FPE: The Joining Sessions

 

fam-schoolFamily Psycho-Education practices begin with the joining sessions which are the first opportunities that practitioners have to facilitate and build a rapport and a working alliance with families.FPE practitioners recognize families’ knowledge and expertise. and the idea of FPE is that families and practitioners join their expertise and strengths to support goal achievement. This collaborative approach forms the foundation for the model. To foster this collaborative relationship, practitioners:

  • demonstrate genuine concern for their families,
  • validate families’ experiences and realities,
  • avoid treating families as ‘patients’ in need of fixing, and
  • avoid playing the blame game with families for their real or perceived problems.

To help foster a more informal environment and working alliance, practitioners begin by socializing, both at the beginning and at the end of each session. This helps to reduce anxiety and allows you to get to know your families as people, as diverse as they may be. If you don’t get to know your families, capacity-building cannot begin or result in maximized collaborative learning, joining, or helping relationships. It is also important that practitioners be open and honest about themselves and who they are as people.

From the first joining session, it is your role to guide, without monopolizing or dominating the conversation, but they must be structured in order to complete this process. There is always an agenda, however informally presented. Following a prescribed and structured meeting lets families know what to expect and what will be accomplished during your time together.

 

Developing a strong alliance and a rapport with families is a long process. If your first contact with families or parents is during a critical episode you may have a special opportunity to build that strong alliance. Respond quickly to  immediate needs as you demonstrate your sincere willingness to help, especially in concrete ways. Establish yourself as a resource and a source of support.

If assistance is sought, offer it quickly. Prompt attention reassures families that you have committed to partnering with them. Do not hesitate to think outside the box and step in and take on non-traditional roles. Act as an advocate, refer services, help obtain entitlements and benefits and help them navigate the system’s bureaucracy.

If this is not your first encounter with families, and any expressed concerns or problems have not arisen, as may have prior, review and revisit those strategies that work to enable forward movement for families and their children. Be solution-focused. Reflection works to help families identify the variables which may or may not be effective. Look, specifically for the positives, and build upon them. Talk them through, and invite imagery to illustrate that which works for them.

Emphasize changes that are identified if any. If so, these changes, apparent or barely noticeable, constitute ‘prodromal signs and symptoms’. For example, if a child were having difficulty in school surrounding behavior and impulse control, whether sporadic or for the first time, there are usually prodromal symptoms. These symptoms make up idiosyncratic behaviors specific to that child, and will precede episodes. Poor sleep, restlessness, irritability, poor eating are those symptoms which give indication of a particular behavior. Your job would be to help families address these behaviors, recognize them early and learn to manage or help their family member manage the impulses that lead to problems.

The joining process allows the exploration of such concerns and helps families to form a working relationship with practitioners and establish that trust required to invest in psychoeducation sessions. Disclosure from families emerges more freely within an atmosphere that is relatively informal, respectful and definitely confidential. What happens in groups or with individual family meetings, stays right there on that floor, in that room. Confidentiality must be maintained at all times!

Parents need to know that they are respected, valued, and that their experiences are validated, whether commonly shared or unique to a family. In order to facilitate an alliance between families, in multi-group sessions, it is important that they socialize, identify common interests, share common experiences, concerns, and recognize shared goals. This is possibly the most important part of the process of utilizing psychoeducation practices and family engagement in education, child welfare, juvenile justice or behavioral health systems.

Some practitioners skip or shorten this phase to more rapidly begin to introduce your program’s agenda. However, shortening this step will usually backfire and families who don’t complete joining sessions are more likely to disengage prematurely. The tasks for Joining Session #1 look like this:

  • Socialize
  • Review a present or past ‘episode’, concern or problem
  • Identify precipitating events
  • Explore prodromal signs and symptoms
  • Review family experiences and validate their experiences as normal human responses
  • Identify family strengths and coping strategies that have been successful
  • Identify coping strategies that have not been helpful
  • Socialize

The purpose of joining is to develop a rapport and cultivate partnerships with families. You may conduct joining sessions with families, either individually or in groups depending on family preference. Meetings usually last for about an hour. Build and convey hope,  establish yourself as a trustworthy, supportive, and valued resource for the empowerment of families, and communities. All of this goes without saying that your services must be framed by culturally responsive practices. Along with trust, these are your building blocks for engaged and invested families. Families need you to support their capacity to advocate for themselves and their family members’ total wellness. Joining is connecting!

Let’s Create a Culture of Family-Centered Practices in School Settings

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For professional educators, serving children in schools means serving the family as well, and we must adopt practices which will move school systems, procedures, perspectives, protocols and program policies, towards being family-centered in the framework of teaching and learning. The elements of family-centered practices all work towards empowering families with the knowledge and skills to make the best decisions  for their children and the family as a unit. When parents are empowered, they feel in control; a palpable sense of agency.They also become more invested when they feel they are respected as experts and collaborators in the educational planning process.

