re-designed nami family-to-family manual
DESCRIPTION
A complete redesign for a friendlier and easiler to follow manual. Notice the hierarchy!TRANSCRIPT
Family-to-FamilyEducation Program
Open Your Mind
NAMI
Compiled and Written by Joyce Burland, Ph.D., National Director
NAMI Family-to-Family Education Program Second Edition ©NAMI, 2001
The Family-to-Family Education Program is sponsored by a charitable contribution from Bristol-Myers Squibb and Otsuka American Pharmaceutical, Inc. Coming together in partnership with NAMI to enhance human life.
NAMI FAMILY TO FAMILY EDUCATION PROGRAM 2/03ei
Table of Contents Nuts and Bolts: Basic elements of organizing a
family education class; the pre-course family visit;
course description; group process Skills for our
model of peer family education; specific leader attributes
that help in teaching family education; principles of help-
ing families through trauma.
Outreach Strategies: Planning for success; local
notice/poster; sample outreach letters; sample
newspaper ads and press coverage; deadline
schedule; strategies for outreach in rural areas (which are
useful in any area).
Technical Timetables and Tasks: Work sched-
ules for Contact Teachers; preparation of local and
state course handouts; sample handout pages;
record keeping tasks; specific tasks for Program Directors
and Teachers.
CLASS 1
Introduction: Special features of the course; learn-
ing about the normative stages of our emotional
reactions to the trauma of mental illness; out
belief system and principles; your goals, for your
family member with: mental illness; understanding
illness symptoms as a “double-edged sword”.
CLASS 2
Schizophrenia. Major Depression, Mania, Schizoaf-
fective Disorder: Diagnostic criteria; characteristic
features of psychotic illnesses; questions and
answers about getting through the critical periods
in mental illness; keeping a Crisis File.
CLASS 3
Mood Disorders, Borderline Personality Disorder,
Anxiety Disorders, Dual Diagnosis: Types and
sub-types of Depression and Bipolar Disorder,
diagnostic criteria for Borderline Personality
Disorder, Panic, Disorder and Obsessive-Compul-
sive Disorder; Co-occurring brain and addictive
disorders; telling our stories.
1
2
3
4Curriculum in Family Education
TABLE OF CONTENTS ii
CLASS 4
Basics about the Brain: Functions of key ‘brain
areas”; research on functional and structural
brain abnormalities in the major mental illnesses;
chemical imbalances in the brain; pathophysiology
of brain cells and neurogenesis; genetic research;
infectious and developmental “second hits” which
may cause mental illness; the biology of recovery:
NAMI Science and Treatment video.
CLASS 5
Problem Solving Skills Workshop: How to define a
problem; sharing our problem statements; solving
the problem; setting limits.
CLASS 6
Medication Review: How medications work; basic
psychopharmacology of the mood disorders;
anxiety disorders and schizophrenia; medication
side effects; key treatment issues; stages of
adherence to medications; early warning signs of
relapse.
CLASS 7
Inside Mental Illness: Understanding the
subjective experience of coping with a brain
disorder; problems in maintaining self-esteem
and positive identity; gaining empathy for the
psychological struggle to protect one’s integrity in
mental illness.
CLASS 8
Communication Skills Workshop: How illness
interferes with the capacity to communicate;
learning to be clear, how to respond when the
topic is loaded; talking to the person behind the
symptoms of mental illness.
CLASS 9
Self-Care: Learning about Family Burden: sharing
in relative groups; handling negative feelings of
anger, entrapment, guilt and -grief; how to balance
our lives.
CLASS 10
The Vision and Potential Recovery: Learning about
key principles of rehabilitation and model
programs of community support; a first-person
account of recovery from a consumer.
CLASS 11
Advocacy: Challenging the Power of Stigma in our
lives; learning how to change the system; meet
and hear from people advocating for change
CLASS 12
Review: Certification ceremony; Party!
567
Course Forms: For teacher’s use only
Glossary: Psychiatric definitions and terms
Bibliography: Using your local library; Reference Lists
NAMI FAMILY TO FAMILY EDUCATION PROGRAM 2/03e1.A
1. One of the important things we are modeling in
Class 1 is “being comfortable” with self-disclosure. Be
sure to take time to think through what you want to
stay in your “self-introduction” on page 1.1. We are
also modeling how to limit the “Saga”: Do not let your-
self go over 2 minute time restriction here.
