Family Therapy

Group Interventions -10

Family Therapy

Family therapy is an important component of psychosocial rehabilitation of mentally ill and substance dependence cases. In rehabilitation centres, the family participation in the treatment process of persons affected with mental illness is encouraged. 

Psychiatric social workers play a role or liaison between the client, family and other treatment professionals. 

Initially the interaction with the family are focused on developing a working relationship, eliciting information about the client, illness and the related problems, brief history of family members, understanding about the family dynamics etc.

Family therapy is based on assumptions like:

1. Family member can often be the best to understand the person’s problem.

2. The behavior of one family member has an effect on other members.

3. Family members can often be the part of the solution of the problem.

Given below are some of the roles of family members in the treatment programme and that can be focused during the therapy sessions.

Family members’ fair and detailed understanding about the nature of patients’ illness is crucial in the treatment and recovery. It is found that many of the family do not understand about the illness in detail. Even though many families know about it, they don’t want to accept the facts about the illness and the nature. Many times family says that ‘my son is not a mental patient’ like that. They always connect aggression and violent behavior with mental illness. Out of fear that if they tell the truth about the disorders to the patient they may feel worried or the illness may get aggravated. It is generally accepted that family members who understand the nature of illness can help the patient to get well.

It is important to know that the treatment for mental disorders is long-term process. Long-term medication and constant psychosocial interventions plays important roles in the treatments.

 Realizing misconceptions regarding illness and correcting these misconceptions. Many a families still do not understand the importance of scientific treatment modalities available and efficacy to the same in healing. They still continue to believe that witchcraft, black magic, etc and supernatural powers are responsible for illness. Many a family believes that marriage of a mentally ill person is the solution to his problems. Usually the spouse is the one who is blamed for the partner’s illness. Sometimes family has a higher/over expectation on the treatment that magical changes happen in the patient soon once the treatment starts.

The atmosphere in the home of the patient is also important factor in the patient’s improvement. If there are quarrels in the house, marked dissention of opinion, physical violence or constant nagging, these can adversely affect the recovery of the patient. Similarly, when there is a communication gap or when family members are hypercritical or if they constantly express their displeasure- with the patient (high expressed emotions) this can again affect the patient’s improvement adversely.

Family joint sessions with the client are helpful in confronting the clients who are guarded or denying their illness and related behavioral disturbances. Many times, they develop a better understanding and acceptance of their problems after the joint family sessions. 

Therapist facilitates direct and open communication between the patient and the family during the sessions and thus, helps to settle many conflicts among them. 

Psycho education, supportive techniques, communication skill training, problem solving, are some of the techniques which can be used in helping the family to have a better understanding and way of dealing with the patients.