1

The Family Crisis Moment The Impact of Mental Illness on Families

PSRT 4271: The Family Role in Rehabilitation

Week Four (June 21, 2012)

2

The Family Crisis Moment

3

What is a crisis? (Roberts, 2005)

“…disruption of psychological homeostatis…”

“…usual coping mechanisms fail…”

“…distress and functional impairment…”

4

A perception… (Bard and Ellison, 1974)

“…subjective reaction…”

“…to stressful life experience…”

Functioning “…seriously compromised...”

5

Characteristics of those in crisis Threat

Incapacity

Fear

Discomfort

Disequilibrium

6

Crisis Theory

There is such a thing…

7

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.

8

How people react to disability (Power & Dell Orto, 2004)

5 determinants:

1. Triggering events2. Severity of disability3. Personal influences4. Contextual influences5. Stigma; societal reactions

9

Effects: 8 “themes” (Power & Dell Orto,

2004) Denial Grief Guilt Isolation Anger Depression Coping Acceptance

10

Needs (Power & Dell Orto, 2004)

Meaning Support Validation Information Balance

11

Ways of Coping

12

Providers: How to help? (Clarke & Windsor, 2010)

Acknowledge; connect; engage

Offer coping mechanisms

Comprehensive involvement at discharge

Instill hope

13

Impact on Families(The Raft of Medusa, by Theodore Gericault, 1791–1824)

14

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

15

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

16

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

17

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

18

Our Presentation Topic…

Bellevue Inside Out Trailerhttp://www.youtube.com/watch?v=Ojd_fsHbGl8

19

Our guest presenter…Ravi Maharahj, Middlesex County Crisis Screening Center