2. The second main job to do in Class 1 is to draw your
class into the course. This we accomplish through
our hospitality and warmth from the minute people
arrive until the “Thanks and Goodnight!” at the end.
You might want to imagine that you are having this
gatherining in your home, where consideration and
concern for “the guest” would be the order of the day.
3. Be sure in the Warm-up Activity that you don’t lose
time. You need to move through each section of the
class without bogging down in any one place. Keep
the lecture sections going and rev up the energy up
after the break.
Your local Support Group Facilitator will attend the
first half of Class 1 to meet participants and inform
thema bout the Support Group meetings. At the end
of the Warm-Up Activity introductions, you will intro-
duce him/her, which will also take a bit more time.
4. On page 1.16, we urge people to join NAMI. Be sure
to bring your state or affiliate membership forms to
Class 1, and keep them out on the resource table for
the duration of the course.
Anytime, in any class, when you feel is appropriate,
tell your group how valuable NAMI membership is, or
disclose how much it has meant to you, personally,
to be a NAMI member. Don’t wait until Class 11 to
promote membership: Help your class understand
how important this is as you go along.
5. In this new version of the course, class participants
will sometimes have the actual lecture text in their
Class Handouts, so they can easily “follow’ what you
are saying. Your Leader Notes will tell you to cue your
class when this cocurs. In Class 1, the lecture text is
included in Class Handouts 4, 6, and 7.
6. Don’t be concerned if you see the class reading a
handout while you are lecturing. Letting the class fol-
low the lecture this way gives participants relief from
“Just listening” to lecture material.
Regarding the contract: we want everyone to hang
in for the whole course. The contract is clear that
except for emergencies, or essential prior commit-
ments, we want class members to stay together, and
attend every class.
7. If you don’t have a support group in your area, tell
the group you might want to stay together after the
course and start a Supporting Group.
Teaching Notes
CLASS 1: INTRODUCTION TO FAMILY EDUCATION
CLASS 1 1.B
1. Call your local Support Group facilitator early so he
can plan to attend CLass 1. (Also set the date for the
Facilitator to attend the Class 12 Party).
2. You will need to set aside time to put the Class
Notebooks together prior to CLass 1. Each notebook
will contain the Title page, Table of contents, Acknowl-
edgements, Library Access Page, Bibliography and
Glossary.
3. Be sure to prepare: Class handout #5: Support
group information (page 1.21); fill in the correct dates
and names on your Course Schedule (Class handout
#9, page 1.26(; xerox the number o copies of these
Handouts you will need. (Samples of these 2 pages
are included at the back of this section after the Sup-
port Person Job Description, page 1.j.).
4. Get material together for your Resource Table. In
Class 1, you should have NAMI brouchures, yoru af-
filiate brochure, back issues of NAMI Advocate, back
issues of your state newsletters, etc.
5. Time: Get set up early in your class location. Start
promptly no later than 5 minutes after the hour.
Be sure to limit the length of time group members
take during the “Goals” exercise, page 1.11. We
have added a chart here so the class can “seee’ the
4 points. Keep them on track by referring them back
to your chart points. Ask for their help and coopera-
tion, if you need to, so you can finish on time. We want
families attending the courese to be our “partners” in
making the course work.
6. Note that most Agenda titles are now “announced”
in the “Transitions” in the lecture.
Technical Notes
At the end of class, pass around the “Class Sign-Up
Sheet,” so you will haev the name and telephone
numbers of class participants. (Be sure to list your
R/S person as a class member). Add any newcomers
through class 3 to this list. This will be your refer-
ence “calling list.”
It will also be your class “starting list” to compare
with your FInal Class Consensus at Class 12. This will
help us keep track of drop-outs. (The Sign-Up Sheet is
located in the “Course Forms” section of your note-
book.)
8. Each week be sure to post the Our Belief System
and Principles chart you make in Class 1.
NAMI FAMILY TO FAMILY EDUCATION PROGRAM 2/03e1.C
CLASS 1: INTRODUCTION TO FAMILY EDUCATION
Welcome!
Word From Our Sponsors!”: NAMI and our
NAMI state organization
Special Features of the NAMI Family-to-Family
Education Course Curriculum
Our Belief System and Principles
Making a Contract
What are your Goals of Independence,
or Healthy Dependence, For Your
Ill Relative?
Understanding Illness Symptoms as a
“Double-Edged” Sword
Homework Handouts and Housekeeping!
