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Employment Multifamily Group Project

Employment Multifamily Group Project. Alex Kopelowicz, MD Roberto Zarate, PhD Human Interaction Research Institute New Haven, CT – March 15-16, 2012. MFG Staff Training: Day 1. 8:00-8:30 am Breakfast 8:30-9:15 am Brief Introductions by Agencies

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Employment Multifamily Group Project

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  1. Employment Multifamily Group Project Alex Kopelowicz, MD Roberto Zarate, PhD Human Interaction Research Institute New Haven, CT – March 15-16, 2012

  2. MFG Staff Training: Day 1 8:00-8:30 am Breakfast 8:30-9:15 am Brief Introductions by Agencies 9:15-9:45 am Welcome/Overview of the MFG Training Program 9:45-10:30- am What is MFG and Why Should We Do It? 10:30-10:45 am Break 10:45-12:30 pm MFG Components (Joining Sessions, Educational Workshop & Problem Solving Groups) 12:30-1:30 pm Lunch 1:30 – 4:00 pm Joining Sessions (Demonstration & Role Plays)

  3. MFG Staff Training: Day 2 8:00-8:30 am Breakfast 8:30–9:00 am Review/Overview of Problem Solving in MFGs 9:00-10:30 am MFG Sessions (Demonstration and Role Plays) 10:30-10:45 am Break 10:45-12:00 noon MFG Sessions (Role Plays Continued) 12:00–1:00 pm Lunch 1:00–3:00 pm MFG Sessions (Role Plays Continued) 3:00 -3:30 pm Questions and Wrap-Up

  4. Standard Approachesto Family Work • Psychoeducation • Communication skills training • Problem solving techniques • Social network development (MFG)

  5. Better Outcomes in Family Psychoeducation • Over 20 controlled clinical trials, comparing to standard outpatient treatment (Dixon, 2003), have shown: • Increased employment • At least twice the number of consumers employed, and up to four times greater--over 50% employed after two years--when combined with supported employment • Improved family relationships and well-being • Reduced friction and family burden • Reduced medical illness in family members • Doctor visits for family members decreased by over 50% in one year

  6. Pretreatment Treatment Follow-up 1-Year Survival Rates Among Bipolar Patients in Family-Focused Treatment Versus Case Management FFT, N=31 CM, N=70 Wilcoxon Test, c2 (1)=3.99, P =.046 Miklowitz DJ, et al. Biol Psychiatry, 2000;48(6):582-592

  7. Stages of a Psychoeducational Multifamily Group Educa- tional workshop Ongoing MFG Families & clients bi-weekly 6 months Joining Family and clients separately 3-6weeks Families only 1 day

  8. Joining with Families and Clients JOINING means to CONNECT, BUILD RAPPORT, CONVEY EMPATHY, ESTABLISH AN ALLIANCE, ENGAGE It is the first stage of intervention Designed to create a bond between Client/Family Members and Family Counselors COUNSELOR as ADVOCATE

  9. Joining Proecedures • THREE Joining Meetings  SEPARATELY with Relatives and Clients  WEEKLY – 1 HOUR with Relatives, ½ HOUR with Clients • Start sessions A.S.A.P. after client/family enrolls • Gain an understanding of family’s stresses, problems, reactions to client’s unemployment/underemployment, etc.

  10. JOINING – I • 15 Minutes of SOCIAL TALK • Discuss the experience of looking for, getting and losing jobs • Review any recent stressful event: Who and what helped or didn’t • IDENTIFY WARNING SIGNS OF STRESS – PRECIPITANTS • Distribute to families & keep for future reference • Describe the plan for ongoing MFG sessions • 5 Minutes SOCIALIZING

  11. JOINING – II • 15 Minutes of SOCIAL TALK • Review past experiences with co-workers, supervisors, supervisees, etc. • FAMILY’S EXPERIENCE DURING STRESSFUL EVENTS  The sharing of painful events: A crucial aspect of “Joining”  The client/family’s understanding of causes • Family’s social network & resources (material & emotional) • 5 Minutes SOCIALIZING

  12. JOINING – III • 15 Minutes of SOCIAL TALK • Family’s social network & resources • Developing and maintaining a support network • SHORT & LONG-TERM GOALS (e.g., Employment) • Preparation for Workshop & MFGs

  13. MULTIFAMILY GROUPS • Five to eight families • Two family counselors/facilitators • 1 ½-hour sessions – biweekly over six months or more • Refreshments/snacks are provided • Initial sessions avoid emphasis on conflict • Initial sessions emphasize establishing a working alliance by building group identity and developing a sense of mutual interest and concern - drop outs are failures

  14. FIRST MFG SESSION “GETTING TO KNOW EACH OTHER” Go Around the Room  Background  Hobbies  Occupation  Interests  Counselor Goes First (Discloses/Shares with the Group) SETTING BASIC RULES  Regular ATTENDANCE (for Relatives)  CONFIDENTIALITY (No Pressure to Disclose)  INTERACTION AMONG MEMBERS  PHYSICAL/EMOTIONAL CONTROL

  15. SECOND MFG SESSION • “HOW UNEMPLOYMENT/UNDEREMPLOYMENT HAS CHANGED OUR LIVES”  Building a SENSE OF TRUST & COMMITMENT  Sense of COMMON EXPERIENCE (Listen to each other)  Strengthening GROUP IDENTITY & SENSE OF RELIEF  The CLIENT’S INNER EXPERIENCES  Counselors emphasize the vital role of SHARING GRIEF, CONFUSION, GUILT, FEAR with those “on the same boat”. AND HOPE • Remind participants about Problem Solving (next session)

  16. GENERAL POINTS • New Members • Late-Arriving Members • Reminders about Attending • Crises & Emergencies • COMMUNICATION & INTERACTIONS  Counselors DON’T speak for clients or relatives  Interaction among members is essential  Clients are ENCOURAGED (not pressured) to participate  Respect other’s turn and avoid criticism

  17. PROBLEM SOLVING IN MFGs • The CORE of MFG Sessions • Designed to compensate for limited education • FORMAT: Checking in 15 Minutes Go-round 20 Minutes Selecting a Problem to Solve 5 Minutes Solving the Problem 45 Minutes Wrap-up Socializing 5 Minutes • Counselors should GET READY and HAVE A PLAN – IN ADVANCE

  18. Selecting an Employment-Related Problem to Solve • TOPICS: (Identified prior to MFG or during group) Transportation Child Care Drugs and Alcohol Life Events/Domestic Problems Housing Disagreements among Family Members • “REJECTED” PROBLEMS: Make a Direct Suggestion and Review Outcome Meet Outside the Group (e.g., Crises) Refer to Past Solutions that Apply Refer to Solution/Family with Successful Outcome

  19. THE PROBLEM-SOLVING METHOD • Define the Problem or Goal • List Possible Solutions • Evaluate Advantages and Disadvantages of Each Solution • Choose “the Best” Solution • Implement Plan to Carry Out Solution • Review Implementation and Outcome

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