Family Matters

It often takes years before a client is connected with an ACT team. This can mean years of crises, hospitalizations and incarcerations. Family members have similarly been dragged along, experiencing the vicarious trauma of witnessing, and being directly affected by, a loved one having severe and persistent mental illness.

Beyond the day to day contact our team maintained with families, Roman and I would periodically facilitate a family group. We did not do this often enough but their effect felt lasting. If your team hasn’t been operating a family group consider giving it a try. Here are a few suggestions for how to arrange it:

  • Offer it in an evening, starting at 7 or 7:30 and allow for around 90 minutes.
  • Serve cookies or pastry, coffee and tea.
  • Hold it in your normal workspace where the team does morning meeting. Throw a drape over the chart rack (if you still have such a thing) to block names.
  • Don’t worry if you’re in the middle of the work area and evening staff are coming and going – it’s good for family members to see how the team operates.
  • Have the team leader facilitate and see if you can get the psychiatrist to come in even if it’s just for 15 or 20 minutes. Other clinicians are usually more than willing to help with this kind of group.
  • Have 30 to 45 minutes worth of material to present. Early in a team’s life the focus should be on the basics of how the team operates, how ACT services are delivered and the like. Don’t present too much – you want to leave ample time for those attending to talk and share. More on what to present below.
  • Invite twice as many people as you expect to attend and aim to have between 10-20 attendees (14-16 is ideal).
  • Welcome all; invite parents and siblings but don’t restrict.  Sometimes there’s an aunt, uncle or grandparent who has been very involved – they should attend.
  • Occasionally you may have a family member who is hurting and monopolizes the discussion. This can be challenging but allow them to talk and try not to cut them off. Family members need time to share the narrative of their experience, which has often been incredibly painful. Let people talk, let others share, don’t feel you have to over-control the process.
  • Don’t feel you have to be an apologist for the mental health system.  Don’t get defensive – listen actively and solicit others’ thoughts and experiences.

A Family Resource Guide cover

Several years ago our team had two excellent nursing practicum students, Lindsay and Uzoma  (see my previous blog on From Treating Team to Training Team), who did a wonderful job of putting together A Family Resource Guide.  It deserves to be shared and used. Consider taking a part of it and using it as the basis for a family session. (Note that on our team we used the term ‘participant’ rather than ‘client’ and you’ll find this term used throughout the document).  Chapter 1, an overview of PACT, is perfect for a first session.

I suggest trying to do a family group twice a year – spring and fall.  Bringing families together to learn from their experiences can be a most gratifying part of our work.

Shalom Coodin

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