A Call for More Services for Families with Loved Ones with Serious Mental Illness

With all the talk about healthcare reform and budget cuts to healthcare programs, my colleague, Jerome Yoman, PhD, and I were inspired to write an editorial about the need for more family services for The Oregonian, our local newspaper. We just found out that the editorial was published in the April 10, 2012 edition!

You can read the editorial by clicking on the linked title below:

Plans for Treating Mental Illness Should Encourage Family Involvement

-By Christeine Terry, Ph.D.

New Law in Oregon: Your Rights to Bereavement Leave

People who experience the loss of a loved one are often tasked with managing life insurance and legal issues, resolving financial paperwork, planning a funeral, and sorting through their loved one’s belongings. All of this often happens while they are in shock or otherwise facing great emotional distress. This is often a time to seek out help and support from friends, family, or elsewhere. Reasonable and compassionate employers is are happy to be flexible and find a solution that allows people to attend to their grief and practical matters while also honoring work obligations. Many businesses have bereavement policies already in place and this is really helpful for those people who need to take advantage of them.

While most employers are quite willing to be flexible with helping their employees manage major life events, in some cases there are also laws in place to help insure reasonable allowances are made. For example, the Family and Medical Leave Act helps ensure that people will be able to take off time from work to care for a newborn child or to help a family member with medical illness. However, there are relatively few laws in place to help people cope with the demands that can come with bereavement.

A notable exception can be found in the recently amended Family Leave laws of Oregon, which now includes bereavement as a major life event warranting protected leave. Oregon is the first state to enact this kind of law, which applies to businesses with more than 25 employees and which goes into effect in January 2014. According to this new law, people may take up to two weeks of bereavement leave to attend a funeral or memorial service of a family member, make any necessary arrangements, and to grieve. The bereavement leave can be taken up to 60 days after you have learned about the death, and it is also possible to take additional leave if you are faced with the loss of more than one family member.

While people rarely finish grieving in under two weeks, taking a little bit of time off often helps people have the space to bring their full attention and care to the practical and emotional process of grieving.

CRAFT: Helping Families With an Addicted Love One

Event Brite Link:


If you have a loved one with an addiction you’ve probably tried everything you can think of to get him/her to stop:  nagging, threatening, ultimatums, bargaining, attending support groups, etc. You may feel like there is nothing that you can do to get them to stop. Don’t give up, there is hope. An approach called CRAFT has been shown in well-designed research studies to get approximately 7 out of 10 loved ones into treatment. Additionally, CRAFT has been shown to improve the well-being of family members. This highly effective approach does not rely on confrontation or detachment. Instead, you will learn about specific actions you can take to free yourself from their cycle of addiction.

Time and date to be determined

Get help coping with your loved one who has persistent mental illness

Do you have a loved one with Bipolar Disorder, Schizophrenia, or another type of persistent mental illness? Having a loved one with a persistent mental illness can feel stressful and overwhelming. The mental health system can be confusing and resources can be difficult to find. I specialize in working with family members to help them develop practical and useful skills to cope with their loved one’s mental illness and improve family relationships.

I offer one-to-one or group training based on evidence-based principles shown to reduce relapses of mental health problems, and improve the well-being of family members. The training is done in a collaborative and supportive style, and is focused on the hands-on skills you can use to improve your and your loved one’s mental health. As a family member of someone with a persistent mental illness, you may have that you are to blame for your family member’s illness. You are NOT to blame for their illness, but there ARE things you can do to improve the quality of life for your family and loved one with mental illness.

Why do I use evidence-based principles in what I do?

The whole team at Portland Psychotherapy has a strong commitment to using evidence-based principles in our work. Evidence-based means that techniques, treatments, or principles were tested in rigorously controlled experimental studies, as well as in studies in settings similar to our center (i.e., outpatient treatment centers), and were shown to be effective in reducing distress, relapses, or functioning. We use what works based on scientific findings, not on fads or untested techniques. Although we have a strong commitment to evidence based principles, we work hard to flexibly tailor these principles to best meet the needs of the individual and the family.

What kinds of things will help me and my family member?