Professionals must recognize that when they develop a relationship with a child, they are also developing a relationship with the child’s family. The more collaborative the relationship is with families, the more invested and engaged the child becomes in the classroom and learning and achievement potential is optimized. Collaboration is the key, and successful relationships require hard work. When the life of a child is at stake, there is no room for failure-it is not an option.

An essential component of family-centered practice is collaboration in decision-making. As a model of partnership, family-centered practice has as its underlying philosophy the belief that
families are pivotal in the lives of children and should be empowered to engage in decision making
for them.
It actually has its origins in Bronfenbrenner’s ecological systems theory, in that it recognizes that children exist within a wider context of family,
community and society where at every level the ecological system is interconnected. In this ecological system, the child, the family and the
environment are inseparable and what affects one member of the system impacts on the other members.  Each member of the system, and their relationships, are in turn influenced by the broader social, political and educational policies. It is this broader system (mesosystem) that shapes the perceptions, expectations and equality of the relationships that exist between the nested systems.

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Since we recognize the interconnectedness of these systems-family, child, school, community- it is logical that we likewise assume a multi-generational approach to teaching and learning at school. What empowers one system, empowers and impacts all others. “If you know better, you do better!” Today, we know better and more about the interplay between learning at home and learning at school. When all are aligned, we maximize successful learning outcomes, we enhance life quality for families, strengthen communities, and position our society and its citizens to thrive in a global economy-the global village.

What remains baffling, however, is why it seems to be such reluctance to ‘share’ power and expand the instructional audience to include families, adult caregivers, and diversity. There is an incredible difference between giving away power and sharing power.

Family-centered practices do not mean that the experts in education are relinquishing their expertise to the parents, whose expertise is in their child, culture and unique strengths they possess. Instead, we are asking that professional educators, whose knowledge, experience and expertise lies in their chosen specializations, share their knowledge and benefits from their expertise with families-a collaboration.

Family-centered practices is a partnership, an alliance between systems of care, where knowledge is shared, goals are mutually identified, designed and collaboratively implemented. When parents and families understand your purpose, recognize common interests, and are given the tools and skills to support and fully align with them, children fare better, relationships become more meaningful,
and come to life in the classroom, the home and the community at large-inseparably.

The pathway to this end is through authenticity, trust, respect and reciprocal communication.With a focus on strengths and solutions- finding, we must adopt a genuine appreciation for diversity, culture, language, family structure, etc… Unless and until we can honestly say that we understand the impact of our own culture and cultural experiences, as it influences our cultural lens, we are challenged to engage in family-centered practices with cultural competence.

Cultural competence is also at the core of family-centered practices, when working with children and their families. To respectfully teach and engage a child in learning is to respect and engage that child’s family and with that child’s culture. Demonstrating respect for the culture is to recognize the differences, acknowledge the similarities, and communicate, in conversation or classroom instruction, responsively. This brings us to ‘mirrors and windows’. Children require, not maybe, but definitely, require in their best interests, a healthy balance of both mirrors and windows in the classroom, within a curriculum framed by a broad and inclusive lens.

Eurocentricity and windows-focused curricula and instruction defy the ‘whole child-whole family’ philosophy, and is harmful to the comprehensive growth and development of children. It also negates our responsibility to empower every child and his or her family, as well. If diversity is represented in a school community, especially, and the instruction does not address, affirm or highlight that diversity, we are ‘mis-educating’ the child, disempowering the family and  performing a great disservice to that community.

Family-centered practices place children and families at the fore and central consideration at the core of curriculum, policy, practice, and procedural design and protocol…if indeed we endeavor to act in the best interest of children, and to help them realize their potential for school, career, and life success.

“So goes the family; So goes the nation.”... interconnectedness!

How To Utilize Family Psycho-Education(FPE) in School Settings

As a former coordinator of a family support services program, employing Family Psycho-Education services as a key practice protocol was essential for supporting and empowering families and caregivers of children with Serious Emotional Disturbances. My work setting was a blend of clinical and community based support services to engage, empower and enhance the total wellness of the family, as a cohesive unit.

In short, the practitioners’ aim is to disseminate information about mental illnesses and help families to enhance their problem-solving and coping skills including their capacity to advocate for their children and themselves. In the process of providing FPE services, families build social supports and networks serving to solidify community connections and increase support program involvement.

What is Family Psycho-Education?

