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Purpose: A multiphase model for experiences of family members of persons with mental illness that considers both positive and negative aspects is proposed. Design and Methods: Mixed methods (semistructured interviews, life history timelines, focus group discussions, and the Experience of Caregiving Inventory) were used with caregivers accessing outpatient services of a nongovernmental organization in urban and rural locations around Chennai, India. Findings: Based on our results, we constructed a multiphase model, which we named The Banyan model of caregiver experiences. The phases are (1) manifestation of symptoms, (2) seeking help, (3) helplessness and attribution, (4) relative control and insight, (5) loss and worries, and (6) finding new meaning. Practical Implications: Our multiphase model allows us to identify in more detail the needs of caregivers at various stages. [ABSTRACT FROM AUTHOR]

Background: Family members of individuals with early psychosis (EP) play critical roles in their engagement with EP services, but family member experiences of those roles are insufficiently understood. Methods: We conducted semi‐structured interviews with 18 family members of individuals enrolled in EP services during the Recovery After an Initial Schizophrenia Episode‐Implementation Evaluation Study (RAISE‐IES study), to better understand their experiences engaging with EP specialty care and their roles in client engagement in services. Results: Family members described diverse experiences with the interplay among distress regarding their loved one's illness, uncertainty engaging with programme staff and highly valued facets of the clinical programme. These included ongoing family outreach and support, frequent communication from staff, programme flexibility and individualization of care. They also described varied and stressful complexities involved in providing practical assistance and encouragement to support their loved one's engagement in care. Competing responsibilities, time and resource limitations, and the intricacy of providing support while fostering autonomy impacted their roles and experiences. Conclusions: Given key family roles for most EP clients, understanding family members’ highly individual experiences and responding to them in tailored ways is necessary to best support families in helping their loved ones engage in care and recovery as well as navigate their own worry and stress. Recommendations for engaging and supporting family members are highlighted. [ABSTRACT FROM AUTHOR]

Abstract: Aim: Research suggests that family support promotes recovery and is a key component of a successful early intervention programme. However, very little is known about family functioning in families that are coping with the onset of a psychotic illness and the factors that help to foster adaptive family functioning during this challenging time. The purpose of this study was to understand the individual, caregiver and family factors that are associated with adaptive family functioning in early episode psychosis. Methods: An online survey with 107 family caregivers of an individual with early psychosis was used to examine relationships among various caregiver and family system variables such as caregiver appraisals, coping strategies, quality of life, perceived helpfulness of support systems and family functioning. Family functioning was assessed using a multi‐dimensional approach and measured along dimensions of cohesion and flexibility. Results: Family members of an individual with early psychosis reported more family difficulties across dimensions of cohesion and flexibility. Family members’ cognitive appraisals about the illness, its consequences and one's caregiving role were significant predictors of wellbeing. Negative appraisals were strongly associated with lower caregiver quality of life, whereas the presence of positive coping strategies was associated with better caregiver quality of life. Finally, positive caregiver appraisals predicted adaptive family functioning. Conclusions: Family functioning is a complex and multi‐faceted construct. The findings from this study have important implications for the field of early intervention in psychosis and could inform relevant treatment targets. [ABSTRACT FROM AUTHOR]

As parents age, well siblings are often asked to assume caregiving responsibilities for their brother or sister with mental illness. However, relatively little is known about how well siblings prioritize sibling caregiving responsibilities with other life demands. We examined well siblings’ attitudes toward self-care and caregiving for their sibling with mental illness (self- and sibling-care) using two cross-sectional samples. The first sample of well siblings (N = 242) was used to examine the psychometric properties of the self- and sibling-care measure (SSCM), designed to assess the degree to which siblings prioritize their own needs and the needs of their sibling with mental illness. A second sample (N = 103) was used to determine the relative contribution of self- and sibling-care attitudes in accounting for variation in well siblings’ reports of personal loss and stress-related personal growth. Results support the psychometric validity of the SSCM and suggest that self- and sibling-care attitudes account for greater variance in scores on perceived personal loss and stress-related growth than demographic or caregiving factors. Our findings support the need to address family care responsibilities and resource limitations through recovery-oriented mental health policies, services, and programs. [ABSTRACT FROM AUTHOR]

Background: Serious mental illness (SMI) is profoundly stigmatised, such that there is even an impact on relatives of people with SMI. Aims To develop and validate a scale to comprehensively measure self-stigma among first-degree relatives of individuals with SMI.Method: We conducted group interviews focusing on self-stigma with first-degree relatives (n = 20) of people with SMI, from which 74 representative quotations were reframed as Likert-type items. Cognitive interviews with relatives (n = 11) identified 30 items for the Self-Stigma in Relatives of people with Mental Illness (SSRMI) scale. Relatives (n = 195) completed the scale twice, a month apart, together with four external correlate scales.Results: The 30-item SSRMI was reliable, with scores stable over time. Its single-factor structure allowed generation of a 10-item version. Construct validity of 30- and 10-item versions was supported by expected relationships with external correlates.Conclusions: Both versions of the SSRMI scale are valid and reliable instruments appropriate for use in clinical and research contexts. Declaration of interest None. [ABSTRACT FROM AUTHOR]

Background: Empirical evidence shows that family involvement (FI) can play a pivotal role in the coping and recovery of persons with severe mental illness (SMI). Nevertheless, various studies demonstrate that FI in mental healthcare services is often not (sufficiently) realized. In order to develop more insights, this scoping review gives an overview of how various stakeholders conceptualize, perceive and experience barriers to FI. Central questions are: 1) What are the main barriers to FI reported by the different key stakeholders (i.e. the persons with SMI, their families and the professionals, and 2) What are the differences and similarities between the various stakeholders' perspectives on these barriers.Methods: A systematic search into primary studies regarding FI was conducted in four databases: Medline/Pubmed, Cinahl, PsychInfo and Web of Knowledge with the use of a PICO scheme. Thematic analysis focused on stakeholder perspectives (i.e. which stakeholder group reports the barrier) and types of barriers (i.e. which types of barriers are addressed).Results: Thirty three studies were included. The main barriers reported by the stakeholder groups reveal important similarities and differences between the stakeholder groups and were related to: 1) the person with SMI, 2) the family, 3) the professionals, 4) the organization of care and 5) the culture-paradigm.Discussion: Our stakeholder approach elicits the different stakeholders' concepts, presuppositions and experiences of barriers to FI, and gives fundamental insights on how to deal with barriers to FI. The stakeholders differing interpretations and perceptions of the barriers related to FI is closely related to the inherent complexity involved in FI in itself. In order to deal better with these barriers, openly discussing and reflecting upon each other's normative understandings of barriers is needed.Conclusions: Differences in perceptions of barriers to FI can itself be a barrier. To deal with barriers to FI, a dialogical approach on how the different stakeholders perceive and value FI and its barriers is required. Methods such as moral case deliberation or systematic ethics reflections can be useful. [ABSTRACT FROM AUTHOR]

