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Family-focused practice in mental health care: an integrative review Highlights  In mental health services, family-focused practice is poorly defined concept  An integrative review was conducted to synthesize evidence in this area  Six core and inter-related family-focused practices were identified  Family as defined by its members provides a basis for "whole of family" care ABSTRACTWhile mental health services are increasingly encouraged to engage in family-focused practice, it is a nebulous and poorly understood term. The aim of this paper was to examine and synthesize evidence on the concept and scope of family-focused practice in adult and child and youth mental health care settings. An integrative literature review method was used. Medline, Embase, CINAHL, PsycInfo and Proquest electronic databases were systematically searched for abstracts published in English between 1994-2014. Data were extracted and constant comparative analysis conducted with 40 included articles. Family-focused practice was conceptualised variously depending on who was included in the "family", whether the focus was family of origin or family of procreation, and the context of practice. As a finding of the review, six core and inter-related family-focused practices were identified: family care planning and goal-setting; liaison between families and services; instrumental, emotional and social support; assessment; psychoeducation; and a coordinated system of care between families and services.While family is a troubled concept, "family" as defined by its members forms a basis for practice that is oriented to providing a "whole of family" approach to care. In order to strengthen family members" wellbeing and improve their individual and collective outcomes, key principles and practices of family-focused practice are recommended for clinicians and policy makers across mental health settings.

Mental health nurses work in challenging and potentially high stress settings. Stressors can occur in the context of consumer, family, and/or staff relationships, as well as the work environment and organization. The cumulative effects of stress and professional challenges can lead to harmful impacts for mental health nurses including burnout and poorer physical and mental health. Resilience involves a process of positive adaptation to stress and adversity. The aims of this integrative review were to examine understandings and perspectives on resilience, and explore and synthesize the state of knowledge on resilience in mental health nursing. Following systematic search processes, screening, and data extraction, 12 articles were included. Constant comparative analysis and synthesis of the data resulted in two key categories: Theoretical concepts of resilience and Knowledge on mental health nurses’ resilience. In mental health nursing, resilience has been variously constructed as an individual ability, collective capacity, or as an interactive person–environment process. Resilience was most often reported as low‐moderate, with positive correlations with hardiness, self‐esteem, life and job satisfaction, and negative correlations with depression and burnout. A resilience programme improved mental health nurses’ coping self‐efficacy and capacity to regulate thoughts and emotions and developed their resilient practice. Use of contemporary resilience definitions will inform more consistent investigation and progressively scaffold knowledge of this emergent construct in mental health nursing. Future research on the implementation of resilience programmes and resilience‐building strategies for mental health nurses at the individual, work unit, and organizational levels is needed.