FPE is an approach for partnering with families to treat serious mental illnesses. Practitioners develop a working alliance with families as their central role. Psycho-education as a term can be misleading to some. FPE includes many elements, but it is not to be mistaken for family therapy. In therapeutic settings, the focus is on the family itself as object of treatment. In FPE, the illness is the object, not the family. In education settings, the objective is student achievement and the comprehensive development of children in learning environments, at home and in the community.  many developmental aspects which intersect or influence learning are varied, and include a wide range of topics to introduce to families.

It is practical to offer useful and relevant information pertaining to family and child wellness. Families of children with learning diagnoses and IEPs benefit from helpful information and engaging in honest discussions pertaining to their children, family life and managing their child’s diagnoses and the symptomology at home. In school settings, in a multi-family format, FPE is helpful for families as it lets them know that they are not alone. It empowers them to participate fully in all things learning and family related. Research shows that outcomes improve if families receive information and support. That support also includes facilitating access to resources and other concrete services

A number of FPE program models have been developed over the years. They may differ in format-whether it is a single or multi-family format, duration of ‘treatment’, family participation and location. Nonetheless, there are critical ingredients of effective FPE, and they include:

  • Education about mental illnesses/learning disabilities
  • Information resources, especially during crises
  • Skills training and ongoing guidance about managing mental illnesses
  • Problem solving, and
  • Social and emotional support

There are 3 specific phases of FPE in which services are provided.

  • Joining sessions
  • An educational workshop and
  • Ongoing FPE sessions

The joining sessions are introductory. Practitioners meet with families to learn about their experiences, strengths and resources and their goals for treatment/participation. It is important to show respect, build trust and offer concrete help. Families have a focus on the long-term, but they really want immediate help and related concerns addressed. That is concrete. The alliance formed between practitioner and family/consumer is the foundation of FPE, and joining sessions are the first phase.

The second phase is educational workshop and they tend to be full day sessions. Workshops are based on a standardized curriculum to meet the distinct educational needs of family members. However, throughout the program, practitioners respond to individual needs of families by providing information and resources. It is important to keep families engaged and thus it is necessary to tailor education to meet their needs, with appropriate relevance.

After completing the joining sessions and 1-day workshop, practitioners ask families to continue attending ongoing sessions. Multifamily group formats are most effective in learning and school settings, as families benefit by connecting with others who have similar experiences and similar concerns. Once again, parents and families learn that they are not alone, as they cultivate mutually beneficial peer support networks. Often times, families without peer networks, will become and feel socially isolated.

Ongoing sessions should focus on current issues that families and parents face and are effectively addressed using a problem-solving or solution-focused approach. Carl Rogers believed that many personal problems can be solved by individuals themselves within the parameters of a working relationship built upon unconditional acceptance, wherein the helping person communicates authentic positive regard, is non-judgmental and employs effective listening or attending skills.

For practitioners to be solution-focused in any setting, these elements must be present, with an underlying belief in the capacity of families to be instrumental and active in working towards their solutions. The interaction between practitioner and family must be built upon cultural responsiveness, within a strengths-based approach, which demands that families are not to be perceived in deficit mode. Rather, focus is on what they can do and what they do already and what they want to address and believe will help to meet their needs. All outside of their capacity is built upon via the information and resources offered to them.

FPE is not a short-term intervention, for it is recommended as beneficial in achieving outcome success when they last for 9 months or more-perfect amount of time in school settings. For family practitioners who work with families and parents in school settings, engaging parents should be designed as family centered programs and a year-long intervention program. Every academic year, approximately 9 months, practitioners and liaisons can plan and implement sessions in a multi-family format in which information is provided, meaningful alliances are developed and parents engage in activities which support and promote their parenting, advocacy and leadership skills.

Family Psycho-Education applies in school settings and once mutually identified goals are set, sessions may be planned and implemented. As stated earlier, it is important to identify specific concerns, needs and challenges families face and address them within a format deemed appropriate. Sometimes the nature of family concerns are best addressed in individual family format. With common concerns, a multi-family format is best. The rules of confidentiality and trust applies, and this highlights the importance of initial joining sessions. Knowing your families is critical to program success and positive outcomes, and the overarching goal is to empower, educate, encourage and engage families towards  total wellness and maximize capacity to support their children’s well being and their own self-sufficiency.

 

 

GRIEF, LOSS and SEXUAL ASSAULT: The Agony of An Untold Story

There is no greater agony than bearing an untold story inside you.

