Getting Family Members Involved in Your Client's Recovery
Involving client families in therapy can improve communications, reduce stress, and help your client's recovery from co-occurring disorders. Despite these benefits, many clinicians find it difficult to include family members in their clients' care. Here are some tips and guides for getting families involved.
Clinicians may want to use the Engagement Checklist during the initial contact over the phone. The checklist was developed by the authors of IDDT.
Despite the effectiveness of family work, many mental health and addiction programs do not have a family component. Many clinicians never ask clients whether they would like to involve a family member in their treatment. Some just assume the clients don't have family, while others believe that family would be more of a problem than a help.
Even when clinicians do ask clients about family, some clients fear involvement would be too stressful or too burdensome for their families. These issues can usually be successfully addressed. Clinicians who lack experience working with families could benefit from practicing with colleagues who have done family work. In addition, clinicians can use motivational techniques to help them in their work with families.
Several key principles should guide the family education process to help make it effective.
First, information must be provided through a variety of teaching methods to allow for different learning styles.
Second, family education must be presented in a low-stress environment; it is easier to learn if everyone in the family is relaxed and feeling safe.
Third, there must be an atmosphere of hope, where clinicians express confidence that recovery from co-occurring disorders is possible. This helps the family members feel hopeful as well. Fourth, the focus is always on the present and future, not the past.
Finally, family psychoeducation is strengths-based. It focuses on the client's and family members' personal strengths instead of deficits.
How to Get Families Involved in Treatment
Family involvement begins with a recommendation from the treatment team. This is easier if family clinicians are members of the treatment team and attend meetings regularly to reinforce the relevance of family psychoeducation. Whenever a family is engaged, the intervention should be listed on the client's treatment plan. In terms of stages of treatment, any stage is appropriate for family psychoeducation. Sometimes a family in crisis may be easier to engage, but families can be involved at any point. Here are the basic steps for involving a family in a treatment plan.
Clinicians inform clients about the family psychoeducation program.
Clients identify family members that they would like to involve.
Clinicians contact the family members to schedule a meeting to discuss the program.
Family members and the client meet with the clinician to discuss the program and decide if they want to participate. (Meeting in the family members' home can be an effective engagement tool.)
If there is interest, an orientation meeting is held. At this meeting, the program is described in more detail, any concerns of the family are addressed, and family work begins.
Possible client issues
Clients often feel that they have put their families through enough and don't want to burden them any further. Clinicians can help clients see that family psychoeducation will reduce stress by improving communication and problem-solving skills within the family.
Some clients worry about family members finding out about their alcohol or drug use or other private issues. Clinicians need to reassure clients that private matters can be kept confidential if they wish. Certain information, such as relapses, will be important to share with the family, and clinicians should encourage clients to do so.
Possible family issues
The initial contact with a family member is often by phone. The goal of the contact is to get family members interested enough to meet the clinician in person. The personal contact allows family members the opportunity to tell their story. If at all possible, clinicians should arrange to meet in clients' homes. In this way, clinicians see clients in their own environment and can learn more about the clients' situation.
Often family members of clients with co-occurring disorders feel stigmatized. They may have given up friends and activities because of embarrassment over the client's behavior. Family members often have built up strong negative feelings and need to vent. By using active and reflective listening, clinicians communicate their understanding to the family members. Clinicians should look for ways to point out how the family psychoeducation program can address the family's present and future needs. Clinicians should also convey the message that change is possible.