Learning about Feelings: Normative Stages
of Our Emotional Reactions to the Trauma of
Mental Illness
Warm-Up Activity: Class Introductions
1 6
2
3
4
5
3 Essential Dimensions of Serious Brain Disorders
Giving you a Feast of Facts
Developing Emotional Understanding and Insight
Information about Our Local Support Group
Break: 10 Minutes
AGENDA
7
8
9
10
Thanks and Goodnight!
CLASS 1 1.D
3’’ x 5’’ cards and pens
Name tags
Easel with pad; big marking pen
Clock
1.5” course notebooks for participants
Class sign-up sheet
Materials for your resource table
Coffee maker
Coffe cups, napkins, plastic spoons
Decafeinnated coffee
Cream, sugar, sugar substitute
Cookies cakes
MATERIALS NEEDED CHECKLISTINSTRUCTIONS TO LEADERS
1. To prepare ahead and have ready for class 1
Have name tabes labeled and ready; have pens
and 3x5 cards at hand for warm up exercise;
have all 3 charts ready.
Decide which co-leader will pair with a student if
you have an uneven number of course partici-
pants. Be ready to introduce youreslf i you have
an odd count.
Have course notebook slabeled with each per-
son’s name. Have extra notebooks for walk-ins.
Have Class Sign-Up Sheet ready.
2. Arrive early to prepare for meeting place (chairs in a circle or grouped around table), make coffee,
tea, set out cookies, etc.
Have all charts ready.
Put out materials on your Resource Table (State
Newsletter, NAMI Advocate.)
3. Distribute class notebooks, nametags, and class
handouts as participants come.
4. Introduce local support group facilitator
5. At end of class distribute
Homework handouts for reading after Class 1.
Class Handout #9: Course Schedule
Get names/numbers on the Class Sign-Up Sheet
NAMI FAMILY TO FAMILY EDUCATION PROGRAM 2/03e
CLASS 1: INTRODUCTION TO FAMILY EDUCATION
Talk about your-
self and your
feelings, not
your ill relatives.
No sagas!
CO1
CO2
I. WelcomeCo-leaders stand at door to greet participants as they enter. Give out class handouts, note-
books and nametags. Start class 5 minutes after the appointed hour.
We want to welcome you to the opening class of The NAMI Family-to-Family
Education Course. We are very excited that this day has finally come and
we can be together, family to family, for this new learning adventure.
Orientation to the meeting space: Directions to phones, rest rooms,
etc. Discuss the duration of each meeting (2 1⁄2 hours with a IO-
minute break for refreshments), and the need for a prompt arrival, so
we can get started on time.
Introduction of both leaders: (Take no more than 2 minutes per)
1. Introduce yourself by name. Tell them briefly why you chose to
train and become a family educator.
2. Establish your “emotional” credentials: Self-disclose about the
most difficult thing you’ve had to deal with regarding mental ill-
ness in your family.
II. Who We Are and What We Do
We want to welcome you to the opening class of The NAMI Family-to-Family
Education Course. We are very excited that this day has finally come and
we can be together, family to family, for this new learning adventure.
NAMI was founded in 1979. Since that time, NAMI has grown into the fore-
most national advocacy organization for persons with brain disorders that
cause mental illness, and their families. Over the years this revolutionary
family and consumer movement has significantly influenced research and
treatment policies made at the highest levels of national government, and
its local affiliates have provided a haven of support and understanding for
thousands of family members seeking to help their loved ones.
Leader Note: direct class to handout #1: NAMI mission.
CO1+2
1.1
CLASS 1 1.2
On your handout NAMI is described ‘as “the nation’s voice on mental ill-
ness.” That’s absolutely right: today it is hard to imagine a world without
NAMI’s vigorous and effective public advocacy. Later hi the course we will
tell you about one of NAMI’s current and most visionary goals, The Cam-
paign for the Mind of America.
The program you are starting today (tonight) is now offered in 46 states,
the District of Columbia, Canada and Mexico to relatives, partners, and
friends of people struggling with mental illness. Over 100,000 people have
graduated from Family-to-Family; it is the
flagship peer education program sponsored by NAMl’s Education, Training
and Peer Support Center. But that’s not all! In addition to this program,
trained consumers are now teaching other consumers in the NAMI
Peer-to-Peer Recovery Course, and are joining with family members to
teach the NAMI Provider Education Program to line staff at public mental
health agencies.