—Zora Neale Hurston, Dust Tracks on the Road, 1969

Sexual assault survivors are among the most disenfranchised populations, coping with narratives of multiple losses, uncertainty, and grief that frequently go unacknowledged. An alleged perpetrator gleefully walks across the stage at a college graduation, cheered on by an audience, some of whom, aware of the assault, applaud nonetheless. Meanwhile, the assault survivor, disoriented and betrayed by a system and society designed to protect offenders, struggles with grief that is suffocated by a system filled with penalties  and oppressive stigma stemming from the assault. The survivor is left to contend with losses of trust and physical and emotional safety. She faces the agony of knowing that despite the perpetrator’s actions, he will experience the freedom to participate in a life of possibilities and protections with few or no social, educational, or legal sanctions—a luxury that, in an instant, was violently seized from the survivor.

Grief, loss, and social injustice are vital elements in the distinct yet intersecting stories of sexual assault and post-assault survivorship. Yet survivors must frequently cope in isolation or in programs and therapeutic settings that do not consistently account for grief and loss as central to their experiences.  These factors, related to disenfranchisement and suffocated grief among young adult females, further complicate grief and mourning processes.

Losses commonly associated with sexual assault and issues of disenfranchisement and suffocated grief that serve to further complicate coping processes for survivors are numerous, cumulative, and multilayered.

The primary loss is the pre-assault life and worldview. There are also a multitude of secondary or accompanying losses that may be both visible (e.g., friendship loss) and invisible (e.g., loss of trust).

Secondary losses in sexual assault include, but are not limited to loss of trust in self and others, as well as:

  • beliefs about the goodness of others
  • loss of self-identity, freedom, and independence
  • loss of control and autonomy, such as in the timing of reporting
  • loss of a sense of safety and security
  • loss of positive self-concept or self-esteem
  • loss of finances and job
  • loss of social capital such as friends and social networks or intimate partnerships and
  • loss of sexual interest and other sex-related losses.

In interchanges with the legal system, there may be multiple losses. There may be a loss of ability to present one’s case in court. Among cases that make it to trial, survivors may lose the ability to tell the assault narrative in a coherent and meaningful way because stories of survivors are often dismantled in court, and survivors are instead expected to respond mainly to yes or no questions[closed questions].

Additionally, there are losses of privacy and time in legal proceedings; court trials often continue for months or even years with no clear ending or resolution, which may prolong or delay grief. The grief process may be further complicated in cases where there is no conviction. Survivors are possibly re-victimized when the verdict is experienced as unjust.

Unfortunately, the losses are not finite, as there can be a continuous presence of loss that is often hidden, invisible, and ongoing in nature which may be exacerbated because the circumstances surrounding the loss result in recurrent pain, grief, or intense distress involving, for example, shame, self-consciousness, or social isolation.

With an understanding of sexual assault as a type of bereavement, offering fitting interventions that enfranchise grief become apparent, and the notion of growth through loss is problematic. It imposes a timeline upon the survivor as to the grieving process- oppressive and greatly unfair. Survivors need time to process the fact that they have been violated and to establish new norms in their ‘post-assault’ life.

Support for any and all feelings of loss is and should be a basic right, should be acknowledged as we consider it an “unearned entitlement” of survivors of sexual assault. Supports can be emotional, concrete, physical, but it is more necessary that supports are comprehensive.

As we deliver supports to sexual assault survivors, we need them to be collaborative, free from stigma or re-victimization, and environments need to be intentionally supportive. By design, it is to be expected that all settings support emotional and physical safety and ultimately, total well-being.

Fragmented services have prevailed for far too long, and this contributes to the isolation, disenfranchisement, and vulnerability often experienced by survivors. The many untold stories need to be told, heard, and prevented from becoming insurmountable barriers to restoring or attaining total wellness of survivors.

“Wellness is a positive state of being brought about by the simultaneous, balanced and synergistic satisfaction of personal, relational, and collective needs…. Wellness cannot flourish in the absence of justice, and justice is devoid of meaning in the absence of wellness.…” (Prilleltensky, Dokecki, Frieden, & Wang, 2007)

Attention to cultural frameworks must be employed in practices designed to understand disenfranchisement and complications to the grief process for survivors. It is all too often the case that unacknowledged or disenfranchised grief is related to lack of assault disclosure[the untold story] among individuals from more marginalized social locations (e.g., African American, female).

Female assault victims are at an increased risk for self-harm or harm to others, and deemed less costly than the effort required to counteract long-standing oppressive patriarchal systems. Punishment for working against privilege and the supported systems is often swift and severe.

For example, a female assault survivor on a college campus who pursues charges against a star football player, seemingly one individual, would actually be working against multiple systems of oppression (e.g., athletic system, legal system). In pursuing her basic right of recognition and justice, she may be publicly maligned and faced with a case in which the perpetrator, supported by multiple systems that reflect and reinforce male privilege and oppression of women, is not convicted.

Nuff said?!!! No. There are still too many untold stories. If you have a story to tell, speak now or later, but tell your story and own your power and your right to heal and be well.

To be continued…