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Welcome to the
Consumer Centered Family Consultation
“Family Education about Psychosis” Webinar
Hosted by:
The Family Institute for
Education, Practice & Research
The webinar will begin shortly. Thank you for your
patience.
For audio access, please call 1-800-244-9194, then enter
code: 990024#
For any technical difficulties, please call 585-732-4040
Agenda for Today
• Hello and introductions
• Family Education - Background and
introducing it to families/consumers
• Structure and Process Considerations
• Materials / Tools that may be helpful to share
• Wrap-up and discussion
What types of family education work
(on a 1:1 family/consumer basis) have
people already done?
Background: Factors that led to experts
viewing families as allies/partners
• Schizophrenia is a neurobiological disorder
• Biology, not families, causes schizophrenia
• Family factors influence psychosis outcomes
• Families are often default caregivers or case managers
• New treatments and approaches (e.g., person centeredness)
bring new roles for people
• Traditional family therapy is not effective for psychosis
• Specific family interventions are among the most effective
treatments for psychosis
Source: Amenson, C. S. Schizophrenia – Family Education Methods (copyright Pacific Clinics Institute)
Background: Family attitudes/skills that are
associated with positive psychosis outcomes
• Accepting the person as having psychosis
• Attribute symptoms to the condition
• Set realistic, attainable goals
• Include the person in the family
• Provide support from a loving distance
• Maintain a calm family atmosphere
• Give frequent praise and encouragement
• Give specific constructive criticism and/or suggestions to
promote growth
Source: Amenson, C. S. Schizophrenia – Family Education Methods (copyright Pacific Clinics Institute)
These family factors are
teachable skills
Education about psychosis
is often a first step in families
learning these skills
Goals of Family Education in Psychosis
• Provide information about the illness
• Provide a rationale for treatment
• Reduce guilt and blame of all involved
• Foster realistic expectations and hope
• Discuss role(s) that families/supports can have in promoting
recovery
• Improve access to services
• Other?
Introducing “Education” to
Families/Supports and Consumers
•
•
•
•
•
Share the idea of providing education to
everyone
Suggest that education can help everyone
in the family/system
Transparency: talk openly about the goals
for education [prior slide]
Psychosis education with supports should
be considered a strategy for helping
consumer achieve his/her specific goal(s)
Offer to provide education (within CCFC)
Be Clear About Structure and Format
of Education
• This is not a “process” and/or support session
• This is not a session with an open-ended agenda
• There is not an unlimited number of sessions
• This is not skills training/coaching
• This is not a session to solve problems
• This is not meant to clarify problems, generate solutions,
and help people select best course of action
Be Clear About Structure and Format
of Education (cont)
• This is designed to provide knowledge and
resources
• This has a concrete agenda that (mostly) should be
clarified “up front” and adhered to
• This is time-limited and curriculum/resource based
• This may or may not introduce skills
Tips
•
Set agenda in advance of meeting
•
Bring enough copies of materials
•
Over-estimate the time it will take to go
through materials
•
Keep one eye on the clock
•
Go slower than you’d think
Tips
•
Take time to orient people to each handout – take
several breaths – then move forward
•
Don’t go into all of the details, and tell people why
you’re doing this (may need to assess reading
levels/interest)
•
Don’t let yourself become overwhelmed by multiple
problems, new issues, or questions that slow the
pace
•
Repeat, repeat, repeat
*Sample Agenda from CCFC*
Education Meeting
Materials that may be helpful
to share with
families/supports
Psychosis – The Basics
[slides developed for and used with families]
Symptoms Indicating Psychosis
 Hallucinations
Hearing voices or seeing visions
 Delusions
False beliefs or marked suspicions of others
 Disorganized thinking
Jumbled thoughts, difficulty concentrating
Copyright West Institute
Evidence-Based Practices
William R. McFarlane, MD
Functions of the Prefrontal Cortex
• Problem-solving
• Planning
• Attention
• Initiative
• Motivation
• Integration of thought and affect
• Mental liveliness
Copyright West Institute
Evidence-Based Practices
William R. McFarlane, MD
Psychosis represents an unusual
sensitivity to:

