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July 02, 2012

Multifamily Group Therapy for Clients with Severe and Persistent Mental Illness

Although there are many forms of therapy which have proven effective for clients with a variety of mental illness diagnoses, there is inconclusive data in regards to schizophrenia. However, one type of therapy has shown to be quite effective: multifamily group therapy (McFarlane 2002). The goals of multifamily groups are to create social networks for families and clients with schizophrenia and bipolar disorder, to educate families about the illness, to reduce symptoms, and to teach problem solving. Research suggests that clients attending multifamily groups have a relapse rate of 50% less than clients not attending the group. Also, over a two year period, clients in the group reported significantly lower negative symptoms (McDonnell et al 2007).

The structure of a multifamily group is important for the integrity and validity of the group. The group runs bi-weekly for two years and typically involves eight families and two leaders. The group begins with two joining sessions in which the leader meets privately with the family and then the client to discuss precipitants, symptoms, coping, and family reactions. Families then attend an educational workshop with other families during a 6 hour session. Usually this is hosted by a multi-disciplinary team which allows family members to ask questions from practitioners with a variety of backgrounds. Next the group begins. The first two sessions are unique in regard to topic. The first session is a “getting to know you” session and illness is not discussed. The second session discusses how the illness has impacted the family.

All later sessions begin with socialization and the bulk of the session is a problem solving activity in which there is a go-around of something good and a struggle. The leader writes all struggles on the board and then chooses one based on severity. The group then discusses possible solutions and writes them on a board. After there are at least 10 options, the group rates the pros and cons of each option. The client then chooses two options to try over the next two weeks.
Group problem solving has proven to be effective because it raises new ideas and options that families may not have considered, and it allows for socialization. The group also follows specific guidelines set by leaders which promote healthy communication and low emotional expression. The role of the leaders is to collaborate with families and facilitate discussion. The leaders are also educators and coaches. These types of groups can be run in any setting and are often led in community mental health facilities.

Posted by desolada at July 2, 2012 10:12 AM

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