The family experience of mental illness: Implications for intervention.

Abstract

This article discusses the family experience of serious mental illness, including subjective and objective burden, potential for family resilience, family roles, and personal and family variables that can mediate the impact of the illness. Following a specification of essential family needs, a number of effective family interventions are presented, including family support and advocacy groups, family consultation, family education, family psychoeducation, and psychotherapy. Finally, the authors examine ways of resolving potential conflicts related to confidentiality and offer suggestions that can enhance the effectiveness of psychologists who work with these families.The serious mental illness of a close relative is a catastrophic event for families. In the words of one family member, "This terrible illness colors everything-a family cannot escape." Because mental illness is often severe and persistent, psychologists are likely to have many opportunities to meet the needs of family members themselves and to assist them in supporting their relative's treatment, rehabilitation, and recovery. In fact, with their broad biopsychosocial perspective and wide range of expertise, psychologists are uniquely suited for meeting the needs of this highly stressed population.In this article, we assist practitioners to build on their existing competencies, to acquire new knowledge and skills, and to develop more effective intervention strategies. We begin with a discussion of the family experience of mental illness, sharing vignettes from our research with family members (vignettes without citations are from Marsh & Dickens, in press). We then present a number of family interventions that can be modified to meet the needs of individual families and can be offered in a variety of settings. The Family Experience of Mental IllnessMental illness has a profound effect on all members of the family, as the following woman asserts:All family members are affected by a loved one's mental illness. The entire family system needs to be addressed. To assure us that

Dilemmas in applying strengths-based approaches in working with offenders with mental illness: A critical multidisciplinary review

“…In this respect, Bourdieu's theory of 'social capital' makes clear that relations with social network and family members without mental illness are essential in empowering mentally ill persons to participate in society (Vander Laenen, 2011). However, it goes without saying that taking care of someone with a mental illness may impose a heavy burden on families and social network members in various domains of life (Lautenschlager et al, 2013;Marsh & Johnson, 1997).…”

The role and experiences of family members during the rehabilitation of mentally ill offenders

“…However, supportive families have to overcome cycles of hope and despair and this can create greater levels of personal advocacy and assertiveness (Spaniol, 2010). Despite this, research into the participation of families in support and treatment rarely discusses the family strengths (Spaniol and Zipple, 1988;Marsh and Johnson, 1997;Tsang et al, 2003;Wynaden, 2007;Ewertzon et al, 2010).…”

“…These strengths have been defined as: "the set of relationships and processes that support and protect families and family members, especially during times of adversity and change; they help to maintain the family cohesion" (Anderson Moore et al, 2002, p.1). Hence, families are now increasingly considered as a critical source of support during the rehabilitation process of their mentally ill relative and are regarded as crisis intervention specialists because they handle relapses and emergencies and protect vulnerable family members (Loukissa, 1995;Marsh and Johnson, 1997;Wynaden, 2007). However, supportive families have to overcome cycles of hope and despair and this can create greater levels of personal advocacy and assertiveness (Spaniol, 2010).…”

“…Taking care of a relative with a mental illness imposes various challenges or "burdens" (a concept developed by Grad and Sainsburry in 1963) on families (Marsh and Johnson, 1997;Lautenschlager et al, 2013). Because the concept of 'burden' is often used in the literature on family members of mentally ill persons (cf.…”

“…Families experience difficulties both objectively and subjectively; they have to deal with both the symptoms of the mental illness, caregiving responsibilities and social stigma (objective burden) and intense emotions such as grief, disbelief, anger, guilt, anxiety and shame (subjective burden) (Thompson and Doll, 1982;Fadden et al, 1987;Maurin and Boyd, 1990;Loukissa, 1995;Baronet, 1999;Marsh and Johnson, 1997;Foldemo et al, 2005). Most studies have focused on families experiencing difficulties, although others have shown that families can change their lives and build family resilience over time (Marsh and Johnson, 1997;Wynaden, 2007;Mokgothu et al, 2015). This shows that, given time, family members can become empowered by recognizing family strengths.…”