The relationship between depressive experience style, family satisfaction, discomfort in interpersonal relationships, and suicidal behavior was studied in a purposive sample of 405 mental health patients in the Metropolitan Region of Chile. They were classified into high severity suicide attempt, low severity suicide attempt, suicidal ideation, and no suicidal behavior. The instruments used were: DEQ, OQ-45.2, APGAR, RFL, Risk-Rescue Rating Scale, and Suicidal Intent Scale. ANOVA, X², and models of mediation and moderation of conditional processes were conducted. The high severity suicide attempt group showed a significant predominance of the dependent style compared with the group without suicidal behavior. There was a high presence of the self-critical style throughout the sample, especially in the suicidal ideation group. The groups with suicide risk had higher dysfunctional rates of interpersonal discomfort and a greater perception of severe family dysfunction than the group without suicidal behavior. Satisfaction with family functioning was observed to influence the intention to die at the time of the suicide attempt. These results underscore the importance of family functioning and interpersonal relationships in suicide risk. [ABSTRACT FROM AUTHOR]

Mental health services have been transforming toward a recovery orientation for more than a decade, yet a robust understanding of recovery eludes many providers, and consensus on a conceptual definition has yet to be reached. This article examines mental health consumers' lived experience of recovery and evaluates the usefulness and comprehensiveness of CHIME, a major framework conceptually defining recovery for adults with serious mental illness. Researchers partnered with a mental health association in a major US city to engage in research with graduates of a recovery and education class for adults diagnosed with serious mental illness. Twelve participants were loaned video cameras and invited to 'Tell us about your recovery' through autovideography. Of the 12 participants, six produced videos directly responding to the overall research question and were subsequently included in the present analysis. Data were analyzed thematically, and CHIME adequately represented the major domains presented in consumer videos with two notable modifications: subdomains of 'reciprocity' within relationships and 'contributing to others' were added to comprehensively represent consumer perspectives about recovery. Adding two subdomains to CHIME more effectively represents consumer narratives about recovery, contributes to the social construction of the personhood of people with serious mental illness, and offers a more robust description of the process of recovery. [ABSTRACT FROM AUTHOR]

Family members often set limits with relatives with psychiatric disorders (PD), however, no scale currently exists measuring the use of such limit-setting practices. The present article describes the development and results of a new measure, the Family Limit-Setting Scale (FLSS). Via a national online survey, the FLSS was completed by 573 adults residing in the U.S. who report having an adult relative with PD. We conducted exploratory and confirmatory factor analyses, examined internal consistencies and other indicators of construct validity, and performed invariance analyses assessing the generality of the optimal factor model to men, women, Caucasian respondents, and non-Caucasian respondents. Results indicate that the FLSS has an acceptable two factor structure (routine limit-setting and crisis prevention limit-setting) with both factors being highly generalizable to all groups of respondents examined. Internal consistencies and other indicators provide additional evidence of the FLSS' construct validity. Use of the FLSS will enable the conduction of quantitative research in this area. In addition, this measure may be employed in education/support organizations for families with a member with mental illness in an effort to identify persons using high levels of limit-setting practices who may benefit from extra support and/or guidance. [ABSTRACT FROM AUTHOR]

Severe mental illness causes suffering for the patient as well as the patient's immediate family. The Swedish National Board of Health and Welfare has recommended the implementation of multifamily psychoeducation in order to assist patient and family in the recovery process. The aim of this study was to determine how introducing multifamily psychoeducation in Sweden has been viewed by professionals. Semi-structured interviews were conducted with 11 service providers, who were involved in evaluating multifamily psychoeducation. Our main findings fell under the headings of defensive culture and unsuitable model. Resistance to introducing the new intervention was found on multiple levels. The model proposed was considered too rigid for both the target group and the organizations because it could not be adjusted to the needs of patients, families, or facilitators. Despite good evidence for the effectiveness of the intervention, there were difficulties introducing the multifamily psychoeducation model in clinical practice. The feasibility of an intervention needs to be evaluated before adopting it as a national guideline. [ABSTRACT FROM AUTHOR]

A collaborative approach to care of parents with a mental illness is essential to address the needs of the whole family. However, a number of constraints within adult mental health and child-focused services prevent a unified approach to the care of families where a parent has a mental illness (FaPMI). This paper reports on a cross-sector workforce development initiative aimed to build skill and knowledge in practitioners to work with FaPMI. The initiative included training in the 'Keeping Families and Children in Mind' e-resource to mental health, child and family services. The resource was combined with face to face training and small group meetings over six weeks, to help develop emerging champions/practice leaders to promote FaPMI-focused practice. A significant decline in the perceived ability to engage in FaPMI-focused practice emerged immediately post-training. The lack of perceived organisational supports was the major barrier to the implementation of FaPMIfocused practice across sectors. However following continued support of practitioners, a significant increase in FaPMI-focused practice across sectors, and a return to pre-survey levels of perceived organizational support, was observed at six-month post-training. The importance of providing additional implementation supports and time to consolidate practice change following training is highlighted. Recommended implementation and training strategies that will improve FaPMI-focused cross-sector approaches to better meet the need of FaPMI are described. [ABSTRACT FROM AUTHOR]

Family members provide a significant source of social support to relatives living with a serious mental health disorder, such as schizophrenia. Few public mental health programs offer families a supportive environment where their relatives can develop independence, life skills, and satisfying relationships that are not dependent on the family's involvement. The Clubhouse is one such model. Although family members are not directly involved, they may experience indirect effects from their relative's participation. Family members with relatives involved in Clubhouse ( n = 35) completed an in-depth semi-structured interview. Transcripts were analyzed to identify underlying themes. Five primary themes emerged ranging from less burden to greater positive family interaction. Specifically, family members attributed Clubhouses as providing a supportive external community for their loved ones, but also ameliorating negative aspects of family care and improving family interactions. Practical implications for family professionals are discussed. [ABSTRACT FROM AUTHOR]

