Family-to-Family Education Course

1. Family-to-Family Education Course Cathy Epperson Kathy Keller NAMI Kentucky NAMI Northern Kentucky May 20, 2011

2. History • First offered in 1989 • 300,000 people have taken the course • Offered in 49 states & 3 other countries • Presented in 6 languages

3. Course Results Dept. 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

4. Course Operations • FREE to all students • Trained volunteer peer-teachers • Teachers read course material for fidelity

5. 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

6. Participants • Commitment to attend each class • Have friend/ family member with mental illness • 16-25 participants per class • 19 or older • Not a support group

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

8. Stages of Emotional Responses • I. Dealing with Catastrophic Events • II. Learning to Cope • III. Moving into Advocacy

9. 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

10. 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

11. 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. III. MOVING INTO ADVOCACY EMOTIONS • Understanding • Acceptance • Advocacy/Action NEEDS • Activism • Restoring balance in life • Responsiveness from System • NAMI

12. 3 Aspects of Mental Illness • Medical • Emotional • Social The course covers all three aspects

13. 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

14. BIOLOGICAL/PHYSICAL(continued) • Adherence to medication • Scientific advances in medications • Early warning signs of relapse • Best medical strategies to maximize recovery

15. BIOLOGICAL/PHYSICAL(continued) • Discuss genetic aspects of mental illness • Cover theories of causality • Try to override guilt • Functions of neurotransmitters

16. BIOLOGICAL/PHYSICAL(continued) • Understanding clinical diagnosis • Share current research • Teach effective interaction with BH specialists

17. BIOLOGICAL/PHYSICAL(continued) • Emphasis on physical ennui • Programs often ignore effects of “brain attack” • Teach to expect extensive recovery period • Resist unrealistic expectations

18. 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

19. Managing Crisis • Go through crisis file • Makes contacting society services easier • Includes practical information • Use to help in a crisis

20. 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

21. 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

22. 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

23. 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

24. 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

25. Social/Occupational(Rehabilitation Dimension) Recovery based knowledge Course Focus: self/renewal re-entry into community • Definitions of recovery • Principals of rehabilitation • Testimonials of recovery • Educated about societal support • Teach problem-solving process

26. 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

27. End of Course • The course is life-changing • Families report ill member’s improved prognosis • Increased empathy of family member to ill relative