Now, a word about our second sponsor: NAMI ____________________________
is our state alliance, which consists of __________ affiliates across the
state. (Introduce your affiliate here). Our work is closely linked to NAMI’s
advocacy goals, and to the support and empowerment of families. Class
Handout #2 is our NAMI ____________________________________ Mission
Statement. Bringing you this course is a prime example of our commitment
to family education.
Leader Note: If you have special funding sources in your state, be
sure to acknowledge them here.
(Transition:) Now to the next item on our Agenda. We want to tell you about
the special features of the curriculum we will be presenting to you in the 12
weeks of this course.
III. Special Features Of The NAMI Family-To-Family Course Curriculum
Because mental illnesses are disorders of the brain, we need to be ground-
ed in some key concepts, which are fundamental to all illness processes.
We call these basic illness concepts and we will be discussing two of them
in class tonight.
The first concept concerns how to “view” the illness experience. So much
of what we read and hear about dwells only on the medical aspects of seri-
ous illness--how symptoms are treated, what medications work best, etc.
It’s easy to forget that there are other dimensions just as crucial: serious
and persistent illness affects people’s hopes and dreams, and it occurs in a
social environment, which responds well or badly to their disability.
CO1
NAMI FAMILY TO FAMILY EDUCATION PROGRAM 2/03e
CO/2
We believe there is no way for us to understand the complexities of coping
with serious brain disorders without integrating the medical aspects of our
relatives’ illness with the emotional and social consequences of this expe-
rience. Therefore the course will cast a wide lens, exploring the biological,
psychological and environmental dimensions of brain disorders. To make
this clear, we have organized the topics in the curriculum for you along
these 3 essential dimensions ‘’bio-psycho-social’’ view of illness.
Leader Note: Direct class to Class Handout #3.
Process Note:
Orient the group to the 3 columns, reading only the top line of titles
down the page.
Then read each column down starting with the “Course Focus” and
ending with “Classes.”
Then read “Note” at the bottom and return to the lecture below.
Covering all these topics means that this course will offer a tremendous
wealth of factual information. Don’t worry about getting overwhelmed:
each of you is looking for specific things to fit the circumstances that you
are
personally dealing with. We will provide a “feast of facts,” and you will take
from it the “food for thought” you need most. We trust absolutely that you
will know best what is important for you.
Notice one other thing: The majority of classes in the course relate to
topics in the middle column--to the subjective feelings of family members
and to the lived experience of those who suffer from mental illness. This
emphasis on emotional understanding and insight of our relatives and
of ourselves, is a theme we will return to again and again. And, for our
last class, we will have a Class Party to celebrate the experience we have
shared together.
Leader Note: stop and ask for questions/comments from the class
about the curriculum.
Transition: Let’s turn now to the psychological/emotional dimension (which
we call ‘’Learning About Feelings”), and talk about the normative stages of
our emotional reactions to the trauma of mental illness.
IV. Learning About Feelings: Normative Stages Of Our Emotional Reactions To Trauma
Having a brain disorder strike someone we love in our family is totally
traumatic. It imposes an overwhelming burden of stress and anxiety upon
our lives. Because we are dealing with trauma, we need to learn about the
impact these devastating mental disorders have on our emotions. T
1.3
CLASS 1 1.4
he principle of recognizing and caring about our feelings comes from a
model of family education called Supportive Family Training, developed by
family member professional Sheila LeGacy.
We know we have many reactions to mental illness when it strikes some-
one we love. We rarely get a chance to talk: about these feelings with
people “in the system.” But with other family members we can talk about
our reactions. We can disclose how we feel, how the stress of care and
chronic worry
affects our lives.
From literally thousands of conversations between family members in
support groups, we know we experience intensely painful feelings and
reactions to mental illness, like:
Leader Note: ask participants to suggest some feelings they have
experienced. CO1+2
Process Note:
Write feelings down on pad as people suggest them. Use list below
for “coaching.”
What separates us from a lot of traditional thinking in the mental health
field is this: We believe these reactions “are perfectly normal responses,
given the catastrophes we are trying to adjust to: (Just look at all the
traumatic emotions up on the board)! We believe that we have a right to our
feelings, and that we need to understand and express them. So let’s spend
some time learning about the predictable stages of our emotional reac-
tions to mental illness.
Leader Note: Position Chart #1: “Stages of Emotional Response” so
everyone can see it.
