Preparation

Partnering With Families Affected by Concurrent Disorders - Facilitators' Guide

In Preparation:

• Adapting the program
• Choosing a delivery method
• Relationship of program to other family and consumer services

Choosing a delivery method

This facilitator’s guide describes a multi-family group education and support program. However, our interviews underlined the importance of offering a variety of approaches to family education and support. Each of the 38 family members involved in our study were randomly assigned to either an education and support group for family members affected by concurrent disorders or to an intervention in which they received only A Family Guide to Concurrent Disorders .

The following comments illustrate the range of opinion among the participants in our study.

. . . you included all of the important areas and the material in all of the topics will help families to understand concurrent disorders. But I still think that you really need the process of meeting in a support group too—so it was all important.

I found for myself that often when I left the CD family group, I felt a little bit down, and I think that’s because I have a problem with guilt . . . and I would hear the other family members talk and some seemed to be doing more with their kids than I was doing with my son. So I was comparing a lot and I tend to do that—and sometimes I would come out at the end of the group feeling a little bit frustrated . . . if I had a choice, I would have preferred just having the manual and going through it on my own.

For me, both the group support and the education were helpful. There was so much I didn’t know—and every time there was a handout, I made sure that I took the time to read it . . . so that was very important for me. But then again, the interaction in the group was equally important. I couldn’t give more weight to one or the other.

One thing for me personally—I tend to like the educational material to read on my own instead of hearing from another person what they’re going through. At the time when I entered the study, I was actually hoping that I would be randomized into the manual group. But I understand that it was a study and that we couldn’t choose one intervention over the other, so I didn’t say anything. But I really did like the information we were given. I sometimes found too that I didn’t like talking in a group.

Program format

Research indicates that both multi-family and single family approaches are effective. There is some evidence that there is a correspondence between the effectiveness of a particular approach and the family’s circumstances. For example, families who have already had some experience with support groups often do better with a single family approach, while those whose relative has recently experienced a first episode of psychosis often find a multi-family group to be more effective (McFarlane et al., 2003). Ideally, substance use and mental health services would offer both types of approaches. In reality, practical considerations often determine the choice of format. In urban settings with constrained resources, multi-family groups are often the most practical option. On the other hand, agencies that serve a population spread over a large area may find it difficult to attract enough family members to support a group, and so may choose a single family format.

Group composition

Traditionally, service provider–led psychoeducation and education and support groups have focused on a single mental health diagnosis. However, requiring a single diagnosis often makes it more difficult to recruit enough family members to form a group. Fortunately, recent studies have suggested that groups consisting of families whose relatives have disparate primary psychiatric diagnoses have a number of issues in common and can reach a consensus on the content of the group program (Pollio, 2002). Pollio and his colleagues also found that parents, siblings and other family members identify a common set of core issues.

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Partnering With Families Affected by Concurrent Disorders

• Overview
• Working with families
• Preparation
• Implementation
• Evaluation
• Session Outlines
  • Session 1: Introduction
  • Session 2: Substance use problems
  • Session 3: Mental health problems
  • Session 4: How concurrent disorders affect family life
  • Session 5: Self-care
  • Session 6: Stigma
  • Session 7: Navigating the treatment system
  • Session 8: Medication
  • Session 9: Relapse prevention
  • Session 10: Crisis and emergency
  • Session 11: Recovery
  • Session 12: Saying goodbye
• References
• Resources
• Appendix 1: An Overview of the Research
• Appendix 2: The Partnering With Families Affected by Concurrent Disorders Project

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