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The Family Crisis Moment The Impact of Mental Illness on Families
PSRT 4271: The Family Role in Rehabilitation
Week Four (June 21, 2012)
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The Family Crisis Moment
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What is a crisis? (Roberts, 2005)
“…disruption of psychological homeostatis…”
“…usual coping mechanisms fail…”
“…distress and functional impairment…”
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A perception… (Bard and Ellison, 1974)
“…subjective reaction…”
“…to stressful life experience…”
Functioning “…seriously compromised...”
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Characteristics of those in crisis Threat
Incapacity
Fear
Discomfort
Disequilibrium
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Crisis Theory
There is such a thing…
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Roberts’ Crisis Intervention Model(Roberts, 2000)
7. Follow up. 6. Make an action plan. 5. Explore alternatives. 4. Deal with feelings. 3. Identify major problems. 2. Establish rapport.1. Assess lethality.
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How people react to disability (Power & Dell Orto, 2004)
5 determinants:
1. Triggering events2. Severity of disability3. Personal influences4. Contextual influences5. Stigma; societal reactions
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Effects: 8 “themes” (Power & Dell Orto,
2004) Denial Grief Guilt Isolation Anger Depression Coping Acceptance
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Needs (Power & Dell Orto, 2004)
Meaning Support Validation Information Balance
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Ways of Coping
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Providers: How to help? (Clarke & Windsor, 2010)
Acknowledge; connect; engage
Offer coping mechanisms
Comprehensive involvement at discharge
Instill hope
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Impact on Families(The Raft of Medusa, by Theodore Gericault, 1791–1824)
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Mothers (Copeland & Heileman, 2011)
Feelings Powerless, voiceless, anxious, frustrated,
isolated, tired, desperate, trapped, guilty, worried, scared, sad, grief, confused
“Internal factors” Sense of safety Perception of care ability Contingencies and consequences Maternal love and obligations
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Fathers (Wiens & Daniluk, 2009)
1. Reflection on roles2. Devastation and vulnerability3. Sadness and loss4. Frustration with the system5. Admiration for the child6. Personal growth and learning
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Siblings (Lukens, Thorning & Lorher, 2002)
One step removed…
Reactions to illness Strategies for coping
Whether, how to intervene? Setting limits? Resentment, anger, hopeless?
Efforts to obtain services Wish for validation
Efforts to help themselves
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Grandparents (Seeman, 2009)
What happens when ill child has children?
Custodial, co-resident, nonresident… Child’s exposure to mother’s illness
Financial impact Isolation Role conflicts Divided loyalties
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Our Presentation Topic…
Bellevue Inside Out Trailerhttp://www.youtube.com/watch?v=Ojd_fsHbGl8
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Our guest presenter…Ravi Maharahj, Middlesex County Crisis Screening Center