You all recognize that mental illness has had an enormous impact on your
lives. What you may don’t know is that you tend to respond to this trauma
in characteristic and predictable ways. Many family members and family
member professionals have written about this “emotional response cycle”
we all go through. It is such an important aspect of our course that we will
go over it now in some detail.
Denial; Fear; Guilt
Sorrow; Grief
Disruption of family relationships
Exhaustion of spirit and resources
Difficulty accepting the illness
Sleeplessness Shame; Anger; Rage
Isolation
Confusion
Frustration
Depression
Apprehension about the future
Suggest some
of these words
to keep the
process going!
NAMI FAMILY TO FAMILY EDUCATION PROGRAM 2/03e
Leader Note: Direct class to handout #4: “Predictable Stages” so
group can follow lecture.
If you will look at your handout, you’ll see there are 9 separate stages of
emotional reactions involved in coming to terms with mental illness in a
family member. We’ve made a chart of this process, which we will be refer-
ring to throughout the course. Let’s go through the 9 emotional responses
first, and then return to the “needs” in each stage.
Leader Note: read the titles and descriptions of the 9 stages of
emotional response from the handout. Return to the lecture below
to read “points.”
There are some important points to emphasize here:
1. None of these stages are “wrong” or “bad.” They are normal
reactions everyone experiences when struggling to cope with
serious illness and trying to deal with critical disruptions in their
lives.
2. This process is ongoing--for most of us it has taken years. The
process is also cyclical; we will start it all over again every time
our relative has a relapse, or suffers a serious setback.
3. Different family members are often at different places in the
cycle, which is why we sometimes have difficulty communicating
with each other and agreeing on what to do.
4. This developmental account is not about expectations. This is
a human process that you do your way. If you know where you are
in it you can be gentler with yourself. We think it offers hope to
see that we do progress through pain and grief to acceptance.
5. As you get to know each other better in this class, you will
begin to recognize these stages and emotional reactions. In this
way, “old timers” help “newcomers”; we inform each other, we
validate our feelings.
Process Note: Ask class, “Do these stages look familiar to you?”
Get class reaction to the “predictable stages” concept.
Final Point: It is vitally important for family members to learn about these
emotional responses because where we are directs us to what we need in
any given stage of the cycle. For example, look at what we need when going
through the hard times of dealing with catastrophe.
Read needs, pointing at chart, Stage 1.
1.5
CLASS 1 1.6
CO1
By stage 2, we are full of emotion and have a different set of needs. We
need to “sound off,” learn to cope, learn all about the illness. Read stage 2
needs, ditto.
And by stage 3, we are getting it together. We need to restore the balance
in our lives; we find purpose in advocacy and action; we help others. As you
go through the NAMI Family-to-Family Education Course you will find the
course material specifically relates to these various levels of family needs.
That is why feelings are at the center of all that we do, and why “learning
about feelings” is a cornerstone of the course.
Transition To Warm-Up Activity: Well, you’ve been sitting for a while and
we want to move you around a bit. It’s time for class introductions, and we
have a special way for you to do this. .
V. Warm-Up Activity
Leader Note: put up chart #2: “topic list”; then read the following
instructions.
1. We will ask you to team up with a person in the class you don’t
know.
2. We want you to do a short interview with each other, talking about
what you’re interested in, what you do, what you like, etc. At the end
of your visit together, we will ask each of you to introduce your part-
ner to the whole group. You’ll have 3 minutes apiece for interviewing
each other.
3. We have only one rule we will ask you to follow: You’re “not allowed”
to talk about your relative who is ill.
4. We’ve posted a Topic List for you to follow. (Leader read topic list
chart.) We want you to say good things about yourself and “crow” a
little; after all, you don’t have to be modest when somebody else is
introducing you!
5. This exercise is not a memory test. If you want to, take notes about
your partner on your card. Also, if you forget anything in your introduc-
tion, your partner can “prompt” you. So, let’s have fun.
6. If you know your neighbor, move to a chair where you can interview
someone you don’t know. I’ll tell you when the first 3-minute interview
is up.
Process Note: when 3 minutes is up, leader tells the pairs to start
the second interview. After the next 3 minutes, the leader announces
time is up.
NAMI FAMILY TO FAMILY EDUCATION PROGRAM 2/03e1.7
CO1
CO1+2
Write bolded
headings on
easel pad as
leader reads
them.
Read bold
print to
indicate that
Handout #6
follows the
lecture.