Background: Caregiver burden is an important issue that needs to be addressed when developing management programs for persons with chronic mental illnesses, but there is, as yet, no reliable way for assessing this in China. Aim: Assess the validity and reliability of a brief adapted Chinese version of the Family Experience Interview Schedule (FEIS) among caregivers of inpatients with mental disorders in China. Methods: We first translated and back-translated the original 114-item FEIS and administered it to 606 primary caregivers of psychiatric inpatients. After excluding 9 items about sociodemographic variables and 9 items that over 15% of respondents were unable to answer, we conducted an exploratory factor analysis using a random half of the sample on the remaining 96 items and, based on the results of the factor analysis, selected the items to be included in the final shortened scale. Correlation analysis, confirmatory factor analysis, and internal consistency measures were used to assess the reliability and validity of the final scale using data from the second half of the sample. Results: The final scale included 28 items that loaded on five dimensions: (a) patients' violent behavior; (b) patients' suicidal tendency; (c) caregivers' depression and anxiety; (d) disruption of caregivers' daily routines; and (e) caregivers' satisfaction with health services. These five dimensions explained 50.5% of the total variance. Confirmatory factor analysis found reasonable fit of this 5-factor model (Χ2/df=2.94, p<0.001, goodness-of-fit index [GFI]=0.85, comparative fit index [CFI]=0.85, root-mean-square error of approximation [RMSEA]=0.08). The correlation coefficients between each item and the corresponding factor were all above 0.5. The Cronbach a coefficient of the entire scale was 0.76 and that for the five dimensions varied between 0.71 and 0.84. Conclusions: The five dimensions of family burden assessed by the 28-item brief Chinese version of FEIS have good internal consistency and, thus, appear to assess valid dimensions of family burden in Chinese caregivers of persons with serious mental illnesses. Further work is needed to assess the test-retest reliability of this scale and its sensitivity to change over time. [ABSTRACT FROM AUTHOR]

The bipolar disorder brings meaningful injury to the patient and his/her relatives. The aim of this study is to investigate the family functioning when one of its members has the bipolar disorder diagnosis, verifying and perceiving how the patients and his/her relatives deal with this disorder, identifying characteristics of common functioning among families which have a member with this diagnosis, as well as coming up with treatment methods. When there is a family member with bipolar disorder, it was possible to find -- through a bibliographical study -- that the other members are affected and have difficulties in intervening with the patient mainly in crisis situations. The families have common characteristics such as high emotional expressiveness, lesser degree of commitment, financial and communication difficulties. [ABSTRACT FROM AUTHOR]

In conjunction with the recent critical assessments of the life and work of R.D. Laing, this paper seeks to demonstrate what is revealed when Laing’s work on families and created spaces of mental health care are examined through a geographical lens. The paper begins with an exploration of Laing’s time at the Tavistock Clinic in London during the 1960s, and of the co-authored text with Aaron Esterson entitled, Sanity, Madness and the Family (1964). The study then seeks to demonstrate the importance Laing and his colleague placed on the time-space situatedness of patients and their worlds. Finally, an account is provided of Laing’s and Esterson’s spatial thinking in relation to their creation of both real and imagined spaces of therapeutic care. [ABSTRACT FROM PUBLISHER]

Antecedents When a family member suffers from a mental disorder, such as schizophrenia, and a relative takes on the role of caregiver, social support is crucial to successfully addressing family functionality and the problems this may cause.Objective Determine the factors of social and structural support associated with the perception of family functionality in persons with a mental disorder and family caregivers.Material and method This is a descriptive, corelational, cross-sectional, non-probabilistic study, with sequential participation. Subjects were divided into two groups: 72 outpatients diagnosed with a mental health disorder, and 66 kinship caregivers. Three instruments were used: an MOS Questionnaire, an APGAR-Family Questionnaire and a Duke-UNC-11 Questionnaire.Results58.2% of the patients perceived family functionality (APGAR); 19.4%, severe dysfunctionality, and 22.2%, slight dysfunctionality. Among relatives, 66.7% perceived family functionality; 10.6%, severe dysfunctionality, and 22.7%, slight dysfunctionality.In the Structural Support Report (MOS), a statistically significant difference was observed (t=2.478, gl=136, p=0.014) in the perception of instrumental support among patients (x̄=11.68) and relatives; the latter perceiving the least instrumental support (x̄=9.91). In functional social support (Duke-UNC-11) no difference (t=1.170; gl=136, p=.244) was indicated between relatives (x̄=40.36) and patients (x̄=38.07).The linear regression model showed that patients with the longest pe-riod of evolution and diagnosis of schizophrenia predict dysfunctionality, whereas social support predicts functionality (p<.001). Among relatives, longer periods of evolution indicated dysfunctionality, while social support predicted functionality (p<.001).Conclusion It is clear that social support plays an important role in family functionality in patients suffering from mental problems and kinship caregivers. In patients, it was observed that the greater the AS, the higher the degree of family functionality. Among relatives, structural support showed an increased perception of family functionality, which reduces the likelihood of relapses and hospitalization. [ABSTRACT FROM AUTHOR]

This paper explores the movements of asylum patients in and out of psychiatric care in French Indochina as the product of everyday interactions between psychiatrists, colonial authorities, and the public, especially patients' families. Throughout the interwar years, families and communities actively participated in psychiatric decision-making in ways that disrupt our notions of the colonial asylum as a closed setting that patients rarely left, run by experts who enjoyed broad, unquestioned authority. Vietnamese families, by debating individuals' suitability for social life, engaged with professional psychiatrists to find common ground for thinking about and discussing mental illness. At the same time, they pursued their own strategies in ways that significantly limited the power of experts. Debates revolved around the mental health of patients, but also around the capacity of families to assume their care upon release, and whether the asylum itself was the most appropriate site for treatment and rehabilitation. By considering how lay people and experts came together to negotiate the confinement and release of asylum patients, this paper offers a novel perspective on the development of psychiatric knowledge and power in colonial settings. I argue that by situating the history of psychiatry within the local dynamics of colonial rule as opposed to expert discourse, the asylum emerges here less as a blunt instrument for the social control and medicalization of colonial society than as a valuable historical site for reframing narratives of colonial repression and resistance. [ABSTRACT FROM PUBLISHER]

Objective Guided by a life course perspective, the present study examined whether aspects of the emerging adult-mother relationship, specifically affection, felt obligation, role reversal, and reciprocity, mediated the association between having a mother with mental illness and poorer psychological adjustment. Method Emerging adults with mothers with mental illness ( n = 52) and emerging adults without mothers with mental illness ( n = 64) were recruited from institutes of higher education and responded to an online self-report questionnaire. Most participants (81%) were female. Results Results from multiple mediation analyses indicated a history of parent-child role reversal mediated the association between having a mother with mental illness and emerging adults' psychological symptoms. None of the assessed aspects of the emerging adult-mother relationship mediated the association between maternal mental illness and emerging adults' psychological well-being, but having divorced parents and being older was associated with lower levels of psychological well-being. Conclusions Findings indicate role reversal contributes to emerging adults' psychological symptoms. Assessment of a history of role reversal may be relevant to clinical practice with emerging adults, particularly those with mothers with mental illness. Life course perspectives can inform future studies of emerging adults with mothers with mental illness. [ABSTRACT FROM AUTHOR]

