Spiritual Approach in Family Therapy and Family Coping

Patient with Mental Disorder

Ah. YusufFaculty of Nursing, Airlangga University, Surabaya, Indonesia.

Mental Disorder

Problem with Behavior;Kognitive, afective,

psychomotor

Global Burden Desease

Family Coping

Objective &

SubjectiveBurden

Family Therapy

Spiritual

Health Belief

InteractionSupport

Mental Health STIGMA

Mental Disorder

Problem with Behavior:Kognitive, afective,

psychomotor

Global Burden DeseaseFamily

Coping Objective Subjective

Burden

Family Therapy

Spiritual

Health Belief

Interaction Support

Mental Health STIGMA

Modality Therapy

Mental Health Disorder in IndonesiaBasic Research in Health , 2013

Website: www.litbang.depkes.go.id

Mental Health Disorderin Indonesia

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Serious Mental Ilness (Psychosis)

East Java Population : 38.000.000. Adult :

70% X 38 mil = 26.600.000. ESTIMATE the Psycho-social Problem (East Java 6,4)

6,4 % x26.600.000 = 1.702.400 people

Disturbed: Quality of Live, Quality Work of Live, and Productivity

Psychosocial Problem (National 6,0)

East Java Population: 38 Mil Adult 70 %:

70% X 38 Mil = 26.600.000. person

ESTIMATE of PSYCHOSIS (East Java: 0,22 %) 0.22 % X 26,6 Mil = 58.520 People

ESTIMATE of PSYCHOSIS (National: 1,7/1000)

ESTIMATE LOSS of ECONOMIC: PATIENT X Regional Salary 58.520 client x 2.200.000 IDR = 128.744.000.000 IDR CARE GIVER 1 = 128.744.000.000 IDR

TOTAL: 257.488.000.000,- IDR/Month

Global Burden Desease

Potential Economic Loss

Mental Hospital in East Java Dr. Wediodiningrat Lawang : 600 bed Menur Mental Hospital : 300 bed Psychiatric Unit General H : 100 bed TOTAL : 1.000 bed

57.520 clientin Hospital with out Wall

(Homeless Psychiatric)

Big ProblemGovernment, Community, and

Family

Mal-Adaptive Coping & Mis Choise of Treatment

Homeless Psychiatric

Serious Mental Ilness with Stocks, 201320.0

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City Village Indonesia

Website: www.litbang.depkes.go.id

Type of Stocks

◦Restrain◦Seclusion

◦Restrain + Seclusion

◦The End of Choice of Treatment Indonesian People for Client with Cronic

Schizophrenia

Restrain

Restrain in MH

Seclussion

Restrain + Seclussion

It’s Wrong Discrimination

Neglected & Violent of Human Right It’s Stigma in a part of Indonesian

Population

I’m so Sorry

Indonesia Concern

Solve: Mental Health Problem

No Neglected & Save Human Right

Now....

New.. Police

WHO Mental Health Action Plan 2013-2020 ASEAN Mental Health Taskforce Sustainable Development Goals 2015-2030 Police Statement:

◦ National Development Plan 2014-2019: Change of people structure, Epidemiologycal transition to increase of Healthy Elderly and prevent of Mental Ilness.

Target: increase public health status: decreasing un-infectious desease (heart attack, diabetes, stroke, hypertention, & mental health)

Indonesian Mental Health LawNo. 18 / 2014

New Spirit for: ◦POLICE REFORMATION◦SOCIAL INCLUTION◦COMPLETELY REMOVE OF STIGMA◦REDUCTION OF DISCRIMINATION◦PREVENTION OF VIOLATION OF HUMAN

RIGHT

MENTAL HOSPITAL

(ACT)

PRIMARY HEALTH CENTER(CMHN)

PATIENT/ FAMILY(SHG)

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Mental Hospital – Public Health Care Center – Family & Community:

◦ Stressfull◦ Objective & Subjective Burden◦ Stigma ◦ Mis Knowledge & Choise of Treatment

Community Based ApproachFamily Treatment

Obstacle

PELATIHAN KADER KESWADI PUSKESMAS TUMPANG

COMMUNITY BASED APPROACH

Family Theraphy Psychodynamic & Bowenian Family

Therapies Experiental Family Therapy Behavioral & Cognitive – Behavioral Family

Thrapies Structural Family Theraphy Strategic & Systemic Family Therapies Solution – Focused & Narrative Family

Therapies

MODEL MAJOR THEORIEST

TREATMENT TECHNIQUE

Psychodynamic and Bowenian FT

Nathan Ackerman Transference Dream and Dayream Analysis Confrontation Focusing on Strengths complementary

Bowen Genograms Going Home Again Detriangulation Person to Person Relationship Differentiation of Self Asking Questions

MODEL MAJOR THEORIEST

TREATMENT TECHNIQUE

Experiential FT Virginia SatirCarl Whitaker

Modelling of Effective Communication Using “I” Messaging

Sculpting Choreography Play Therapy Filial Therapy Humor Touch Props Family Reconstruction Family Drawings Puppet Interviews

