Today there is an expectation that mental health practitioners work with families, are able to provide support to children, parents and all family members (Houlihan et al 2013). In addition, co-operation with families has been shown to be effective and important intervention (Pharoah et al 2010, Jung & Newton 2009). However there still seems to be a need to develop these practices. Differences have been found also between professional groups and how they work with families. (Maybery et al 2014.) It is well known that education for professionals positively affects their attitude and willingness to work with families (Sveinbjarnardottir et al, 2011.)
Family members need information about mental health promotion in general, like factors supporting our wellbeing and affecting our mental health. Different crisis situations in life and individual reacts to them can have an impact on mental health. Therefore we need to listen to the families and be prepared to support their own mental health.
When working with the family, the professionals knowledge, skills and attitudes play a big role. In this section we use the term "interaction skills", but in the literature this is also described as 'communication skills' or 'therapeutic interaction'. You can also find more information using terms like: caring relationship, therapeutic alliance or therapeutic relationship. In nursing, terms like nurse-patient interaction, nurse-client relationship, family-nurse relationship or partnership could be found.
This relationship could be described as a trusting relationship between professional, family and service user (Piippo & Aaltonen 2009). It is the relationship that you as a professional (or together with your colleagues) and the family create together. In the Open dialogue it means that you and the family are together creating an equal partnership and a team working together.
This kind of relationship can include reciprocal honesty and openness, a sense of wholeness and autonomy facilitated by a versatile interchange of knowledge and understanding (Piippo & Aaltonen, 2008).
We identified some key competencies in our interviews with Master's level students, nurses in different clinical settings and representatives of family and service user organisations. They mentioned key competencies like:
This could be summarized as a need of highly competent interaction and communication skills when working with a family who is affected by mental health problems. As there are more people within the therapeutic relationship, it means more relationships between participants and mental health professionals which can make the interventions more challenging. Clinical supervision is one method to help you to strengthen your professional competence in this.
How can you create that kind of a relationship in a way that you are helping the family in their problematic life situation? Everything starts with the skill of being present. In addition, early contact, early information and protection and active listening (Gavois et al., 2006; Mahone et al 2011) are also very important.
We would like to introduce you to some ideas with six short animations. You can look at them all and create a picture of one family meeting or if you are trying to find some specific information, you can look at them individually.
This chapter includes these items
Please meet the Smith family in their first meeting with a mental health professional!
Falloon, IRH. 2003. Family interventions for mental disorders: efficacy and effectiveness. World Psychiatry 2(1), 20–28.
Jeon YH. 2004. Shaping mutuality: nurse-family caregiver interactions in caring for older people with depression. International Journal of Mental Health Nursing 13(2), 126-34.
Leff, J. 2000. Family work for schizophrenia: practical application. Acta Psychiatrica Scandinavica 102, Supplement s407, 78–82.
Leff J, Sharpley M, Chisholm D, Bell R & Gamble C.2001. Training community psychiatric nurses in schizophrenia family work: A study of clinical and economic outcomes for patients and relatives. Journal of Mental Health 10 (2), 189-197.
Leggatt M. 2002. Families and mental health workers: the need for partnership. World Psychiatry 1(1), 52–54.
Houihan D, Sharek D & Higgins A. 2013. Supporting children whose parent has a mental health problem: An assessment of the education, knowledge, confidence and practices of psychiatric registered nurses in Ireland.. Journal of Psychiatric and Mental Health Nursing 20, 287 – 295.
Jung XT & Newton R. 2009. Cochrane Reviews of non-medication-based psychotherapeutic and other interventions for schizophrenia, psychosis, and bipolar disorder: A systematic literature review. International Journal of Mental Health Nursing.18(4), 239-49.
Maybery D, Goodyear M, O'Hanlon B, Cuff R & Reupert A. 2014. Profession Differences in Family Focused Practice in the Adult Mental Health System Family Process 53(4), 608–617.
Pharoah F, Mari JJ, Rathbone J & Wong W. 2010 Family intervention for schizophrenia Cochrane Database for Systematic Reviews, published 8(2).
Piippo J & Aaltonen J.2009. Mental health and creating safety: the participation of relatives in psychiatric treatment and its significance. Journal of Clinical Nursing 18(14), 2003-12.
Sveinbjarnardottir EK, Svavarsdottir EK & Saveman BI.2011. Nurses attitudes towards the importance of families in psychiatric care following an educational and training intervention program. Journal of Psychiatric and Mental Health Nursing 18 (10), 895-903.
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