Working in a family therapy setting with families where a parent has a mental illness: practice dilemmas and strategies

Abstract

There is strong evidence supporting the benefits of family work, for both parents and children, in the treatment of parental mental illness. However, there has been only limited research on the implementation of family work in settings outside the mental health sector, such as family therapy or family counselling services, where mental illness may not be the primary presenting issue for a family. This article reports on a qualitative study that explored the experiences of family therapists working with families affected by parental mental illness. The article focuses on dilemmas clinicians faced integrating discussions about parental mental illness into family sessions. The findings support the need for clinicians to have appropriate training in family work related to mental health issues and also to develop the skill set needed to actively introduce, negotiate and explore the topic of mental illness with families. Practitioners points Developing knowledge, language and confidence in talking about mental illness may assist clinicians to raise discussions about parental mental illness in family sessions. Training in evidence‐based interventions for working with children of parents with a mental illness may provide a tool for clinicians in family sessions. Clinicians must be attuned to the ‘emotional readiness’ of parents and children to discuss parental mental illness. Developing readiness may take time.

Severe Mental Illness and Family Involvement During Treatment

“…For example, children of parents with severe mental illness are more susceptible to poor emotional and social outcomes. Parents with SMI are at a higher risk for poverty and homelessness (Power et al, 2015).…”

A unique regional family interventions training programme

“…Our 10-day course allows us to address a range of issues such as the influence of parental mental illness on children (Power et al, 2015;Whitlock and Rapsey, 2016), the importance of tailoring the sessions to meet family members' needs, and the different types of family involvement including -"routine" and "formal family interventions" (IRIS, 2012); "triangle of care" partnership working; "partner assisted", "disorder specific" and "couple/family therapy" (based on Baucom et al, 2012) and individual and multiple family therapy (Gelin et al, 2018). In addition, from the first day the group of clinicians from each service are encouraged to plan how they will be able to practice and maintain their newfound skills in their particular work context.…”

A Delphi survey to explore best practice for practitioners offering family intervention for psychosis to families with children

“…In circumstances specific to psychosis, Power et al () highlight challenges which arise in treatment when raising questions about the impact of psychosis for each member of the family, given the risk of provoking feelings of shame in the parent. They discuss ways of asking questions that make it more possible to explore the mental health issue and share information with the family where this seems helpful.…”