Ask people to take a minute apiece to introduce their partners.
A word of welcome from the leader, and applause, should come at the
end of each introduction.
Leader Note: At the end of introductions, introduce the support
group facilitator and refer to class handout #5.
Facilitator: take 2-3 minutes to tell about local meetings.
Announce a class break of 10 minutes and refreshments.
Class break: 10 minutes
VI. Our Belief System and Principles CO:1
Now we want you to know about our belief system and principles, about
how we approach this curriculum as a group of family members.
Leader Note: direct class to class handout #6 so group can follow
lecture.
1. We will stay on top of the resources you might need: Throughout
the course, information will be made available to you about the
community services that you are entitled to. We have asked one of
our members to serve as a “Resource/Support Person” for this class
for the duration of the course to help with your questions and offer
support if you are in any kind of quandary or crisis with your mentally
ill relative during this time. I would like you to meet him/her now.
(Introduce resource support person.)
In addition, we consider each of you a valuable resource because of
your own experience dealing with mental health providers. We hope
that you will share these experiences with the group.
2. We have no magic formulas: When times get bad, and we know
there is no cure for serious mental illness, it is natural to look for
“magic answers” to our dilemmas. But there aren’t any. You have
certainly done your very best to deal with the intense and frustrating
problems you are presented with. We can try to learn as much as
possible about brain disorders, and that’s why we’re here.
3. We use empathy as the doorway to understanding; when we actu-
ally can grasp the lived experience of our relative with mental illness,
every aspect of communication and problem solving gets easier for
us. The classes will give you an understanding of what your relative
needs in order to function better in the world-and what can be done
CLASS 1
to encourage improved functioning. As your insight increases, you will
know what you can realistically expect from your family member.
4. We emphasize the “universal aspects” of mental illness; all brain
disorders involve a profound disturbance of the central nervous
system. Many of these illnesses are functionally related, and many
symptoms overlap. It’s important for us to be exposed to the
“universe” of brain disorders to understand better the range of prob-
lems our relative may be dealing with. So, no matter what diagnosis
our own relative has, we can all learn from each other’s experience.
5. We are vigilant “Guilt-Busters”: The blaming of family members is
the single, most devastating event in the lives of families of individu-
als with mental illness. As Ken Terkelson, a leading psychiatrist, has
said, “The thought of having brought harm to a loved family member,
intentionally or unintentionally, consciously or unconsciously, causes
intolerable guilt --and, we might add, pain, shame and stigma. In this
course, we will focus on mental illnesses as biological brain disorders.
We hope you will adopt, and insist upon, this “no-fault” approach.
6. You can’t know what no one has told you: Because of the
widespread convention of confidentiality in the mental health field,
many families remain in the dark for years about the true nature of
their relative’ s illness. As you learn new facts in this course, you may
feel that it is information you “should have known,” or “should have
gotten on your own.” We implore you to remember that you cannot
possibly know what no one has told you. None of us knew any of this
stuff until someone let us in on it!
7. You are the expert: We honor the fact that you are the best judge
of what will work or will not work for your relative. And no one expects
you to become perfect mothers, fathers, siblings, children or spouses
as a result of taking this course. There will be no pressure to follow
suggestions offered in these classes, or for you to share anything
against your will. We want you to learn to trust your own instincts and
take from this course what you find helpful.
8. Be our partners in learning: The NAMI Family-to-Family Education
Course is the first national peer program in America. Thousands of
family member graduates tell us that family members often know
more than the professionals do about coping with mental illness. As
family members we get on-the-job training; all of us have Ph.D.s from
the School of Hard Knocks!
Sometimes we won’t know the answers to your questions, but we’ll
work together to look them up It’s not necessary to know everything:
What’s important is to know how and where to find the information
you need.
1.8
NAMI FAMILY TO FAMILY EDUCATION PROGRAM 2/03e
VIII. What Are Your Goals Of Independence/Healthy Dependence For Your Ill Relative?
Leader Note: put up chart 3: “goals”; then read below
We would like you to share your goal of independence for your ill fam-
ily member, to the degree possible for that person.
If someone is not comfortable with “independent” goals, tell us your
goal of “healthy dependence.”
Process Note:
Ask participants to start by:
1. Repeating their name. Ask them to limit introductory
information by telling us only
2. their relative’s name and their relationship
CO1
CO2
In this course we want to build a compassionate learning community,
where we strengthen one another by being in charge of the learning
process.
