This month we learn about the first family psychoeducation project in Kansas.  Sue Ellen Jayne, consultant and trainer in the Office of Mental Health Research & Training at KU's School of Social Welfare facilitated the implementation and we hear from her about the process and outcome of the training thus far.

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By Sue Ellen Jayne, LMSW

Kansas Partnership of Families (KPF) is a family-consumer-professional partnership that combines clear, current information about mental illness with training in problem solving, communication skills, coping skills, and the development of social networks.  Extensive research shows that implementing family psychoeducation dramatically improves the lives of people diagnosed with schizophrenia, as well as reducing family stress and strain. (http://mentalhealth.samhsa.gov/cmhs/communitysupport/toolkits/family)

The following summarizes the events at Valeo Behavioral Health Care in Topeka, Kansas, which became the first site in Kansas to implement evidence-based practice family psychoeducation.

Since January of 2008, staff from Valeo has been meeting regularly to plan and develop KPF.  Cara Weeks, Crystal Bearden, Chris Wills, Shirley Hudson, Linda Edwards, Mike Fowler, and Glea Ashley make up the team of staff who has diligently worked together with KU to develop KPF.  Eric Harkness and Tammy Broadbent of NAMI have also been a part of this team in developing the program.

Engagement and Joining:
In June of 2008, family practitioners started “joining” with consumers and their family members.  In these joining sessions, family practitioners start partnering with the consumer and family to build rapport, to convey empathy and hope, and to establish an alliance.  These sessions focus on the family’s and consumer’s experience with mental illness, the consumer’s precipitating factors and prodormal signs, and the identification and teaching of coping skills.  The family practitioners meet with the consumer and family for at least three joining sessions to gather information for a “family support plan”.  This plan acts as a crisis plan for the practitioner, family member, and consumer to refer to.

Educational Workshop:
After the joining sessions were completed with six consumers and their family members, the KPF team along with Valeo’s psychiatrist, Dr. Mohiudden, presented a one day educational workshop for consumers and family members in September of 2008.  The curriculum covered psychobiology, diagnosis, treatment and recovery, reactions to experiencing psychosis as a family, relapse prevention, and family guidelines.  One family member’s response to the workshop was “…what a great sharing of information and resources!  The setting was so pleasant and the format interesting and helpful.  Actually, I would say the material is life changing.  The heartening thing is we get to continue this group!  I’m excited!”  

Multifamily Groups:
The following month, the six consumers and their family members, along with the family practitioners, and the KU consultant, Sue Ellen Jayne, met for the first multifamily group.  During the first and second multifamily groups the partnership building between the consumers, family members, and professionals continues.  Everyone is given the opportunity to introduce themselves by talking about their hobbies and interests, and the opportunity to talk about how mental illness has affected their lives. 

Problem Solving Process:
In November of 2008, the group met for their third multifamily group session.  This session began the problem solving process which will be the focus of the multifamily groups.    During the problem solving process, everyone is given the opportunity to provide ideas on how to solve a problem that someone in the group is dealing with.  This process is structured to include identifying the problem, defining the problem, generating solutions, reviewing pros and cons, selecting a solution, and developing specific plans to carry out the solution.  The consumer and family are asked to try the solution during the next two weeks, and then to discuss the results at the next multifamily group.  The group will continue to meet twice a month for 9 months and then once a month for however long the group determines.

Fidelity:
In January of 2009, KU completed a 6 month fidelity review to determine the progress of implementation for the program.  The results of this show that Valeo’s dedication to working with consumers and family members has been successful.  The fidelity scale for family psychoeducation outlines in detail the steps of implementation in which Valeo has worked on to develop the program.  Valeo scored the highest that could be achieved at this stage of implementation with a score of 62 out of 70.  This is an increase from the baseline score of 14.

Outcomes:
The following information was gathered at the fidelity review from charts, interviews with staff, consumers, and family members, and observation:

·         Decrease in crisis calls by a family member.

·         Increase in utilization of mental health services instead of hospitalization.

·         Increase in knowledge about mental health, recovery, the mental health system and NAMI.

·         The use of the problem solving process outside of the multifamily groups.

·         Increase in relationship building among staff, consumers, and family members.

·         Consistent attendance and participation of consumers and family members from the beginning of implementation to the present.

Valeo’s success as a pilot project in partnering with consumers and family members is being used as an example for other mental health centers that are in the process of developing their own Kansas Partnership of Families program.