Mental Health Care Services are part of the National Health Services for Samoa. Their function is to provide mental health care services to the population of Samoa, which numbers 180,000 people. However, like many other countries in the Pacific region, mental health is considered a low priority. The mental health budget allocation barely covers the operation of mental health care services. More broadly, there is a lack of political awareness about mental health care services and mental health rarely becomes an issue of deliberation in the political arena. This article outlines the recent development of mental health care services in Samoa, including the Mental Health Policy 2006 and Mental Health Act 2007. It tells the story of the successful integration of aiga (family) as an active partner in the provision of care, and the development of the Aiga model utilizing Samoan cultural values to promote culturally appropriate family-focused community mental health care for Samoa. Mental Health Care Services today encompass both clinical and family-focused community mental health care services. The work is largely nurse-led. Much has been achieved over the past 25 years. Increased recognition by government and increased resourcing are necessary to meet the future health care needs of the Samoan people. [ABSTRACT FROM AUTHOR]

Objective: The present study examined the role of personal loss due to mental illness and meaning-related coping strategies on reports of caregiving among well siblings of adults with serious mental illness. Method: A sample of 103 well siblings of adults with serious mental illness completed an online survey. Participants were recruited through websites related to mental illness and through contact with leaders of family support groups. Results: Personal loss, not meaning-related coping, was the strongest predictor of current caregiving among well siblings. Well siblings' age, support group affiliation, and perceived level of sibling dependence also contributed to variation in reports of current caregiving. Conclusion: Personal loss has powerful implications for research and interventions focused on sibling involvement in caregiving for adults with mental illness. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Studies indicate that patient-rated outcomes and symptomatic remission as defined by the remission in schizophrenia working group rely on different assumptions. The aim of this observational study was to assess symptomatic remission by patients with schizophrenia, family members and psychiatrists and to compare their assessments with standardized criteria and clinical measures. Methods: One hundred and thirty-one patients with schizophrenia (DSM-IV), family members and psychiatrists assessed remission within the European Group on Functional Outcomes and Remission in Schizophrenia (EGOFORS) project. Symptoms (Positive and Negative Syndrome Scale [PANSS]), functional outcome (Functional Recovery Scale in Schizophrenia [FROGS]), subjective well-being (SWN-K) and demographic characteristics were investigated. Results: Remission assessed by psychiatrists showed the best accordance with standardized remission (80%), followed by remission assessed by family members (52%) and patients (43%). Only in 18%, patients, relatives and psychiatrists agreed in their assessments. Good subjective well-being was most important for remission estimated by patients, good subjective well-being and symptom reduction by family members, and finally better symptom scores, well-being and functioning by psychiatrists. Discussion: Self- and expert-rated clinical outcomes differ markedly, with a preference on the patients’ side for subjective outcome. Symptomatic remission as assessed by the standardized criteria plays a secondary role for patients and relatives in daily clinical practice. A more thorough consideration of patients’ and caregivers’ perspectives should supplement the experts’ assessment. [Copyright &y& Elsevier]

The article offers information on the stigma attached to the people with mental illness and their families and discriminatory behavior towards them. It states that there has been increasing attention to the deleterious effects of stigma and discrimination and calls for psychiatrists to take on key roles in combating stigma and working toward its abolition.

El artículo presenta los resultados de un estudio exploratorio sobre la posible influencia del maltrato infantil en adolescentes con desórdenes psiquiátricos. El estudio fue realizado entre pacientes de un hospital psiquiátrico infantil en México. Los autores ofrecen información social y demográfica sobre la muestra de individuos estudiada, métodos utilizados y conclusiones a la luz de los datos analizados.

Obsessive-compulsive disorder (OCD) is a prevalent neuropsychiatric disorder in children, adolescents and adults. Prevalence rates of 2% to 4% have been reported. Despite the presence of effective treatments, underdiagnosis in children and adolescents is frequent. In addition, OCD is frequently comorbid with externalizing disorders such as attention deficit hyperactivity disorder (ADHD) and anxiety disorders such as generalized anxiety disorder (GAD), panic disorder, social phobia and separation anxiety disorder. Comorbidity with affective disorders is frequent too. The OCD association with major depressive disorder (MDD) increases in adolescence, reaching similar rates in adults. The comorbidity and other clinical variables, such as the duration of illness, have been mentioned as predictors of severity and treatment response. An erratic family functioning has also been associated to the severity of the illness. The aim of this study was to determine if there were differences in demographic variables (sex and age), clinical variables (age onset of the illness and comorbid disorders) and family functioning between children and adolescents with mild/moderate vs. severe OCD. Methods In a comparative cross sectional design, 60 children and adolescents aged 6 to 17 years, who met criteria for OCD and were drug naive, were assessed. Subjects who were unable to complete the interviews or had severe neurological or medical comorbidities were excluded. Subjects were recruited at the inpatients and outpatients services of the Child Psychiatric Hospital Dr. Juan N. Navarro (HPIJNN). Trained physicians interviewed the subjects and their parents using the Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version (K-SADS-PL), the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), the Global Assessment of Functioning Scale (GAS) and the family APGAR rating scale. Based on CY-BOCS scores, the sample was divided in mild/moderate OCD (CY-BOCS < 30 points) and severe OCD (CY-BOCS > 30 points). Statistical analyses: Descriptive statistics (frequencies, means, standard deviation) and comparative (t student and Chi square) were used. Univariate analysis and linear regression were conducted for assessing factors associated with OCD severity. Results The sample had a mean age of 12.57±2.91 years old, they were 71.7% male. The mean duration of their illness was 19±10.75 months. The average score of CY-BOCS was 22.76±8.66, family APGAR 14.68±6.02 and GAS 54.91±15.05. A relative with OCD symptoms was reported by 23.3% of the sample; in these relatives, the most common symptoms were those related to contamination fears and washing (16%), symmetry and order (6.6%), checking (3.3%) and hoarding (1.6%). The mean number of comorbid disorders was 3.16±1.68. The most frequent were MDD, ADHD and GAD. The internalizing disorders were reported as secondary to OCD. The most common obsessions in the sample were those related to contamination and germs 60% (n=37), followed by fears to harm 58% (n=35), somatic 26.7% (n=16) and symmetry 20% (n=12). The most common compulsions were washing 50% (n=30), repeating 43% (n=26) and checking 35% (n=21). Six subjects reported contamination thoughts or rituals-related enuresis and encopresis (fear of contamination when using the bathroom or doing it only at a specific time). The main reason for attention seeking was the presence of anxiety or depressive symptoms (48%), externalized symptoms (27%), OCD symptoms (20%) and psychotic symptoms (5%). The KSADS-PL interview showed that 26% (n=16), 33% (n=20) and 43% (n=26) of the sample reported academic, social and family dysfunction respectively. When the sample was divided according to their severity, 81.7% (n= 48) belonged to the mild/moderate OCD group and 18.3% (n=11) to the severe OCD group; this had a shorter duration of illness (16.54±5.3, vs. 19.73±11.5 months; t= 0.913, df=58, p=0.003). The comparison of demographic characteristics, OCD in family members, and family functioning showed no differences between severity groups. Significant differences on rituals between groups were found, since they were reported in 45% of the severe OCD group and in 4% of the mild/moderate OCD group (?²=14.9, df=1, p= 0.001). Although the severe OCD group had shorter duration of illness, some symptoms were present for a longer time than in the mild/moderate OCD group: checking (12.6±3 vs. 2.4±4.3 months, t=3.58, df=58, p=0.001), repeating (8.3±12 vs. 3.4±5.1 months, t=2.1, df=58, p=0.03) and the inclusion of others in their rituals (20.34±1.7 vs. 2.6±4.4 months, t=2, df=58, p=0.049). Two patients of the mild/ moderate OCD group and one of the severe OCD group were affected with schizophreniform disorder. Psychotic symptoms secondary to OCD were found only in the severe OCD group (45.5%). The main reason for attention seeking of the severe OCD group was the presence of obsessions and compulsions, and in the mild/ moderate OCD group the presence of internalized disorders. Univariate analysis showed that counting compulsions (F=7.27, p=0.01) and rituals (F=17.24, p=0.000) were related to OCD severity. However, the linear regression model showed that only the presence of rituals predicted the severity of OCD (B=0.591, t=4.1, p<0.001). Discussion The studied sample represents 2.7% of the patients who were evaluated during a seven-month period at the HPIJNN, the inclusion of a screening instrument for OCD would be helpful for the identification of obsessions and compulsions in clinical samples of children and adolescents. The demographic characteristics of the present sample were similar to those reported in previous studies of pediatric OCD. The duration of illness reported by this sample suggests an age of onset around 10 years old; the frequency of obsessions and compulsions reported were also similar to those in other samples. In particular, compulsions without obsessions and the rituals involving others. Almost all the studied patients had comorbid disorders, which in many cases lead their attention seeking. It has been observed that subjects with severe obsessions regarding contamination and aggression seek for help more frequently than patients with other symptoms. Rituals were more frequently seen in patients with severe OCD; these symptoms have been associated to alterations in executive functions and have been related with psychosocial dysfunction. Conclusions: Subjects of the mild/moderate OCD group sought attention mainly due to the symptoms of comorbid disorders. Subjects with severe OCD had a shorter duration of illness and more frequency of psychotic symptoms. In the present sample, rituals predicted the severity of OCD (B=0.591, t=4.1, p<0.001). [ABSTRACT FROM AUTHOR]