Leader Note: stop and ask for group questions and comments
about our belief system and principles.
VII. Making a Contract
We would like to make a contract with you. It has three parts:
First: We would like you to agree tonight to come to every class for
the next 12 weeks. These classes build on each other; being together
each time increases trust and continuity. Breaks in attendance affect
our learning and our solidarity as a group.
Second: If you have an emergency and can’t be here, please call and
let us know. (Our phone numbers are on the class schedule we will
be handing out). There is a lot of bonding that goes on as the course
progresses. If you can’t be here, we all want to know that you are O.K.,
or if you have a crisis, how we can help.
Third: We also ask you to agree to keep the personal disclosures
shared in these classes confidential. This is a basic rule of all NAMI
groups, and it makes us feel safe and protected.
How does that sound? Do you feel you can make the contract?
Ask for a show of hands, raising your own.
1.9
CLASS 1 1.10
3. the diagnosis, and
4. the number of years ill. That way we can get around the circle by
closing time.
Keep people focused on the chart topics, so they won’t get into the
“saga of the ill relative.”
You may need to be directive; tell them, just keep to the information we
are asking for on the chart: we will tell our stories in class 3.
Transition: Thank you for sharing your thoughts on your goals for your
family member. Now, onto our final Agenda topic for tonight---understanding
illness symptoms as a “double-edged sword.”
Leader Note: Direct class to handout #7 so group can follow lecture.
IX. Understanding Illness Symptoms As A “Double-Edged Sword”
We want to introduce the second “basic illness concept” which will be
important to us in the course. This one has to do with the way illness
symptoms overtake us and undermine us at the same time, striking us
from two sides like a “double-edged sword.”
For example, let’s take a physical illness we’ve all had. When we come down
with the flu, a host of new, unwanted symptoms (fever, headache, conges-
tion) well up and engulf the healthy self. At the same time, we are drained
by symptoms, which take away personal resources we’ve always depended
upon (energy, will, drive to keep going, etc.).
The more severe the illness, the more our healthy self is overwhelmed and
the more our dependable, resourceful self is diminished Also, we have no
control over the severity of symptoms that attack us, and during the period
we are ill, it’s almost impossible to summon up our dependable responses.
Mental illnesses are no different except that, because they are disorders
of the brain, many symptoms of mental illness are expressed as complex
behaviors. When our loved ones have a brain disorder, a host of unfamiliar,
unwanted behaviors appear that were never part of their personality; at the
same time, many of the resourceful qualities we have always counted on
are taken away.
We want to introduce this concept tonight because, next week, we will
look at the symptoms of 3 major mental illnesses, which can deeply alter
the people we care about. One of the most important insights for family
members to gain is to know which addedbehaviors and diminished
responses occur in their relative’s illness, which may look to be under his/
her control, but are not. This will help us learn how to separate the person
from the illness.
CO2
NAMI FAMILY TO FAMILY EDUCATION PROGRAM 2/03e1.11
CO1X. Homework Handouts and Housekeeping
Every week we will be giving you “Homework Handouts” to read, which will
go in your notebook. Some will address material we have covered in class;
some will introduce material we will cover in the next class. We really en-
courage you to set aside time each week to go over them at home.
We also hope you will read on your own. There is a splendid bibliography
at the back of the course notebook you have. There are also instructions
about how to get these books and articles through your local library. You
will also find a Glossary at the back of your notebook to help with terms,
which may be unfamiliar.
We are also passing around a Class Sign-up Sheet so we will know how to
reach you by phone in case we ever have to reschedule class. It would be
very helpful to know your work number, too, if you have one.
Leader Note: ask for any questions.
“Thanks & goodnight!”
By the end of the course, you will be able to define very clearly how the
“double-edged sword” of illness symptoms pertains to your relative’s ill-
ness. Let’s see if we can picture this basic illness concept, looking at some
symptoms which are common “early warning” signals of brain disorders.
Leader Note: direct class to class handout #8.
Process Note: ask class to look at the two columns.
Focus them on what is “added” to the person in the left column and
what is “taken away” on the right.
Read the heading of the left column. Then read down the text in that
column. Next, read the heading of the right column, and read down
the text in that column.
Ask if they grasp the basic illness concept of the double-edged
sword. Let class discuss this.