Sensory stimulation

Prolonged stress, strenuous demands

Rapid change

Complexity

Social disruption

Illicit drugs and alcohol

Negative emotional experience
Copyright West Institute
Evidence-Based Practices
William R. McFarlane, MD
Psychological Functioning:
Attention & Sensory Overload
• In order to pay attention, the human brain needs
to filter and integrate incoming information
• In a psychotic state, people are over-loaded,
which makes it hard to pay attention…information
is missed
• With negative symptoms, a person is slow to
register information and/or has poor attention
EXPERIENCE OF PSYCHOSIS
Actual Experiences
“Sometimes when people speak to me my head is
overloaded. It’s too much to hold at once. It goes out as
quick as it goes in. It makes you forget what you just
heard because you can’t get hearing long enough. It’s just
words in the air unless you can figure it out from their
faces.”
Actual Experiences
“People took on a devilish look with a black outline and
white shining eyes: all sorts of objects—chairs, buildings,
obstacles—took on a life of their own; they seemed to
make threatening gestures, to have an animistic outlook.”
Schizophrenia
Overview Packet
(Document adapted from the Training &
Education Center, Philadelphia, PA)
The Complete Family
Guide to Schizophrenia
Mueser & Gingerich (2006).
When someone you love
has a mental illness
Woolis, R. (2003).
The Family Guidelines
Family Guidelines – Sources: Carol Anderson, Schizophrenia and the Family (Guilford Press, 1986); Dr.
William McFarlane, Multi-Family Groups in the Treatment of Severe Psychiatric Disorders (Guilford Press,
September 2004).
Family Guidelines
1.
Go slow—things will get better in their own time.
2.
Keep it cool—tone down disagreements and enthusiasm.
3.
Keep it warm—stay connected, supportive and respectful.
4.
Give each other space—time out is important for everyone.
5.
Set limits—a few good rules keep things clear.
6.
Ignore what you cannot change—let some things slide, but DON’T
ignore violence.
7.
Keep it simple—say what you have to say in clear, calm, positive terms.
Family Guidelines
(continued)
8.
Follow the treatment plan (Consider using medications)—take
9.
Carry on business as usual—re-establish family routines as quickly as possible
only medications that are prescribed and take them only as prescribed.
and reconnect with family and friends.
10. Take care of yourself—it’s important to keep your own batteries “charged”.
11. Avoid street drugs or alcohol—they make symptoms worse.
12. Pick up on early warning signs—observe changes then consult with your
clinician.
13. Solve problems step by step—make changes gradually…work on one thing at a
time.
14. Lower expectations temporarily—don’t make unrealistic comparisons, e.g.,
compare this month to last month rather than this year to last year.
Sample “Future” Education Topics to
Cover with Families/Supports and
Consumers…
•
Information in the CCFC training guide
•
Skills for Relapse Prevention
•
Future Planning
•
Communication Skills
•
Other books
•
APA and other trade association materials
•
On-line / web-based information (e.g., SAMHSA, NIMH, NAMI)
•
Partnering with local NAMI affiliate (Family to Family Education program)
Questions to Consider…
• What are your thoughts and/or
reactions to providing education
to families/supports?
• How does this fit in (or not fit in)
with the work you’re doing with
consumers?
Discussion and Q & A
Thank you for being with us today
• Please complete the 3 survey questions before you
log off.
• The slides in this webinar will be made available on
our website at www.nysfamilyinstitute.org
• Next event for PRACTITIONERS will be held on July9th
& 10th from 3:00pm-4:00pm
• Next webinar series for QITs will be held on July2nd &
3rd from 3:00pm-4:00pm

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