This study provides evidence that FFEP is helpful to relatives of persons with SMI by reducing subjective burden and worry, and increasing empowerment, knowledge about SMI, understanding the mental health system, and self-care.

Objective The Family-to-Family Education Program (FTF) is a 12-week course for family members of adults with mental illness offered by the National Alliance on Mental Illness (NAMI). This study evaluates the effectiveness of FTF. Method A total of 318 consenting participants in five Maryland counties were randomly assigned to take FTF immediately or to wait at least three months for the next available class with free use of any other NAMI, community or professional supports. Participants were interviewed at study enrollment and 3 months later (at course termination) regarding problem and emotion-focused coping, subjective illness burden, and distress. We used a linear mixed effects multilevel regression model to test for significant changes over time between intervention conditions. Results FTF participants had significantly greater improvements in problem-focused coping as measured by empowerment and illness knowledge. Exploratory analyses revealed FTF participants had significantly enhanced emotion-focused coping as measured by increased acceptance, reduced distress, and improved problem solving. Subjective illness burden did not differ between groups. Conclusion This study provides evidence that FTF is effective for enhancing coping and empowerment of families of persons with mental illness, though not for reducing subjective burden. Other benefits for problem solving and reducing distress are suggested, but require replication.

This study assessed the efficacy of the Family-to-Family Education Program, a structured 12-week program developed by the National Alliance for the Mentally Ill. A total of 37 family members who participated in the program were evaluated by an independent research team of trained family member assessors at baseline, after completing the program, and six months after program completion. After completing the program, the participants demonstrated significantly greater family, community, and service system empowerment and reduced displeasure and worry about the family member who had a mental illness. These benefits were sustained at six months.

One of the most telling indications of the failure of deinstitutionalization to improve the circumstances of individuals with serious brain disorders is the phenomenal growth of the family and consumer advocacy movement over the last twenty years. Although the early theoretical blueprints for community mental health called for alternative services designed by and for consumers and concerned family members, with both parties involved in program delivery as respected paraprofessionals, nowhere has this vision been realized in a global or systematic way. In spite of a social policy that returned seriously ill relatives to their families for care and support, traditional "blame the family" theories prevailed, and a mission to serve caring families never became an integral component of community treatment planning.Just as nature abhors a vacuum, so do social movements abhor inertia. What the conventional wisdom of the day withholds, those whose lives and prospects hang in the balance will eventually claim. A specific case in point is family education. Over the last generation an extensive literature has developed that describes the dilemma of burden among family caregivers and suggests criteria for programs to address family needs. A number of educational curricula have been developed under the separate theoretical provinces of "psychoeducation" and "family education," and reviews of this body of work are widely avail-

Objective This study examines 6-month follow-up data from participants in a randomized trial of a peer-driven 12-session family support and education program, called family-to-family (FTF) and offered by the US National Alliance on Mental Illness, to determine whether improvements in distress, family functioning, coping and empowerment were sustained. Method Individuals randomized to the FTF condition were assessed after program completion and then 3 months later on measures of distress, family functioning, coping, and empowerment. We used a multilevel regression model (SAS PROC MIXED) to test for significant changes over time (baseline, 3 and 9 months). Results All significant benefits that FTF participants gained between baseline and immediately post-FTF were sustained at 9 months including reduced anxiety, improved family problem-solving, increased positive coping, and increased knowledge. Greater class attendance was associated with larger increases in empowerment and reductions in depression and displeasure with ill relative. Conclusion Evidence suggests that benefits of the FTF program were sustained for at least 6 months without any additional boosters or supports. Peer-based programs may produce sustained benefits for individuals seeking help in addressing challenges and stresses related to having a family member with a mental illness.