Family-to-Family Education Course

Cathy Epperson Kathy KellerNAMI Kentucky NAMI Northern Kentucky

May 20, 2011

History•First offered in 1989

•300,000 people have taken the course

•Offered in 49 states & 3 other countries

•Presented in 6 languages

Course ResultsDept. of Psychiatry University of Maryland Study

of Family-to-Family students, post-course

Greater empowerment Greater knowledge of mental illness Higher coping skills Less anxiety Better personal skills Reduced depression symptoms Less distress

Course Operations

•FREE to all students

•Trained volunteer peer-teachers

•Teachers read course material for fidelity

Course Operations (continued)

•Kentucky’s Goal: to offer course annually in each of 20 affiliates

•Larger affiliates subsidize additional

courses

•Length: 12 week period, 1 day/evening

per week

•Each class: 2 & ½ hours

•Commitment to attend each class

•Have friend/ family member with mental illness

•16-25 participants per class

•19 or older

•Not a support group

Participants

Class Covers•Schizophrenia•Bipolar Disorder•Major Depression•Anxiety Disorders•OCD•PTSD•Borderline personality disorder

Stages of Emotional Responses

•I. Dealing with Catastrophic Events

•II. Learning to Cope

•III. Moving into Advocacy

Stages of Emotional Response ChartI. DEALING WITH CATASTROPHIC EVENTS

EMOTIONS• Crisis• Chaos• Shock• Denial;• “normalizing”• Hoping against hope

NEEDS: • Support • Comfort • Empathy • Help finding resources • Crisis intervention• Prognosis • Empathy for pain• NAMI

II. LEARNING TO COPE

EMOTIONS

• Anger• Guilt• Resentment• Recognition• Grief

NEEDS:

• Vent feelings• Keep hope• Education• Self-care• Networking • Skill training• Letting go • Cooperation from System• NAMI

III. MOVING INTO ADVOCACYEMOTIONS

•Understanding•Acceptance•Advocacy/Action

NEEDS

•Activism •Restoring balance

in life•Responsiveness

from System •NAMI

Finally, the chart serves as a guide to hope for the future, and ways to respond in a positive way. In other words, we teach families to turn lemons into lemonade whenever possible.

3 Aspects of Mental Illness

•Medical

•Emotional

•SocialThe course covers all three

aspects

BIOLOGICAL/PHYSICAL (Medical Dimension)

Science-based knowledge Course Focus: Medical aspects of Illness

•Symptoms; Diagnosis

•Prognosis

•Acute care in critical periods

•Medications and medication side-effects

BIOLOGICAL/PHYSICAL (continued)

•Adherence to medication

•Scientific advances in medications

•Early warning signs of relapse

•Best medical strategies to maximize recovery

BIOLOGICAL/PHYSICAL (continued)

•Discuss genetic aspects of mental illness

•Cover theories of causality

•Try to override guilt

•Functions of neurotransmitters

BIOLOGICAL/PHYSICAL (continued)

•Understanding clinical diagnosis

•Share current research

•Teach effective interaction with BH

specialists

BIOLOGICAL/PHYSICAL (continued)

•Emphasis on physical ennui

•Programs often ignore effects of “brain

attack”

•Teach to expect extensive recovery period

•Resist unrealistic expectations

BIOLOGICAL/PHYSICAL (continued)

•SYMPTOMS

▫Particularly useful to participants

▫Learn which behaviors are added and taken

away

▫Learn to separate symptoms from the

person

▫Open communication despite person’s

symptoms

Managing Crisis•Go through crisis file

•Makes contacting society services easier

•Includes practical information

•Use to help in a crisis

Crisis File Contents•Local Crisis Phone numbers

•Behaviors to use during a crisis

•Identifying a good psychiatrists

•Questions for the psychiatrists

•Interacting with BH professionals

Crisis File Contents (Continue)

•Integrated treatment MI & SA•Dealing with the criminal justice system•Suicide•QPR (Question, Persuade, Referral)•Setting limits •Managing violent/disruptive behavior•Principals for dealing with critical periods

in MI

PSYCHOLOGICAL/EMOTIONAL (Personal Dimension) Psychology-based knowledge Course Focus: Subjective emotions and

feelings •The inner experience of brain disorders •Normative family responses to the trauma

of mental illness

•Telling our stories; validating family strengths

PSYCHOLOGICAL/EMOTIONAL (cont’d)•Coping strategies used to protect self-

esteem in mental illness

•Empathetic listening and responding

skills •Burdens of different relative roles in the

family

PSYCHOLOGICAL/EMOTIONAL (cont’d)

•Handling anger, frustration, and feelings of entrapment

•Setting boundaries

•Self-care skills; keeping our lives going

•Coming to terms with “shattered dreams”

•Value of peer understanding and support

Social/Occupational(Rehabilitation Dimension)Recovery based knowledgeCourse Focus: self/renewal re-entry into community

• Definitions of recovery

• Principals of rehabilitation

• Testimonials of recovery

• Educated about societal support

• Teach problem-solving process

Social, Occupational, Rehabilitation Dimension (continue)

•Speaker who has MI

•Introduce advocacy

•Deconstruction of societal stigma towards MI

•Long term planning

•Encourage independence of person with MI

End of Course•The course is life-changing

•Families report ill member’s improved prognosis

•Increased empathy of family member to ill relative