Using Problem Solving in NAMI signature programs

1. Using Problem Solving in NAMI signature programs An instructional module for people who have already been trained to facilitate a NAMI support group or teach the NAMI Family-to-Family program

2. What is Problem Solving and how does it relate to NAMI programs? There are many ways to approach solving problems. The approach that has proven most effective for: • NAMI Connection Support Groups • NAMI Family Support Groups • NAMI Family-to-Family Education Program is the Problem Solving Technique, a group process that honors the way people solve problems while offering them more options when they’re feeling discouraged.

3. A disclaimer about timing • Because NAMI Family-to-Family is a 12 session course, there is more time available for the Problem Solving Technique; 45 -60 minutes • When the Problem Solving Technique is used during a support group it is important to limit the entire process to 20 minutes to allow other group business to occur

4. The three steps that make up the Problem Solving Technique Step # 1: Define the problem Step # 2: Solve the problem using “POW” Step # 3: Set realistic expectations

5. The Problem Solving Techniqueis used when someone: • Is stuck in the same problem week after week • Feels they have exhausted all their options and have turned down the options provided by the group • Doesn’t recognize a problem “pile up” and needs help setting priorities or breaking the problem into manageable pieces And/or: • Specifics of a problem are not clear enough to use group wisdom

6. TIP The Problem Solving Technique isnot helpful when dealing with illness issues over which the individual or family member with the problem have little or no control. Example: “How can I make my relative take medications?” If you get a problem like this explain the limitation, then rephrase the issue. Example: “What kind of strategies are useful in helping someone explore their barriers to taking medication consistently?” This way you have something concrete to work on, and you won’t get stuck trying to solve an impossible problem.

7. Tools needed for the Problem Solving Technique 1) Flip chart 2) Black and red markers

8. Please note that although this example of the Problem Solving Technique focuses on a family member’s problem, the process is the same for individuals with mental illness that wish to solve a problem that is important to them

9. We now invite you to walk through a lesson in using the Problem Solving Technique Bythe end of this lesson you should feel comfortable using the process of Problem Solving during your NAMI support groups and NAMI Family-to-Family classes.

10. Problem Solving Techniquestep #1: Define the Problem • Pick the one most pressing problem, right now • Be specific • Determine the real issue

11. Tasks to accomplish in Step # 1 • Have the individual willing to share their problem come to the front of the room • Ask the individual to identify what he/she believes the problem at hand to be • Expect to hear a problem “pile up” rather than the true problem • Help the individual “untangle the pile up” by asking questions about the stated problem and trying to help them narrow it down • Write down each layer of the problem identified to create a list that the individual can refer to later

12. One of the best ways to learn is to see a demonstration You will now see an example of the Problem Solving Technique in action as psychologist Dr. Joyce Burland, creator of the NAMI Family-to-Family program, follows the steps with Norma Bangs a State Trainer for NAMI Family-to-Family and National Trainer for NAMI De Familia a Familia

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14. Tasks to accomplish in Step # 1 Ask the person to pick the single most pressing problem on the list. They may combine facts, but the focus must be on only one problem.

15. TIP You are not in the driver’s seat during this part of the exercise; you are only the recorder.Park your own personal opinions as well as those of the audience when using this Problem Solving Technique. Use the problem chosen by the person that has the problem.

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17. Tasks to accomplish in Step # 1 In collaboration with the person, write the problem as a problem statement. The leader may offer suggestions, but the statement must be owned by the person

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19. Tip In order to drill down the problem statement: • Askthe person with the problem to get as specific as they can about the problem that they have chosento share • Guide the group to ask for more specifics related to the problem. It is important for them to focus on details that help them see the problem more clearly • Remember, the person with the problem is in charge, the group is offering suggestions – you are the facilitator in this part of the exercise

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21. The process of drilling down continues At this time Norma continues listing her concerns about her daughter, Christine: • She has a difficult time expressing herself clearly • She’s withdrawn and she isextremely shy • She doesn’t like any type of physical contact, even hugs from family members

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23. Tip It is not time to solve the problem yet. At this point during Problem Solving the objective is to find out more about the problem, not offer solutions.

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25. The process continued with more questions from the audience like: • When did you start worrying about Christine? • Is she able to work? • How often do you see her? • Was there anything else that happened in the recent past that might have been unusual in her life • Are you concerned about suicide? • What do you do with your daughter when you see her? • Does she ever talk about her illness? • What are her strengths? • Does she prepare her own meals?

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27. Tip Allow about 15 minutes for questions and answers. Once the question and answer section is complete, summarize what you have learned.

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29. Problem Solving Technique Step #2: Solving the problem using “POW” • Evaluate the Past Experience • Generate Options • Plan for What if’s

30. Tasks to accomplish in Step #2Past Experience • Ask the person what they have tried in the past in order to solve the problem. List this on a separate sheet of paper on the easel pad. • When all past solutions are listed, have the person identify which have not worked and cross them off with a red marker. Tell the group that the worst way to solve a problem is to keep doing what doesn’t work. Leave any solutions that have been somewhat successful on the list.

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32. What Norma has tried • Tried to get Christine to communicate with her about this problem • Tried to talk to Christine’s doctor • Tried to involve her sister to help • Tried to involve her “NAMI family” • Brought Christine to work to get her out of the house

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34. Tasks to accomplish in Step #2Generate Options • Ask the group for new options • Ask that the options be as specific as possible • No options should be discounted or eliminated. This is a brainstorming session and all options are valid in this process

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36. The group continues to brainstorm a range of options

37. Tasks to accomplish in Step #2What if’s • Summarize the list of options suggested by the group • Ask the person to pick a “first choice” option and underline that option with a red marker • Ask the person: What if this doesn’t work? Then allow the person to select a second choice from the list as a backup solution. Star this item on the list and give them the entire list to take home

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39. Problem SolvingTechnique Step #3: Set realistic expectations The final step of Problem Solving is to remind the person with the problem that it is important to create some realistic expectations of • One’s self • One’s family The goal of setting realistic expectations for ourselves and others is to remain aware that while there are many aspects of mental illness that are responsive to problem solving, there are many that will not be. Our message of hope is that we must never give up working together.

40. For more information on the Problem Solving Technique and other skills used in the provision of NAMI signature programs please visit the NAMI Education, Training and Support Center Help Desk at www.nami.org/eduhelpdesk