Family Involvement

Julienne Giard, LCSW, 860-418-6946,

Tips for Involving Family Members
  • Family members often serve as de facto case managers, offering emotional support and advocacy on behalf of consumers.  They help with medication management, appointments, and activities of daily living.  They provide financial assistance and housing for consumers.
  • Family members frequently lack access to needed resources and information.
  • Family members experience practical problems like paying medical bills and obtaining services.
  • Family members have diverse emotional responses to having a relative living with a mental illness including hope, denial, guilt, grief, fear and anger.  These are all normal reactions to altered hopes and expectations and are not a result of family members’ dysfunction or illness.
  • Family members experience stigma—extended family, friends and even mental health providers may blame them in some way for their loved one’s illness/behaviors- which can lead to feelings of shame, self-blame, isolation and even depression.
  • When there is tension and conflict between consumers and families, this destabilizes families and consumers and interferes with recovery.
  • Children of individuals with mental illnesses or substance use disorders experience higher rates of depression and anxiety, and may have more behavioral and school difficulties.
Benefits of Involving Families in Consumers’ Recovery
  • Involving family members improves clinical outcomes, satisfaction, and higher rates of recovery among consumers.
  • Consumers may feel more supported in their efforts to manage the effects of illness.
  • Consumers may be able to reestablish or strengthen relationships with families.
  • As they gain greater knowledge about serious mental illnesses, families experience general improvement in well-being, including decreased feelings of confusion, stress and isolation and reduced medical illnesses and use of medical care.
  • With lower relapse rates and fewer hospitalizations, family involvement practices cost less than the traditional approach of medication management and individual therapy.
  • Involvement can lead to decreased complaints from families about services and greater family support for agencies providing services.  This can translate into grassroots political support for increasing funding for expanded and improved services.
  • Family members and family advocacy organizations can support and encourage other family members, enabling mental health providers to focus on their primary task of caring for the person in recovery.
Ideas for providers to ensure successful family involvement in services
  • A Consistent Message:  Discuss the importance of family involvement for positive outcomes and inform consumers of their right to involve family members in the treatment process. Actively request consent to contact family members and significant others in order to evaluate how they can be involved in the consumer’s recovery. Don’t wait for a crisis to ask about involving family; modify intake and assessment procedures to ensure that consumers are routinely told about the opportunity to involve family members.  Revisit this issue on an ongoing basis.
  • Partnership & Respect:   The partnership of provider, family and consumer is a key to the success of consumers’ recovery.  Successful family involvement recognizes and validates family members’ strengths, experience and expertise as a part of the partnership.  A strengths-based and respectful environment instills hope for the future.
  • Support and Advocacy:  Family involvement approaches offer social and emotional support to families, sending the message that they are not alone and providing an opportunity for constructive problem solving around specific issues. Peer support and mutual aid can create a social support network for consumers and their families.NAMI-CT, along with the Regional Mental Health Boards, also offer opportunities for family members to advocate for better services and for mental health policy change at the state and federal level.  The Regional Mental Health Boards were established by the Connecticut State Legislature in 1975 and offer a unique grassroots structure for ensuring quality services throughout the state. (Please visit: Regional Mental Health Boards for more information.)
  • Education and Resources:  Family members who receive information and resources about mental illnesses are better able to support consumers.  They are able to identify symptoms and risk factors, understand and support treatment goals, and promote recovery.   It is recommended that providers have brochures and information on local resources available to families (including information on local NAMI affiliates.
  • Ongoing Guidance:  In partnership with the consumer and family members, create a detailed crisis response plan, including contact information for providers and services.  Family members like to feel equipped to respond when a consumer is in danger of relapse.
  • Expectations:  Each family member may have differing expectations of the mental health treatment program, and some may be unrealistic.  These expectations may also conflict with the consumer’s perspective and goals.  It may be necessary to continually clarify expectations throughout the course of treatment.
  • Communication:  Be sensitive to family members’ feelings of denial, anger, guilt and loss.  Listen to differing viewpoints from family members and the consumer.  Family members may not always want answers, but may simply need someone to listen to them and validate their feelings.  Family members may need assistance in coming to terms with altered hopes and expectations, and with finding services that support their own needs in this process.  Help families and consumers create clear ground rules for communication, to ensure that the needs and preferences of the consumer are being heard and fully involved in discussions.  Support the family in sticking to these ground rules.
1.  Levels of Family Involvement
a.  Definitions (e.g. education, support, recovery planning/treatment team, therapy)
b.  See #5 below for information on Family Psychoeducation
2. Tools for Programs to Develop Capacity/Infrastructure
3.  How to Engage Families
4.  Resources for Staff in Working with Families
5. Family Psychoeducation
Note:  While DMHAS would prefer the term “family education”, SAMHSA and many other sources use the term “family psychoeducation”, therefore, the more well-known family psychoeducation terminology is referenced throughout this website. Also, while the specific Family Psychoeducation model released by the Center for Mental Health Services (CMHS) at SAMHSA targets individuals with severe mental illnesses being served in mental health settings, it is generally accepted that supportive family involvement in the recovery process is important and beneficial for all consumers with behavioral health disorders in all mental health and addiction treatment settings.
There are many ways that families/support persons can be involved in the recovery process.  The Family Psychoeducation model is discussed below as well as other types of involvement.
a.  Overview