MODEL MAJOR THEORIEST

TREATMENT TECHNIQUE

Behavior and Coqnitive Behavior FT

Gerald PattersonNeil Jacobson Behavioral Parents

Training Marriage / Couple

Therapies Education Functional Family

TherapBehavioral Parents Training

Marriage / Couple Therapies Education

Treatment of Sexual Dysfunctioning

Functional Family Therapy

Education Communication and Problem Solving

Strategies Operant Conditioning Contracting Classical Conditioning Coaching Contigency Constracting Extinction Positive Reinforcement Quid pro Quo Reciprocity Shaping Systematic Desenitization Time Out Chatting Premack Principle Disrupting Irrational Thoughts Thought Stopping Self Instructional Training Modelling and Role Playing

MODEL MAJOR THEORIEST

TREATMENT TECHNIQUE

Strucutural FT Salvador Minuchin

Joining Disequilbrium Techniques Enactment Working with Spontaneus

Interaction Boundary Making Intensity Restructuring Shaping Competence Diagnosing Adding Cohnitive Constructions

MODEL MAJOR THEORIEST

TREATMENT TECHNIQUE

Strategic and Systemic FT

Jay Haley (Strategic)

Reframing Directive Paradox Ordeals Pretend Positioning

Mara Selvini Palazzoli (Systemic)

Hypothesizing Positive Conotation Circular Cuestioning Invariant/Variant Prescriptions Rituals

MODEL MAJOR THEORIEST

TREATMENT TECHNIQUE

Solution-Focused and Narrative FT

Steve deShazerBill O’Halon(Solution Focused)Michael White(Narrative)

Externalization of the Problem Influence (Effect) of the Problem

on the Person Influence (Effect) of the Problem

on the Problem Raising Dillemas Predicting Serbacks Using Questions Letters Celebrations and Certificates

Spiritual Approach

Family Theraphy, suitable with Indonesian Culturally

Someone with severe stress will seek comfort and strength from God

The core of all the values of human spirituality is prayer

Prayer contains the component of direction, obedience, and acceptance (DOA)

Spirituality

Direction, Obedience & Acceptance: Mental Ilness is can be Solve

Patient with Mental Ilness:◦ 33 % total recovery◦ 33 % social recovery◦ 33 % permanent in mentally ilness

Stressfull (Family with Schizophrenia)

That all of considers of this is the will of God. This is a good thing, just not a helplessness and despair families

BE PATIENCE

TRUST

Patience is not weakness, it is the power of patience

Patience is not apathy but a zest for life Patience is not sentimentality but

perseverance Patience is not pessimistic but optimistic

Patient is not silent but patience is unyielding struggle

BE POSITIVE ALWAYS

PATIENCE

BE POSITIVE ALWAYSIf you think you have huge tension,

look at them.

If you think your job is tough,how about him?

If you think your salary is low,how about her?

If you think you don't have many friends, ask yourself if you have one sincere friend?

If you think study is a burden,how about her?

When you feel like giving up,think of this man.

If you think you suffer in life, do you suffer as much as he does?

If you complaint about your transport system, how about

them?

If your society is unfair to you, how about her?

Don’t Forget.. Pray to Allah

If you asked Allah for one thing and received another

TRUSTAllah will give You

Cactus & CaterpillarrPhylosophy

Don’t Forget

Once there was a man who asked to Allah for a

flower & a butterfly

Once there was a man who asked to Allah for a

flower & a butterfly

But instead Allah gave him a Cactus....But instead Allah gave him a Cactus....

....and a

Caterpillar.....and a

Caterpillar.

The man was sad, he didn’t understand why his request was mistaken.

The man was sad, he didn’t understand why his request was mistaken.

Then he thought:Oh well, Allah has too many people to care

for...

Then he thought:Oh well, Allah has too many people to care

for...

And decided not to question.And decided not to question.

After some time, the man went to check up on his request that he had left forgotten.

After some time, the man went to check up on his request that he had left forgotten.

To his surprise, from the thorny & ugly cactus a beautiful flower had grown.

To his surprise, from the thorny & ugly cactus a beautiful flower had grown.

And the unsightly carterpillar had been transformed into the

most beautiful butterfly.

And the unsightly carterpillar had been transformed into the

most beautiful butterfly.

Allah always does things right!Allah always does things right!

His way is always the best way,even if to us it seems all wrong.His way is always the best way,even if to us it seems all wrong.

If you asked Allah for one thing & received another, TRUST.

If you asked Allah for one thing & received another, TRUST.

You can be sure that He will always give you what you need at the appropriate

time.

You can be sure that He will always give you what you need at the appropriate

time.

What you want...What you want...

....is not always what you need!....is not always what you need!

ALLAH never fails to grant our petitions, so keep on going for Him without doubting or

murmuring.

ALLAH never fails to grant our petitions, so keep on going for Him without doubting or

murmuring.

Today’s THORN...Today’s

THORN...Is tomorrow’s FLOWER!

Thank You

Is tomorrow’s FLOWER!

Thank You