In this age of spiraling health care costs, it is imperative that the family's role in treating patients with chronic mental illness not be overlooked - by policy makers and clinicians alike. The families themselves insist that the government and care-providing agencies learn new ways to relate to them and patients. Helping Families Cope with Mental Illness is a comprehensive guide to the family's experience of chronic and serious mental illness for clinicians and educators in a wide range of mental health disciplines. It details all major areas of the clinician-family relationship - consumer perspectives, cultural diversity, social policy, ethical issues, practical coping strategies, research and training issues, major service issues, managed care, and cost-saving measures.

Research shows that many adults with serious mental illness live with or maintain contact with their families. But families are rarely given information about their relative's illness and their own needs for support are ignored. To be optimally beneficial, family members and other caregivers need education about the disorder, some knowledge of illness management techniques, and personal support. Family psychoeducation (FPE) is a powerful evidence-based psychosocial intervention that serves consumers and their families.
FPE has proven efficacious in reducing relapse and hospitalization, reducing symptoms, increasing employability of persons with severe and persistent mental illness, and, in many cases, enhancing their families' well-being. Its success rests with a state-of-the-art education model for improving caregivers' understanding of their loved one's illness through learning what is known and not known about it and how to assess and cope with its manifestations. Here, in the first book of its kind, Harriet P. Lefley traces the history of FPE -- including the developments in mental health services and systems and theoretical approaches that inform it -- and the robust empirical evidence it now claims after a quarter-century of development and evaluation at major research centers around the world. Presenting first the approach's generic components, training models, and required competencies, Lefley then discusses the available variations, such as Family Education (FE), a brief manualized form of FPE offered by professionally trained family members that has some empirical support for knowledge gains and easing family distress. The result is a comprehensive, practical introduction to family psychoeducation that critically appraises the evidence and examines the model's place in contemporary mental health systems.
This groundbreaking volume is an ideal training tool for graduate students of social work, psychology, and psychiatry and a valuable addition to the clinician's armamentarium of evidence-based practices for clients with serious mental illness.

Research has shown that interventions providing psychoeducation and assistance to family members significantly reduce hospitalizations for people with serious mental illness, and help families cope. But research-based models have not been implemented in most mental health systems. This volume looks at the political and socioeconomic realities involved, and describes ways innovative family services have been provided, despite those factors, in many countries throughout the world.

Written by some of the world's leading researchers on psychoeducation, the text also includes material on the rise of family advocacy organizations worldwide. Professionals looking for innovative, culturally appropriate ways to help families and patients cope with mental illness will be most interested.

"This is the most comprehensive book to-date about the role that families play in caring for adults with mental illness. Unique to this volume is an examination of caregiving roles from an historical perspective as well as from the perspective of various caregiving relationships--parents, adult children, and siblings. Of special importance is Dr. Lefley's delineation of the nature of caregiving throughout the life cycle of the family." Agnes B. Hatfield, Ph.D., University of Maryland at College Park "I find Harriet Lefley's new book Family Caregiving in Mental Illness to be extremely thoughtful and comprehensive. It is all here--family theories and research, caregiving in the context of changes in the family life cycle, coping strategies, cross-cultural issues, advocacy, patient rights, and mental health policy. Dr. Lefley is the expert of experts when it comes to family caregiving in serious mental illness. The book is very readable and accessible to family members, social workers, and policymakers. It represents another big step in Dr. Lefley's courageous effort to bring family issues to public attention." --Richard Tessler, Ph.D. University of Massachusetts Deinstitutionalization suddenly catapults family members into being the primary caregivers for functionally impaired adults who are diagnosed with mental illness. This role as caregiver is one that family members are untrained and unprepared for. In Family Caregiving in Mental Illness, author Harriet Lefley explores the experiences of those giving care for adults with mental illness. She thoughtfully examines the unique characteristics and conceptual models related to mental illness and then surveys the experience of mental illness in the context of the family life cycle and developmental stages of the illness. Family burden, including social stigma; treatment barriers; iatrogenic stress; and the relationship between the patient and caregiver are appraised while the influence on other family members is highlighted. The stages of familial response, specific types of coping strategies, and professional and nonclinical services for families are reviewed, along with positive affects on the family's welfare. Finally, cultural factors affecting family caregiving are discussed in the international context and in terms of ethnic differences within the United States. Also considered are the impact of advocacy movements on caregivers, the legal and ethical barriers to care, alternative models to family caregiving, and the maintenance and growth of consumer-run services. All professionals working with persons with mental illness as well as researchers and students in this area will find Family Caregiving in Mental Illness illuminating and valuable.

In this era of revolutionary progress in the areas of science and medicine, it comes as no surprise that knowledge of the biology of mental illness and psychopharmacologic treatments has increased greatly within the past few decades. During this same time frame, however, the experiential side of mental illness has been almost completely neglected by researchers and educators. Fortunately, the trend is being reversed. Leading authorities are becoming increasingly aware that the personal experiences of people with severe and persistent mental illness can reveal the most authentic--and perhaps most helpful--information on behaviors that have long puzzled professionals in the field. This has contributed to a renewed and growing interest in learning more about the ways people experience mental illness and the process of recovery.
Leading the way in redressing the imbalance, this book examines the subjective experiences of patients with multiple diagnoses, including schizophrenia, bipolar illness, major endogenous depression, and other disorders with psychotic features and long-term disabling consequences. Numerous personal accounts are drawn from research reports, newsletters, journals, spoken reports, and observed behavior to shed light on the inner worlds of people afflicted with severe and persistent mental illness.
The volume covers a wide range of topics, starting with disturbances in the sense of self, in emotions, relationships, and behaviors, and in the ways reality is experienced by the mentally ill. In the process, some common patterns of lifetime experience are revealed even among patients with great differences in levels of functional capability andin their emotional and rational assessment of their experience.
The final section of the book is directed toward understanding the process of acceptance, growth toward recovery, and the development of an acceptable identity and new purpose in life.
Material is presented within the conceptual framework of coping and adaptation and self theory; in addition, considerable attention is given to the patient's perception of which types of personal and professional relationships have been helpful or not helpful. As a result, the book yields important lessons--from the patients themselves--on how service providers, caregivers, and the community at large can be most helpful to those afflicted with major mental illness.
Professionals who wish to increase their capacity for empathy, develop more effective rehabilitation strategies, and advance research linking brain anomalies and patient experience will find this book illuminating. Because it illustrates in moving and powerful ways how people truly experience psychiatric disability in a society that demeans their condition and in a helping environment that only dimly understands their agony, the book will be extremely useful for psychiatrists, psychologists, social workers, psychiatric nurses, educators, and graduate students in psychopathology and clinical skills training.