
>> Managing responsibilities.
>> OK.
>> For all of the psychotic disorders, there's a kind of common problem,
which is a sensitivity to stimulation that translates into difficulty thinking at a
much lower level of stimulation than is true for people without these disorders.
It's almost as simple as that.
So the threshold is just lower for disorganization.
Life is pretty tough in general, but it depends on looking at options that you've
got in front of you, and choosing, based on your experience,
what's the best thing to do.
With disorganization of thinking, they can't quite even make the decisions
about which thing to try.
>> I can feel things changing, and knowing that,
like, getting frustrated really easily, um...
>> You're asking yourself to do it all.
It is too much.
>> You actually set up a situation in which people,
in a very supportive kind of way, are challenged to do some thinking,
only this time, there's a lot of brains helping with that thought process.
What the outcome of that is, it's just, over and over again,
is a sense of being validated, appreciated,
and then also, at a sort of practical level,
you get some good ideas to go out and try in your own life,
in your own terms, in ways that fit you and your family.
>> The group offers possible solutions to help Judy see new ways
of solving her problem.
>> Are there any cons to making a to-do list?
>> I could put too much on there and feel overwhelmed,
'cause I think I have to do the whole thing.
>> It would just seem like too much to do, so...
>> Yeah.
>> ... where do I even start?
>> After discussing the pros and cons of each of the possible solutions,
Judy is now able to choose several that will become her plan of action
in the coming week.
>> It feels really good.
It helps. It feels doable.
>> And I think that the power of these groups is that there's families and
individuals who live a similar kind of life,
and when they say something to someone it goes right in and hits them,
and they make changes.
>> And right now I have issues with my family...
>> Marsha is not only struggling with schizophrenia,
she's struggling with family rejection and stigma.
>> ...what it's like to be hearing voices, what happens to me when I'm psychotic.
They don't understand.
>> Have any of you had experience talking to your families about your illness?
>> Now, as far as my family is concerned, like my sister,
my sister and I have drifted apart because she didn't understand the ill...
my mother didn't understand, I didn't understand the illness
that started like 5 years ago.
[murmurs of assent] >> Well, I'd like to [indistinct] about my illness and you
know, and how, you know, how it can be a lot better for them to understand it
so they can, you know, better understand me.
>> I'm trying my best to help her understand more.
She came here one time, and I would like for her to come here more
and to learn how to treat me and to understand.
>> This is a person who has a burden.
You know, like, Donnie is not a schizophrenic.
He is a man, and he goes to college, and he loves his family,
and he plays with my children, and he has schizophrenia.
>> ...and for all of your many blessings, amen.
>> Family involvement made all the difference for Elizabeth's brother Don,
whose atypical schizophrenia led to misdiagnosis and years of serious illness
and deepening hopelessness for him and his family.
>> It lets me know I'm not alone, I'm not struggling,
I'm not the only one struggling with this illness.
And you know, the other people give me insight into how they're doing and how
they are dealing with things, and I learn new things,
you know, new coping skills and stuff from them.
>> I think the benefits for a clinician to be involved in this kind of group
is its tremendous variety.
It's tremendous satisfaction to see people getting better.
It's very gratifying to watch people sort of move out of themselves
and reach out to other people in the group, other families in the group.
You really get to see a restoration of somebody's personality as time goes on.
>> I've seen people who have been very, very, very
bothered by the illness over the course of the 18 months to 2 years make a
miraculous turnaround, and I see clinicians who have clearly been burned
out by the system get rejuvenated, thinking about,
"Wow, I can really make a difference here."
>> The multi-family group is helping in so many areas.
I mean, it's helped in the employment...
you know, being totally unemployed for 5 years and not employable to anyone
at that time because of the illness.
>> I thought that he was going to be an invalid the rest of his life,
but now I see little by little there's hope out there,
and it's from looking around and seeing the accomplishments that these folks
have made here that there's hope for him,
and it's making me feel a lot better and more comfortable.
>> He's thinking for himself.
Before, "Where's my keys, where's this, where's my wallet?"
But now, he has it all together.
>> It's like I have my little brother back.
It's just like I have him back.
>> In clinical trials, family psychoeducation with either single- or multi-family groups
reduces relapses and re-hospitalizations of consumers by over one half.
Their families enjoy improved relationships and experience
a reduced burden for their care.
In addition, family members have significantly fewer medical illnesses
after one year in the groups.
Ultimately, consumers and family groups are 50% more likely to be employed after 2
years than those who have not experienced family psychoeducation.
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