Issues in Implementing Family Work in Services

Abstract

Family work for psychosis has a strong evidence base demonstrating that a marked reduction in relapse rates can be achieved when information and support is offered to the family, and when relatives are helped to develop effective strategies to deal with the challenging situations they face. In some countries such as the UK, the strength of the evidence base has resulted in the development of guidelines and policies stipulating that families should receive appropriate interventions. In other countries, where such policies do not exist, whether or not families receive support tends to depend on the interests of individual clinicians.

Those attempting to implement family work in routine mental health services can encounter various obstacles. Some staff do not posses the skills to deliver family work. Some services, particularly in adult mental health, concentrate on the individual with the mental health difficulties and are not aware of the importance of the person's social network in their recovery. Some managers do not prioritise family work or facilitate their staff in having the time needed for training or for implementing this type of intervention.

This paper will outline effective strategies for ensuring that evidence-based family interventions are available to the families of those with psychosis and other serious mental health difficulties. These will include strategies to address the following:

• • Organisational issues;

• • Training of staff;

• • Supervision;

• • Role of management;

• • Involving family members to advocate for change;

• • Changing service structures to ensure the delivery of family work.