psrt 4271 the family role in rehabilitation week four
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The Family Crisis Moment The Impact of Mental Illness on Families

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PSRT 4271: The Family Role in Rehabilitation Week Four . The Family Crisis Moment The Impact of Mental Illness on Families. The Family Crisis Moment. What is a crisis? (Roberts, 2005). “…disruption of psychological homeostatis …” “…usual coping mechanisms fail…”

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what is a crisis roberts 2005
What is a crisis? (Roberts, 2005)
  • “…disruption of psychological homeostatis…”
  • “…usual coping mechanisms fail…”
  • “…distress and functional impairment…”
a perception bard and ellison 1974
A perception… (Bard and Ellison, 1974)
  • “…subjective reaction…”
  • “…to stressful life experience…”
  • Functioning “…seriously compromised...”
characteristics of those in crisis
Characteristics of those in crisis
  • Threat
  • Incapacity
  • Fear
  • Discomfort
  • Disequilibrium
crisis theory
Crisis Theory

There is such a thing…

roberts crisis intervention model roberts 2000
Roberts’ Crisis Intervention Model(Roberts, 2000)

7. Follow up.

6. Make an action plan.

5. Explore alternatives.

4. Deal with feelings.

3. Identify major problems.

2. Establish rapport.

1. Assess lethality.

how people react to disability powers dell orto 2004
How people react to disability (Powers & Dell Orto, 2004)

5 determinants:

  • Triggering events
  • Severity of disability
  • Personal influences
  • Contextual influences
  • Stigma; societal reactions
effects 8 themes power dell orto 2004
Effects: 8 “themes”(Power & Dell Orto, 2004)
  • Denial
  • Grief
  • Guilt
  • Isolation
  • Anger
  • Depression
  • Coping
  • Acceptance
needs power dell orto 2004
Needs (Power & Dell Orto, 2004)
  • Meaning
  • Support
  • Validation
  • Information
  • Balance
providers how to help clarke windsor 2010
Providers: How to help? (Clarke & Windsor, 2010)
  • Acknowledge; connect; engage
  • Offer coping mechanisms
  • Comprehensive involvement at discharge
  • Instill hope
impact on families
Impact on Families

(The Raft of Medusa, by Theodore Gericault, 1791–1824)

mental illess decision elements
Mental Illess: Decision Elements
  • Medical
  • Cultural?...
  • Political?...
overall milliken northcott 2003
Overall (Milliken & Northcott, 2003)
  • Disenfranchisement

“When parents try to assume responsibility for an ill adult-child with schizophrenia, the law,

mental health prac-titioners, and often the ill person reject their right to do so.”

mothers copeland heileman 2011
Mothers (Copeland & Heileman, 2011)
  • Feelings
    • Powerless, voiceless, anxious, frustrated, isolated, tired, desperate, trapped, guilty, worried, scared, sad, grief, confused
  • “Internal factors”
    • Sense of safety
    • Perception of care ability
    • Contingencies and consequences
    • Maternal love and obligations
fathers wiens daniluk 2009
Fathers (Wiens & Daniluk, 2009)
  • Reflection on roles
  • Devastation and vulnerability
  • Sadness and loss
  • Frustration with the system
  • Admiration for the child
  • Personal growth and learning
siblings lukens thorning lorher 2002
Siblings (Lukens, Thorning & Lorher, 2002)

One step removed…

  • Reactions to illness
  • Strategies for coping
    • Whether, how to intervene?
    • Setting limits?
    • Resentment, anger, hopeless?
  • Efforts to obtain services
    • Wish for validation
  • Efforts to help themselves
grandparents seeman 2009
Grandparents (Seeman, 2009)

What happens when ill child has children?

  • Custodial, co-resident, nonresident…
  • Child’s exposure to mother’s illness
  • Financial impact
  • Isolation
  • Role conflicts
  • Divided loyalties
redefining parental identity milliken northcott 2003
Redefining parental identity (Milliken & Northcott, 2003)

“Anticipating” Parent


Disenfranchised parent

“Embracing the collective”

Re-enfranchised parent

Evaluating my life

Emancipated parent

our presentation topic
Our Presentation Topic…

Bellevue Inside Out Trailer

our guest presenter
Our guest presenter…

Jim Romer, Monmouth County Crisis Screening Center

> 30 years of experience.

County Services Director for Monmouth Medical Center (Long Branch, NJ)

Former Director of Screening Services for Ocean County at Kimball Medical Center in Lakewood, NJ

President of the Mental Health Emergency Screening Association

NJ Certified Screener No. 1

Monmouth Youth Council.

Special interests: kids in crisis. youth suicide issues.

Bachelors of Arts from Seton Hall University.

jim romer
Jim Romer
  • James Romer, Monmouth County Services Director, Monmouth Medical Center (Howell, Monmouth), Member, NJ SAFE Task Force
  • James Romer is a mental health professional with more than 30 years of experience. He currently serves as the Monmouth County Services Director for Monmouth Medical Center in Long Branch, New Jersey. He previously served for nearly 20 years as Director of Screening Services for Ocean County at Kimball Medical Center in Lakewood, between 1991 and 2009. Romer is President of the Mental Health Emergency Screening Association, was the first certified screener in New Jersey and serves on the Monmouth Youth Council. Romer has been proactive reaching out to law enforcement regarding issues of kids in crisis. His current work includes health screening for individuals, providing evaluations for the danger they pose to themselves or others, kids and adults alike. Romer has also experience working with school populations on youth suicide issues. He obtained his Bachelors of Arts from Seton Hall University.