Mental health problems, specifically mental disorders, develop from a complex system and not from a single cause. Obsessive-compulsive disorder (OCD) affects more than 2% of the population and generally the course of the illness is insidious and chronic. When functioning adequately, family constitutes a very important resource to face health problems and to help to improve the patient's life quality. This is the reason why it is important to underline the relevance of a stable, good functioning of the family system aimed at attaining an optimal development of all its members. Such development may be hindered by the family's incapability to modify functioning patterns at crucial moments when they are trapped in a series of inadaptable interactions which prevent to give specific solutions to the problems that are appearing, and when reporting, within a context of expressed emotion, an emotional over-involvement and high levels of hostility and criticism towards the member with OCD. Family accommodation is a phenomenon typical of families where the identified patient exerts a control based on aggressiveness when his/her wishes are not rewarded within the group. There are very few researches on the functioning of families of patients diagnosed with obsessivecompulsive disorder. Generally, these researches are related with the partially negative effects that the interactions have on the behavior of patients and their relatives by preventing or hindering the development of the subject's system. The accordance between the patient's emotional regulation or emotional intelligence and their relatives has not been studied. On the other hand, the knowledge of the beliefs that relatives hold regarding the illness may be related with the functioning of the group as a family, whereas beliefs will provide consistency to family life because they provide continuity between past, present and future. They are also a way to address new and ambiguous situations such as mental illness. This is the reason why getting to know these family systems may allow elaborating more specific and effective intervention programs for groups and families. Objective To determine the family types through a member identified with obsessive-compulsive disorder; to compare the emotional intelligence profile between patients and relatives according to the perceived type of family; to compare the relatives' beliefs toward the illness according to the perceived type of family. Material and methods A sample of patients and their families with obsessive-compulsive disorder was obtained from those who were sent by the doctor in charge of their treatment to participate in a model of group therapy for OCD, consisting of cognitive behavioral theory, practices and psychoeducation. During the first session patients and their relatives answered the following instruments: Family Adjustment and Cohesion scales (FACES-II) by Olson, Profile of Emotional Intelligence (PIEMO) by Cortés et al., Beck Inventory of Anxiety. Relatives answered too the Beliefs and Attributions Questionnaire by Salorio et al. In addition, data on family structure was complied. The sample was constituted by 48 patients and 61 relatives. All instruments were self-applied. Once that the type was obtained according to the Olson's circumflex model, the emotional profile, the anxious and the depressive symptoms were compared through factorial 2×3 ANOVA. Beliefs and attributions were compared through simple ANOVA. Results Three types of families were determined as follows: high cohesion with chaotic standards for expressing emotions and ideas; high cohesion with a rigid expression of ideas and emotions; low cohesion with a little expression of ideas and emotions. Different profiles of emotional intelligence were found not only for patients but also for relatives, in each family type. Families with high cohesion and high adjustment appear as most emotionally intelligent, less anxious and depressed, and with beliefs more attuned to reality. This type of family function was the less frequent. For beliefs and illness attributions, it was observed that comprehension of the disorder increases in proportion to a higher family adaptation, while the tendency of family members to experience feelings of guilt either towards themselves or towards the patient is decreased. As a result, the perception of experiencing the patient's illness as a nuisance disappears. With regard to the results of the Beck scales, family members perceived a high cohesion and low adaptation had higher scores for depression and anxiety. In patients who show high levels of depression and anxiety perceive family functioning as a rigid structure, with little prospect of change and interaction that prevents growth (high cohesion, low adaptation), and in those perceived isolation, without significant emotional ties with other family members and with the rigidity that prevents problem situations. Conclusions The results obtained are congruent with Olson's statements in regard to family functioning in the specific case of obsessive- compulsive disorder; these findings permit to understand the family dynamics which may typify the symptoms in the identified patients, and also to explain the adjustment situation described in literature. Family intervention is justified, stressing the handling of emotions as an important element to be considered in order to obtain higher therapeutic benefits for the patient. This study found differences in adjustment between patients and their families, do not perceive the need for flexibility in the operation of the system to find solutions that do not perpetuate and sustain interactions that reinforce symptoms. As for depression and anxiety, similar levels in either condition may be observed, thus confirming the close relationship between both. It was found that in patients and relatives, higher levels of family adaptation correspond to lower levels of depressive and anxious symptoms. One of the first approaches to the dynamics of these systems must be headed towards the family systems of beliefs, as the ideas that family members hold regarding the importance of their participation in the whole process of the illness has an impact in its course. Many families have rigid systems that make them more vulnerable to the fluctuations that this illness presents since for their members it is important and decisive to have control over the ailment. Families with flexible systems of beliefs are more prone to experience losses with a feeling of acceptance and therefore it is easier for them to let their members to implement changes in their functioning, thus compensating and overcoming their limitations. In this sense it is important to attain a therapeutic collaboration relationship that may create within the family a sense of realistic control and may help also to put into action the system's capabilities to promote improvement. This idea allows for openness in the system that may lead it to consider that there are more efficient operational measures that those applied to date. [ABSTRACT FROM AUTHOR]

