Session One: Introduction

Partnering With Families Affected by Concurrent Disorders - Facilitators' Guide

Session Goals

• Welcome and engage participants.
• Provide overview of support group process.
• Identify and address participants’ concerns and issues.
• Start the discussion of how substance use and mental health problems interact.

Content Outline

• Understanding the terminology.
• The relationship between substance use and mental health problems.
• The impact of concurrent disorders.
• The biopsychosocial approach to understanding concurrent disorders.
• An introduction to treatment.

Leaders’ Notes

Most participants like the opportunity to check in at the beginning of each session. For the facilitator, this creates the challenge of working with participants’ stories and connecting them with the key themes for the session. Participants are often anxious to share information about life events. We have found that allowing this to happen first is much more engaging for the participants than requiring that they wait until we have introduced our material.

Introducing the group: a checklist of topics to cover

• Introductions (families and facilitators introduce themselves and give a five-minute overview of why they are here).
• Overview of purpose and process.
• Weekly group—follow-up at intervals over the next 12 months.
• Facilitators’ goals.
• Group members’ goals.
• Confidentiality.
• Differences among participants—the principle of respect.
• “Air time”—giving everyone a chance, making sure everyone is included, not being clock-watchers.
• Facilitators’ role.
• Group members’ role.
• Housekeeping—breaks, bathrooms, refreshments, seating.
• Group structure—readings, activities, attendance, checking in when absent.
• Check-out at the end of the session—discuss concerns, suggestions, requests with the group.

Icebreakers

To help the group members get to know one another, consider using some activities where each group member responds to questions by moving to a place in the room that represents his or her answer. For example, line people up in a row and ask them to guess the percentage of people who will have—over their lifetime:

• a mental health problem
• a substance use problem
• both problems.

Move the participants into groups that represent the actual percentages, and ask them how these facts match their assumptions or perceptions. The goal is to use the information to invite participants to comment, share their reactions and interact with one another. It is important to proceed carefully and respectfully, and to acknowledge that no one should feel coerced or obliged to participate.

Other easy icebreakers include:

• asking people to arrange themselves in a line that represents the distance that each member has travelled to attend the session—from the longest to shortest distance
• asking people to arrange themselves in a line that represents the length of time they have been dealing with the health problems of the family member they are concerned about. To figure out who has spent more or less time dealing with the issue, and where in the line they should be located, they will have to interact with one another.

Once the group members have started to feel comfortable with one another, you can ask them to group themselves in terms of their relationship to the family member with concurrent disorders. For example, have the parents, (or mothers and fathers separately) group themselves, have siblings group, offspring, or spouse and partners, or friends. You could also ask the members to form groups based on the gender of the family member with concurrent disorders (male or female) or by mental health or substance use diagnosis.

A suggested order is:

• travel distance
• family member status (father, mother, offspring, spouse/partner, sibling, friend)
• mental health issues involved
• addiction issue involved
• length of time they have been dealing with mental health and addiction issues
• length of time involved with the health care system.

Stop and process participants’ thoughts, observations and comments after each activity with some, of course, taking more time than others.

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Partnering With Families Affected by Concurrent Disorders - Facilitators' Guide

• 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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