Employment multifamily group project
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Employment Multifamily Group Project. Alex Kopelowicz, MD Roberto Zarate, PhD Human Interaction Research Institute New Haven, CT – March 15-16, 2012. MFG Staff Training: Day 1. 8:00-8:30 amBreakfast 8:30-9:15 amBrief Introductions by Agencies

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Employment Multifamily Group Project

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Employment Multifamily Group Project

Alex Kopelowicz, MD

Roberto Zarate, PhD

Human Interaction Research Institute

New Haven, CT – March 15-16, 2012


MFG Staff Training: Day 1

8:00-8:30 amBreakfast

8:30-9:15 amBrief Introductions by Agencies

9:15-9:45 amWelcome/Overview of the MFG Training Program

9:45-10:30- amWhat is MFG and Why Should We Do It?

10:30-10:45 am Break

10:45-12:30 pmMFG Components (Joining Sessions, Educational Workshop & Problem Solving Groups)

12:30-1:30 pmLunch

1:30 – 4:00 pmJoining Sessions (Demonstration & Role Plays)


MFG Staff Training: Day 2

8:00-8:30 amBreakfast

8:30–9:00 amReview/Overview of Problem Solving in MFGs

9:00-10:30 amMFG Sessions (Demonstration and Role Plays)

10:30-10:45 amBreak

10:45-12:00 noonMFG Sessions (Role Plays Continued)

12:00–1:00 pmLunch

1:00–3:00 pmMFG Sessions (Role Plays Continued)

3:00 -3:30 pmQuestions and Wrap-Up


Standard Approachesto Family Work

  • Psychoeducation

  • Communication skills training

  • Problem solving techniques

  • Social network development (MFG)


Better Outcomes in Family Psychoeducation

  • Over 20 controlled clinical trials, comparing to standard outpatient treatment (Dixon, 2003), have shown:

    • Increased employment

      • At least twice the number of consumers employed, and up to four times greater--over 50% employed after two years--when combined with supported employment

    • Improved family relationships and well-being

    • Reduced friction and family burden

    • Reduced medical illness in family members

      • Doctor visits for family members decreased by over 50% in one year


Pretreatment

Treatment

Follow-up

1-Year Survival Rates Among Bipolar Patients in Family-Focused Treatment Versus Case Management

FFT, N=31

CM, N=70

Wilcoxon Test, c2 (1)=3.99, P =.046

Miklowitz DJ, et al. Biol Psychiatry, 2000;48(6):582-592


Stages of a Psychoeducational Multifamily Group

Educa-

tional

workshop

Ongoing

MFG

Families &

clients

bi-weekly

6 months

Joining

Family and

clients

separately

3-6weeks

Families only

1 day


Joining with Families and Clients

JOINING means to CONNECT, BUILD RAPPORT, CONVEY EMPATHY, ESTABLISH AN ALLIANCE, ENGAGE

It is the first stage of intervention

Designed to create a bond between Client/Family Members and Family Counselors

COUNSELOR as ADVOCATE


Joining Proecedures

  • THREE Joining Meetings

     SEPARATELY with Relatives and Clients

     WEEKLY – 1 HOUR with Relatives, ½ HOUR

    with Clients

  • Start sessions A.S.A.P. after client/family enrolls

  • Gain an understanding of family’s stresses, problems, reactions to client’s unemployment/underemployment, etc.


JOINING – I

  • 15 Minutes of SOCIAL TALK

  • Discuss the experience of looking for, getting and losing jobs

  • Review any recent stressful event: Who and what helped or didn’t

  • IDENTIFY WARNING SIGNS OF STRESS – PRECIPITANTS

  • Distribute to families & keep for future reference

  • Describe the plan for ongoing MFG sessions

  • 5 Minutes SOCIALIZING


JOINING – II

  • 15 Minutes of SOCIAL TALK

  • Review past experiences with co-workers, supervisors, supervisees, etc.

  • FAMILY’S EXPERIENCE DURING STRESSFUL EVENTS

     The sharing of painful events: A crucial aspect of “Joining”

     The client/family’s understanding of causes

  • Family’s social network & resources (material & emotional)

  • 5 Minutes SOCIALIZING


JOINING – III

  • 15 Minutes of SOCIAL TALK

  • Family’s social network & resources

  • Developing and maintaining a support network

  • SHORT & LONG-TERM GOALS (e.g., Employment)

  • Preparation for Workshop & MFGs


MULTIFAMILY GROUPS

  • Five to eight families

  • Two family counselors/facilitators

  • 1 ½-hour sessions – biweekly over six months or more

  • Refreshments/snacks are provided

  • Initial sessions avoid emphasis on conflict

  • Initial sessions emphasize establishing a working alliance by building group identity and developing a sense of mutual interest and concern - drop outs are failures


FIRST MFG SESSION

“GETTING TO KNOW EACH OTHER”

Go Around the Room

 Background

 Hobbies

 Occupation

 Interests

 Counselor Goes First (Discloses/Shares with the Group)

SETTING BASIC RULES

 Regular ATTENDANCE (for Relatives)

 CONFIDENTIALITY (No Pressure to Disclose)

 INTERACTION AMONG MEMBERS

 PHYSICAL/EMOTIONAL CONTROL


SECOND MFG SESSION

  • “HOW UNEMPLOYMENT/UNDEREMPLOYMENT HAS CHANGED OUR LIVES”

     Building a SENSE OF TRUST & COMMITMENT

     Sense of COMMON EXPERIENCE (Listen to each other)

     Strengthening GROUP IDENTITY & SENSE OF RELIEF

     The CLIENT’S INNER EXPERIENCES

     Counselors emphasize the vital role of SHARING GRIEF,

    CONFUSION, GUILT, FEAR with those “on the same boat”.

    AND HOPE

  • Remind participants about Problem Solving (next session)


GENERAL POINTS

  • New Members

  • Late-Arriving Members

  • Reminders about Attending

  • Crises & Emergencies

  • COMMUNICATION & INTERACTIONS

     Counselors DON’T speak for clients or relatives

     Interaction among members is essential

     Clients are ENCOURAGED (not pressured) to

    participate

     Respect other’s turn and avoid criticism


PROBLEM SOLVING IN MFGs

  • The CORE of MFG Sessions

  • Designed to compensate for limited education

  • FORMAT:

    Checking in15 Minutes

    Go-round20 Minutes

    Selecting a Problem to Solve5 Minutes

    Solving the Problem45 Minutes

    Wrap-up Socializing5 Minutes

  • Counselors should GET READY and HAVE A PLAN – IN ADVANCE


Selecting an Employment-Related Problem to Solve

  • TOPICS: (Identified prior to MFG or during group)

    Transportation

    Child Care

    Drugs and Alcohol

    Life Events/Domestic Problems

    Housing

    Disagreements among Family Members

  • “REJECTED” PROBLEMS:

    Make a Direct Suggestion and Review Outcome

    Meet Outside the Group (e.g., Crises)

    Refer to Past Solutions that Apply

    Refer to Solution/Family with Successful Outcome


THE PROBLEM-SOLVING METHOD

  • Define the Problem or Goal

  • List Possible Solutions

  • Evaluate Advantages and Disadvantages of Each Solution

  • Choose “the Best” Solution

  • Implement Plan to Carry Out Solution

  • Review Implementation and Outcome


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