Support for families of children with autism spectrum disorders continues to be important, but formal support groups may not fit every need. The authors describe Family Fun Days, a program that paired leisure activities with opportunities for support. There was an increase in the number of participants over traditional support meetings, communication, and knowledge. [ABSTRACT FROM AUTHOR]

Summary: This review focuses on helping clinicians identify resources and develop strategies they may use to effectively negotiate safe and effective use of complementary and alternative medicine (CAM) treatments with families of children with autism spectrum disorders (ASD), as well as other neurodevelopmental disorders. Since new types of CAM continue to be introduced into the autism community, emphasis is placed on providing clinicians with tools to help families negotiate the myriad of available treatments and make decisions based on current safety and efficacy data, while remaining mindful of the reasons families may be considering these treatments. We familiarize readers with high-quality, evidence-based resources that providers and families may use to ascertain current information about specific types of CAM, verify the content of biologically-based treatments, identify ongoing CAM research and obtain toolkits designed to help healthcare providers raise the topic of CAM usage and facilitate disclosure and discussion of CAM use with patients and their families. [Copyright &y& Elsevier]

This study examined whether parents of adolescents diagnosed with mental disorders self-blame for their child's disorders; their reasons for self-blame; and the relationships between parental self-blame and lower psychological well-being, perceived stigmatization, social support, potential hereditary factors related to adolescents' mental disorders, demographics, and youths' clinical characteristics. Analysis of qualitative and quantitative interview data was used to classify 68 parents as “more” or “less” (40%) inclined to self-blame. The most common reasons for parental self-blame included perceived (a) bad parenting, (b) ineffective oversight of child's mental health status, (c) passing on “bad genes,” and (d) negative family environment. Greater parental self-blame was related to parents' lower psychological well-being and associated with potential hereditary transmission, family support, and adolescents' clinical characteristics. [ABSTRACT FROM AUTHOR]

The authors discuss the significance of siblings and the relations between them in the family system. Quoting clinical examples, they consider the role and place of siblings in family therapy. [ABSTRACT FROM AUTHOR]

Children in families affected by mental illness are at an increased risk for developing psychopathology, emotional and behavioural problems. Nurses have direct and frequent contact with patients and their families, and are in a unique position to evaluate the situation of these children before problems arise. The aim of this study is to describe the interaction that practical mental health nurses (MHNs) and registered mental health currently have with children of their clients and predictors of this interaction when a parent is receiving psychiatric care. This is a cross-sectional study. In 2005, questionnaires were sent to all registered (n = 373) and practical MHNs (n = 235) working in 45 adult psychiatric inpatient and outpatient units in five Finnish university hospitals. The total response rate was 51%, while 60% (n = 222) of registered MHNs and 36% (n = 88) of practical MHNs responded. Most of the nurses did not meet children of their clients regularly, although they reported that information about children of the clients were gathered regularly at the units, and discussed clients′ children with them. The personal characteristics of nurses, such as gender, age, marital status and being a parent, were significantly related to the nurse’s propensity to pay attention to the children of their clients in adult psychiatry. Nurses’ professional experience, further family education and use of family-centred care at the unit increased their interaction with the children of their patients. These results indicate that clients’ children are not entirely invisible for most of the nurses in adult psychiatry. Knowledge of the risks faced by these children and implementation of the preventive approach should be included in the basic education of nurses. [ABSTRACT FROM AUTHOR]

Introduction. In this article the attitudes towards mental illness in those families who have mentally ill members is presented in order to compare them with those found 25 years before in a similar research. Methodology. In order to carry out the survey we used Struening and Cohen's Opinion about Mental Illness (OMI) questionnaire, adapted for use in Spain by Yllá and Guimón (1979). The population studied were the families associations of the mentally ill persons suffering from psychotic and affective disturbance, alcoholism and Alzheimer's dementia; the control group was made up of a number of Civil Servants and another section of health care workers. The samples were collected at random among the associated members. For the study we undertook a factorial analysis of the answers. Results. The first five factors contain the greater part of the accumulated variation, that is to say 34.2%, 19 factors explain the whole 100% of the variation. The five principle factors are: (i) Mental hygiene (14% of the variation), (ii) therapeutic negativism (7% of the variation), (iii) Social reinsertion (4.87% of the variation), which was also similar to the following factor, (iv) social rehabilitation, and (v) authoritarism (3.62% of the variation). Conclusion. The extensive knowledge of these illnesses and a close relationship with those who are ill could be the cause of the large and diverse opinions and that some attitudes are more complex nowadays. According to these five principle factors we can see that the controls are appreciably less authoritarian and restrictive than that of the families of these ill people and that the attitudes vary depending on the age, profession and diagnosis of the illness. [ABSTRACT FROM AUTHOR]

It is well-known that a parent's mental disorder has a significant psychosocial influence on the development of her or his children. This study reports the development process and psychometric testing of the preventive child-focused family work (PCF-FW) questionnaire in adult psychiatric settings. The PCF-FW instrument was developed to measure support for parenting, dependent children and family relationships in order to promote child development and mental health in adult psychiatry. A 133-item PCF-FW questionnaire was developed; the content validity, construct validity and reliability of the instrument were ensured by expert review, pilot test and internal consistency. The final instrument was distributed to all nurses (n= 608), including registered nurses (n= 373) and practical mental health nurses (n= 235), working in 45 adult psychiatric units in five university hospitals in Finland. Some 51% of all nurses responded. Correlation variables in each subscale varied between 0.1 and 0.8. Cronbach's alpha coefficients were 0.55-0.95 in each subscale, demonstrating the moderate to excellent internal consistency of the instrument. The Cronbach's alpha coefficient for the entire instrument was 0.94. In spite of some caveats, such as possible response biases, the present study suggests that the PCF-FW instrument is a valid and reliable tool for studying preventive child-focused family working in adult psychiatry. [ABSTRACT FROM AUTHOR]

