Exam 1 Mental Health Chapter 11

Chapter 11 Working With the Family Family!&!the!Recovery!Model! -Family members are main providers economically, emotionally, physically, and as a source of knowledg -Family members face the following challenges: >caregiver burden >stigmatization >fear of aggression >potential for mental illness in one family member negatively influencing th mental health or other m >mourning >shame & guilt >difficulties in communicating with health care professionals -Movement within the cyclical nature of mental illness involves positive risk taking A!Normal!Family -Functional -Normality is not measured by a lack of symptoms or the severity of problems -Fits established social or cultural patterns -No families are problem free -Effective coping mechanisms Family!Characteristics! -Nurture & support members -Provide stability & cohesion -Protect the vulnerable -Provide the platform of truth for children -Provide clear lines of authority -Acknowledge each member’s value -Prepare members to cope in society Stages!of!Family!Development 1. Young adulthood: separation from family of origin without a cutting off 2. Coupling: joining of 2 families, characterized by an overlapping of 2 families to develop a 3rd 3. Family with young children 4. Family with adolescents 5. Family at midlife: launching children & moving on the explore new pursuits (empty state) 6. Family later in life: deal with issues of adjusting to retirement, becoming grandparents, facing eventua Contemporary!Families! -Nuclear family is no longer predominant structure; divorce, remarriage, & same sex marriages have led parent families, blended families, and families with two parents of the same gender -More culturally diverse as a result of immigration, intermarriage, and cross cultural adoption -New challenges; balance between cultural heritage, values, norms, & behaviors; discrimination & racism familiarity with a new culture; difficulty speaking the language; lack of job -Societal changes can cause stress in the family -Communication technology (constantly aware of world events); fear about future; personal safety; rando violence; gang wars; racism Family!Systems!Theory -A collective unit made up of individual parts -Every member plays a critical & unique role in system -Change in one member of the system affects the entire system The child taking care of the adult responsibilities in the family A member of the family who is blamed for the conflict in the family; family members trying to “fix” the identified patient rather than the real issues A family structure that resists the demands for change; individual boundaries are not r A family structure where members are distant & disconnected; boundaries are rigid behaviors of one family member does not affect other members Occur when there is a conflict between 2 family members and they attempt to in a third person to take a side Effects!of!Mental!Disorders!on!the!Family! -Dx can elicit feelings of guilt, concerns over prognosis and course, & worry that others may become ill -Stigma to mental illness leads to shame & embarrassment about how others might view the family -Dealing with patient behaviors and consequences & agencies and institutions available to assist family m -Common issues that may surface as a result: >medication use Family!Reactions!to! >lack of energy to complete >social isolation Psych!TX!&! >acting out behaviors Hospitalization! >mood swings >denial of disorder -Initially relief may be felt >inappropriate or incomprehensible communication -Immediate family may not want others to kno >persistence of dangerous behavior -Family might be exhausted because of difficu >manipulation of others coping with patient behaviors -Grief issues: -May have conflicting emotions with involunta >loss of individual functioning commitment >altered family functioning -Frequent admission might cause burnout >lost income -If abuse or assault is discovered in the family, >stigma patient may feel relieved but also feel ange >questionable future rejection, or humiliation -Nurse’s role: >assess & listen without judgement >refrain from perceiving family as problem >refrain from placing blame >family therapy is beyond scope of practic Abilities!Needed!when!Working!with!Families! -Avoid allowing personal concerns or crisis to interfere with the ability to care for the patient & family -Nurse must model adaptive self care & stress management techniques -Assessments include: >family characteristics in both the family of origin and the present family >development stage of family at time >family’s accomplishment of developmental and daily tasks >patient & family’s reason for seeking tx & reactions to care >effects of mental illness on family members & family as a whole >family strengths >family understanding of mental disorder >current interaction skills between family members >other aspects of the patient, family members, or significant others that might affect care >understanding of mental disorder >current coping skills