NAMI FAMILY TO FAMILY EDUCATION PROGRAM 2/03e1.ECLASS 1
Class Handout #3: Bio-Psycho-Social Dimensions of Serious Mental Illness Covered In the NAMI Family-to-Family Curriculum(Includes Schizophrenia, Major Depression, Bipolar Disorder, Panic Disorder, Obsessive Compulsive Disorder)
Biological/Physical
(Medical Dimension)Science--based knowledge Course Focus: Medical aspects of Illness
Symptoms; Diagnosis
Future course of illness (prognosis )
Acute care in critical periods
Medications and medication side–effects
Adherence to medication
Scientific advances in medications
Early warning signs of relapse
Insight into clinical realities of brain disorders
Best medical strategies to maximize recovery
Current research on brain disorders
(Classes 2, 3, 4, 6)
Psychological/Emotional
(Personal Dimension)Psychology-based knowledge Course Focus: Subjective emotions and feelings The inner experience of brain disorders
Normative family responses to the trauma of mental illness
Social/Occupational
(Rehabilitation Dimension)Recovery-based knowledgeCourse Focus: Self/Renewal Re-entry into Community
Definition and testimonials of recovery
Principles of rehabilitation
Increased self-determina-tion
Problem Solving Skills (Workshop)
Communication Skills (Workshop)
Challenging negative ste-reotypes
Advocacy for better ser-vices and fair policies
(Classes 4, 5, 7, 10, 11, 12)
Telling our stories; validat-ing family strengths
Coping strategies used to protect self esteem in mental illness
Empathetic listening and responding skills
Burdens of different rela-tive roles in the family
Handling anger, frustration, and feelings of entrapment
Coming to terms with "shattered dreams"
Self-care skills; keeping our lives going
Value of peer understanding and support
Maximum personal fulfill-ment and quality of life
Sources of system/commu-nity support Restoration of social ties
Long-term care
NOTE:
These 3 bio-psycho-social dimensions are interdepen-dent:
1) No one dimension can ignore the knowledge base of the other two
2) Focusing on one dimen-sion alone is not sufficient for recover.
(Classes 1, 3, 4, 7, 8, 9, 10, 12)
1.G
Class Handout #5:Local Support Group Info
Our local support group meets on ______________________________________________.
Our meeting is located at ______________________________________________________.
We meet from _________ P.M. to _________ P.M. During this time we will focus entirely on sharing and caring.
The directions to our meetings are as follow.
1) ___________________________________________________________________________
2) ___________________________________________________________________________
3) ___________________________________________________________________________
4) ___________________________________________________________________________
5) ___________________________________________________________________________
6) ___________________________________________________________________________
7) ___________________________________________________________________________
8) ___________________________________________________________________________
For information, call _____________________________________
_____________________________________
NAMI FAMILY TO FAMILY EDUCATION PROGRAM 2/03eCLASS 1
NAMI FAMILY TO FAMILY EDUCATION PROGRAM 2/03e1.J
Class Handout #8: Understanding Symmptoms of Brain Disorder as a Double Edged Sword
Behaviors You Never Saw Before, Which May Be Added to the Person Who is Ill
Behaviors You Always Counted On, Which May Be Taken Away From the Person Who is Ill
Irritability, criticalness, even abusiveness
Unpredictable over-reaction to things
Indifference; inflexible obstinacy
Irrational statements and responses
Obsession with own activities and pursuits; inflated self-concept
Forgetfulness and losing things
Uncontrollable sadness or crying
Rudeness and hostility
Fearfulness and hyper-vigilance
Devastated by peer disapproval
Disinterest in sex, or hyper sexuality
Indecisiveness
Inappropriate and bizarre behaviors
Wish to be withdrawn and isolated
Traumatic changes in a person due to symptoms of brain disorders (mental illnesses)
Ability to focus and concentrate
Insight about what is happening
Pride in appearance and personal hygiene
Capacity for intimacy
Ability to cope with minor problems
Enjoyment of Family, friends, work
Ability to exercise self-control
Optimism, faith, belief in the future
Warmth and thoughtfulness in relationships
Ability to appreciate people and accept their help
Pride in taking responsibility
Ability to express joy
Capacity to see another point of view
Emotional resiliency
Willingness to follow a treatment plan when ill
Traumatic changes in a person due to symptoms of brain disorders (mental illnesses)
Traumatic Losses In A Person Due To Symptoms Of Brain Disorders (Mental Illnesses)
CLASS 1