Objective: The objective of this paper is to provide a description of Family Options, a rehabilitation intervention for parents with serious mental illnesses and their children focusing on recovery and resilience, and to report the findings from a pilot study at 6-months post-enrollment for participating mothers. Methods: A developmental design, and mixed quantitative and qualitative methods facilitate an in-depth understanding of Family Options and its impact on parents early in the implementation process. Results: Participating families faced significant challenges, including long-term mental health conditions in adults, and emotional and behavioral difficulties in children. Data from mothers (n = 22) demonstrate significant improvements in well-being, functioning, and supports and resources at 6 months post-enrollment in Family Options. Mothers report help from Family Options staff consistent with the intervention as conceptualized, and high levels of satisfaction with the intervention as delivered. Conclusions: Innovative study design and analytic strategies are required to build the evidence base and promote rapid dissemination of effective interventions. Findings from this study will assist purveyors in refining the intervention, and will lay the groundwork for further replication and testing to build the evidence base for parents with serious mental illnesses and their families. [ABSTRACT FROM AUTHOR]

The article focuses on family therapy in late life. Common factors in successful family interventions include increased family contact, clearer decision-making policies, and ample information related to medical and neuropsychological issues. Family therapy focuses on the interactions of relationships and structures which are mediated to create opportunities and desired situations. Information on how family therapy works is offered.

Being raised by a single mother is one factor that has been suggested as contributing to the plight of African American males. Yet few studies have focused specifically on African American single mothers' experiences with raising sons. This qualitative study explored the following questions: (1) What are the experiences of African American single mothers in the raising of their sons? (2) What coping strategies do African American single mothers use in the raising of their sons? Two rounds of unstructured open-ended interviews were conducted with 11 African American single mothers of at least one son. Implications for family therapy based on the interviews are presented. [ABSTRACT FROM AUTHOR]

The article focuses on a study which examines the effects of parental expressed emotion (EE) on the symptomatic outcomes of adolescent bipolar disorder (BD) patients. The study evaluates the difference between family-focused therapy for adolescents (FFT-A) and a brief psychoeducational treatment or enhanced care (EC). The indicates that BD adolescents with high EE parents show more response to the FFT-A session compared to the psychoeducation in terms of improvement in depressive and mania symptoms of BD. The study also underlines the importance of assessing EE or other family-related functions before venturing on a full course of family treatment.

Objective To compare the relative long-term benefit of family-focused cognitive behavioral therapy (FCBT) and child-focused cognitive behavioral therapy (CCBT) for child anxiety disorders at a 1-year follow-up. Method Thirty-five children (6–13 years old) randomly assigned to 12–16 sessions of family-focused CBT (FCBT) or child-focused CBT (CCBT) participated in a 1-year follow-up assessment. Independent evaluators, parents, and children rated anxiety and parental intrusiveness. All were blind to treatment condition and study hypotheses. Results Children assigned to FCBT had lower anxiety scores than children assigned to CCBT on follow-up diagnostician- and parent-report scores, but not child-report scores. Exploratory analyses suggested the advantage of FCBT over CCBT may have been evident more for early adolescents than for younger children and that reductions in parental intrusiveness may have mediated the treatment effect. Conclusion FCBT may yield a stronger treatment effect than CCBT that lasts for at least 1 year, although the lack of consistency across informants necessitates a circumspect view of the findings. The potential moderating and mediating effects considered in this study offer interesting avenues for further study. [ABSTRACT FROM AUTHOR]

Objective: Qualitative research methods were used to understand the experiences of families seeking treatment for young people with recent-on- set psychosis; such knowledge can inform services design. Methods: The authors conducted open-ended interviews in 1999 through 2002 with family members of 13 patients with recent-onset nonaffective psychotic disorders in the New York metropolitan area, focusing on their experience in seeking treatment and engaging with mental health services. Results: Family members described early lack of clarity of diagnosis and obstacles to obtaining treatment. Entry into the mental health system frequently occurred in the context of crisis, with African-American families specifically reporting police involvement. Inpatient hospitalization was depicted as traumatic yet offering relief. Aftercare was described as fragmented, and issues with third-party payers were paramount. Families expressed a desire for more education, information, and support and described their struggles with stigma. These data from families are presented in the context of more recent literature as to the efficacy of specialized treatment programs for early stages of psychotic disorder and their involvement of families. Conclusions: These qualitative research data support the importance of involving and educating families about psychosis: its recognition, its treatment, and access to services. They also highlight the need to address stigma and implement structural changes in treatment that ensure continuity and coverage of care. Specialized first-episode psychosis services may address these issues, and they may minimize the traumatic experiences of involuntary hospitalization and police involvement early in treatment. [ABSTRACT FROM AUTHOR]

Expressed emotion (EE) is a robust predictor of outcome in bipolar disorder. Despite decades of research, interventions to reduce EE levels have had only modest effects. This study used an expanded model of EE to develop an intervention. Research has demonstrated a strong link between attributions and EE in families of patients with psychiatric disorders. There is also substantial research to suggest that anger can drive blaming attributions. Combining these ideas, this study built on previous psychoeducation interventions through the addition of an acceptance component designed to decrease anger and blaming attributions among family members of those with bipolar disorder. Twentyeight family members attended a 1-day or 2-evening multifamily group workshop and completed a follow-up assessment 1 week later. At follow-up, participants demonstrated more knowledge about bipolar disorder. Anger, blaming attributions, and number of criticisms remained unchanged. Results of this study are consistent with others in that it is difficult to change EE. Implications for future clinical research in this area are addressed. [ABSTRACT FROM AUTHOR]

This study addresses the dearth of research on families of children with serious emotional disturbances (SEDs) by examining parents’ perceptions of their families’ resources and stressors. Parent and/or guardian responses on the Family Inventory of Resources and Stressors (FIRST) whose children were receiving treatment for SEDs ( n = 80) were compared to those with children without SEDs ( n = 48). One-way ANCOVA analyses revealed that, when controlling for income and education level, families of children with SEDs reported significantly greater stress levels than families of children without SEDs, but both groups reported similar levels of resources. The principles derived from this study provide critical information for treatment providers and researchers seeking to develop an in-depth understanding of the resources and stressors of families of children with SEDs so as to more effectively collaborate with them in treatment planning. [ABSTRACT FROM AUTHOR]

This article analyzes help provided by relatives and/or services to the needs of individuals with severe mental illness who have, versus do not have, regular contact with family. Factors that influence help are also examined. Data collection is based on a random sample of 186 Quebec outpatients. Patients’ needs were assessed using the Camberwell Assessment of Need. Relatives provided adequate help for social and functioning needs, adequately complementing services in other needs categories. Six sociodemographic variables influence help from relatives, only one affects help from services. The role of relatives is identified as important in meeting patients’ needs, either solely or jointly with services. [ABSTRACT FROM AUTHOR]

The article discusses three treatment areas in the early stages of psychosis: medications, psychological treatments and psychosocial interventions. The ideal setting and timing for treatment of first-episode psychosis is described. Practical advice on the initial medication management of first-episode psychosis is given. Psychological treatments including cognitive-behavioral therapy and cognitive remediation and psychosocial treatments such as patient and family psychotherapy education, and family and vocational interventions are discussed.

