Families, only us.Families, only us.

For better for worseIn sickness and in health

Val Jackson March 11th 2015

Research EvidenceResearch Evidence Meta analyses of research studies show that systemic therapy is

at least as effective as other therapies and/ or medication (and is not harmful).

“The review of the existing evidence base finds substantial evidence for the efficacy and the effectiveness of family interventions. Where economic analyses have been carried out, family therapy is found to be no more costly, and sometimes significantly cheaper, than alternative treatments without loss of efficacy.” Peter Stratton (2011:4)

Russell Crane (2008) The cost effectiveness of Family Therapy: A summary and progress report. Journal of Family Therapy, 30:399-410

Alan Carr’s reviews of evidence base for child and adult studies (2011) Journal of Family Therapy, 36: 107–157 & 158–194.

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Key messagesKey messagesInvolving a partner & /or the family

improves outcome

Relapse rates in psychosis are more than halved when family interventions are added to standard care (including medication).

Well-being of all family members improves and visits to GP are reduced.

Family therapy reduces carer stress/burden which may otherwise precipitate serious mental health problems in carers.

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NATIONAL POLICIESNATIONAL POLICIES

1. (NSF) for Mental Health (1999)

2. (NSF) for Older People (2001)

3. Valuing People: A new strategy for learning disability (2001)

4. MH Policy Implementation Guide: CMHTs (2002)

5. MH PIG: Adult Acute Inpatient Care (2002)

6. MH PIG: Psychiatric Intensive Care Units & low Secure (2002)

7.NICE Clinical Guidelines for Schizophrenia (2014)

8. NSF for Children, Young People and Maternity Services (2004)

9. NICE Clinical Guidelines for Eating Disorders (2004)

10.NICE Clinical Guidelines for Depression (2004)11.NICE Clinical Guidelines for Dementia (2006)12.Think Family: Improving the life chances of families at risk

(2008)13.Triangle of Care; NMHDU/ Carers Trust (2010/13)

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What’s different?What’s different?

If we expect our clients to talk about their backgrounds we must consider our own,

or we may be confronted with unexpected reactions that influence the conversations we have with our clients.

SOCIAL GWRRAACCEESS SOCIAL GWRRAACCEESS (JOHN BURNHAM ET AL )(JOHN BURNHAM ET AL )

Gender CultureWealth ClassRace EducationReligion EthnicityAge Spirituality Ability Sexuality

Family life cycleFamily life cycleBirths Deaths MarriageChildren starting schoolChildren leaving homeMoving house Divorce/separation Illness Change of occupation

Polyphonic (inner)voicesPolyphonic (inner)voicesMotherWifeSisterDaughterAuntFriendClinicianSupervisorDog owner

Write down your own Write down your own polyphonic voicespolyphonic voices

Mary

Sue29

Peter

Tom 25

Ben27

Joe32

2 serious psychotic episodes, 2nd one after stopping his meds

Both after visits to his father

Left the family home when Ben 11, very successful business man,travels the world, paid no maintenance, several partners

Lots of violence in the home, father had destroyed all the internal doors

Worked full time as a shop assistantto raise her children alone, no new partner. Raised in Kenyaas an only child, her 4 elder siblingshaving been killed in ‘ethnic cleansing

Turn to your neighbour and Turn to your neighbour and ask them which ‘polyphonic’ ask them which ‘polyphonic’ voice was the loudest ?voice was the loudest ?

BethBeth I chose to speak to my sister about some key events

during our early life. Despite growing up in the same home I was really surprised that we had such different experiences and memories of events. What surprised me most was my surprise at this revelation.  I often think about this perspective talking with my clients and help them understand the responses of friends, family and loved one though the idea that you can be next to someone experiencing the same thing and yet tell a different story or have a different memory of the event as we are all different yet somehow I hadn’t applied this to my own family and our experiences. It’s funny how you can know the theory and yet not really get it. It’s the difference between head knowledge and heart knowledge. Talking with my sister really helped me feel and fully understand this reality more than ever before. I’m not going to forget that quickly.

Only us