This cross-sectional study utilized a stress-process model to examine the impact of caregivers' (N = 82) perceptions of their relationship quality with a female family member (i.e., care-recipient) with substance-use or co-occurring substance and mental disorders on caregivers' perceived burden. Regression findings indicate that relationship quality impacts both subjective and objective burden. Higher levels of emotional support given to the care recipient by the caregiver predicted lower levels of caregiver displeasure; whereas higher levels of undermining of the care recipient by the caregiver predicted higher levels of caregiver stigma. Higher levels of emotional support received by the caregiver from the care recipient were associated with lower levels of caregiver displeasure and lower objective burden; higher levels of undermining of the caregiver by the care recipient predicted higher objective burden. Implications for practice and service delivery are presented. [ABSTRACT FROM AUTHOR]

Objectives: To understand and promote recovery from serious mental illnesses, it is important to study the perspectives of individuals who are coping with mental health problems. The aim of the present study was to examine identity-related themes in published self-narratives of family members and individuals with serious mental illness. It adds to the body of research addressing how identity affects the process of recovery and identifies potential opportunities for using published narratives to support individuals as they move toward positive identities that facilitate recovery. Method: Forty-five personal accounts from individuals with severe mental illness, which were published in two prominent research journals between 1998 and 2003, were qualitatively analysed. Results: Individuals with mental illness and their family members described a loss of self and identity that had to be overcome, or at least managed, for recovery to become possible. Writers described (i) a loss of self, (ii) the duality of (ill/well) selves, (iii) perceptions of normality, (iv) specific concerns about parenting and identity, and (v) hope and reconciliation. Conclusions: Individuals' stories of their experiences of severe mental illness describe severe challenges managing identity. Efforts to publish personal accounts that focus on strengths-based patient-centred stories, rather than on deficits, could be helpful to provide hope for patients. These published narratives highlight the importance of moving recovery and hope to the forefront among patient, family, and clinician groups. Increasing such information and role models can provide important resources to individuals working to redefine themselves and create a sense of self-worth and stable identity that will support productive, happy lives. [ABSTRACT FROM AUTHOR]

Many studies have examined the construct validity of the criticism component of expressed emotion, but little work has been done on clarifying the emotional overinvolvement (EOI) construct. In a sample of 115 recently episodic patients with bipolar disorder, the authors of the present study examined the construct validity of an observational coding system for both appropriate and inappropriate emotional involvement that permitted separate ratings for relatives' intrusiveness, self-sacrificing behaviors, and distress related to the patient's well-being. Findings support the measure's reliability and convergent validity and are moderately supportive of the measure's discriminant validity. Results also suggest that Camberwell Family Interview (C. E. Vaughn & J. P. Left, 19761 EOI ratings do not discriminate among the different dimensions of the emotional involvement construct (or their appropriateness or inappropriateness) as revealed in laboratory-based interactions. The findings suggest that clinicians working with such families might consider differentiating among the various ways in which family members are involved with the patient and helping them learn to judge under what circumstances such involvement is appropriate and inappropriate. [ABSTRACT FROM AUTHOR]

This article presents findings from a qualitative study of family group conferences (FGCs) in Wales, UK. The study examined the process of seventeen FGCs involving twenty-five young people, using semi-structured interviews, analysis of documents and collection of data on welfare outcomes. Young people were re-interviewed after six months. The article focuses on the data concerning reported communications between family members during the family meetings. These data are discussed in relation to similarities and differences between FGCs and family therapy sessions. The authors conclude that each method of intervention presents potential lessons and challenges to the other. FGC co-ordinators might wish to reflect on how to manage and prepare family members for the potential for expressions of emotion and disclosures of confidential information that might arise in a family meeting. Family therapy has a long history of successfully working with such processes. Additionally, family therapists may wish to reflect on the successful management of intra-familiar conflict and disclosure by many families acting without a therapist or other professional present in a FGC. [ABSTRACT FROM AUTHOR]

Family psychoeducation is a highly effective, but underused, evidence-based practice in the treatment of schizophrenia and other serious mental illnesses. This study examined views about family relationships and family participation in care among a sample of 69 consumers with serious mental illness receiving treatment within the Department of Veterans Affairs healthcare system. We found that younger consumers and those with higher levels of psychiatric symptoms were more likely to report family conflict and distress. Of participating consumers, 67% wanted family participation in their psychiatric treatment and those with at least weekly contact with family were more likely to want family participation. Consumers endorsed a number of barriers to family participation in their mental health treatment, including their own concerns about privacy and burdening family and skepticism that family involvement would be helpful. We discuss implications of these findings for the implementation of evidence-based family programs, including efforts toward development of a novel intervention that will address consumers' concerns and promote effective family participation in care. [ABSTRACT FROM AUTHOR]

The article focuses on the research of practice guideline for family psychotherapy assessment. Family assessment is described as one of the major components of complete psychiatric assessment for children with psychiatric disorder. The research examines the genetic history of the child's disorder, as well as the family interaction with the child's disorder. It illustrates the clinical standardization in assessing medical treatment for children with psychiatric disorder.

The PLAY Project Home Consultation (PPHC) program trains parents of children with autistic spectrum disorders using the DIR/Floortime model of Stanley Greenspan MD. Sixty-eight children completed the 8–12 month program. Parents were encouraged to deliver 15 hours per week of 1:1 interaction. Pre/post ratings of videotapes by blind raters using the Functional Emotional Assessment Scale (FEAS) showed significant increases (p ≤ 0.0001) in child subscale scores. Translated clinically, 45.5 percent of children made good to very good functional developmental progress. There were no significant differences between parents in the FEAS subscale scores at either pre- or post-intervention and all parents scored at levels suggesting they would be effective in working with their children. Overall satisfaction with PPHC was 90 percent. Average cost of intervention was $2500/year. Despite important limitations, this pilot study of The PLAY Project Home Consulting model suggests that the model has potential to be a cost-effective intervention for young children with autism. [ABSTRACT FROM AUTHOR]