Numerous research studies have shown that certain techniques are more effective in improving your well-being and your family member’s mental health. Communication skills, particularly skills that decrease the expression of negative emotions, can decrease symptoms of and relapses of persistent mental illnesses, such as schizophrenia (Butzlaff & Hooley, 1998). Problem solving and education about mental health problems and treatments can improve your well-being and help your loved one and family resolve problems more effectively (Malouff, Thorsteinsson,  & Schutte, 2007; Dixon, Stewart, Burland, Delahanty, Lucksted et al., 2001). Self-care strategies for family members can decrease stress, anxiety, and even, health problems (Cuijpers & Stam, 2000). I help family members learn these evidence-based skills that will help you and your family member improve your lives.

What will I learn if I work with you?

If you contact me, we will schedule an initial consultation, from which we will develop a plan on how to help you with your family member. The plan could include any of the following elements:

  1. Information about the mental illness your loved one has and treatments for that mental illness.
  2. Information about the mental health system and community resources.
  3. Communication skills training to more effectively express your needs and emotions, set limits, and reward your loved one’s actions.
  4. Help with identifying limits you are comfortable with and how to reward actions that promote mental health and recovery.
  5. Problem solving skills that generate multiple solutions tailored to your unique circumstances.
  6. Realistic self-care strategies that you can implment in your life.
  7. You will also get access to a support group of families struggling with a similar situation that I run.

What can I expect during our meetings?

In the first couple of sessions we will focus on a developing a detailed understanding of your loved one’s mental health symptoms, the impact of the symptoms in your lives, and your own mental health. Then, we will create specific and action-oriented goals that we will use to evaluate our progress. The following sessions will focus on learning and practicing skills described in the section above (i.e., communication skills, problem solving, education about mental health, and self-care). You will be asked to practice the skills in between meetings so we can make any revisions or adjustments to how you use the skills.

I do my best to create a supportive and collaborative environment. I will work with you to learn and tailor the skills to your unique situation. You have valuable information and knowledge about the situation you are in. I actively seek out your contributions and experiences and incorporate them into the learning process. I work hard to create an accepting and positive environment where you can share your experiences and practice the skills. You are not defined by your difficulties, therefore, your strengths and values will also be incorporated into the training.


General Mental Health Resources

Resources for Specific Mental Health Problems

  • Schizophrenia.com has list of resources on schizophrenia and topics related to schizophrenia (e.g., schizophrenia and drug use).
  • Pendulum.org is a website that has information about Bipolar Disorder, including links to support groups.
  • Depression and Bipolar Support Alliance is a national organization for individuals with depression and Bipolar disorder. It includes a helpful tip sheet for family members of what to say and what not to say to a loved one with Bipolar Disorder.
  • The National Center for PTSD is part of the Veterans Administration dedicated to researching, educating, and treating PTSD. Although there is a strong focus on Veterans, the website includes useful information and resources on PTSD for people who are not Veterans.
  • Families for Depression Awareness is a national organization for families who have loved ones with depression.
  • Anxiety and Depression Association of America has information and resources for people with anxiety disorders or depression.
  • Substance abuse resource website at Portland Psychotherapy has links to information about, organizations, and support groups (for people with addictions and for family members of people with addictions) for addictions.

Help! How Do I find Resources for My Loved One with an Addiction?

Recently a colleague alerted me to an article in the Chicago Tribune about CRAFT (Community Reinforcement and Family Training). A few months back I wrote a blog post about CRAFT that described the research support and basic ideas of the treatment. Briefly, CRAFT teaches family members with loved ones with addictions how to non-confrontationally change their loved one’s substance use. Additionally, CRAFT helps family members learn skills to improve the quality of their lives by breaking free of the cycle of their loved one’s addiction.

First, I think it’s awesome that CRAFT is getting noticed by the mainstream press and that people may learn about the treatment and, as a result, get help for themselves. The article offers interesting facts about the rise of prescription pain killer dependence, as well as tips for helping your loved one. While the tips for getting you and your loved one help were useful, I felt they were incomplete. Additionally, the article didn’t offer resources to help family members access services, get support, or learn the skills discussed in the article. With so many people affected by addiction, I think an opportunity to provide resources for substance use related issues was missed.

How to Find Help for Yourself and Your Loved One:  Some Tips and Resources

While this isn’t a complete list, here are some ideas on how and where you might find the resources mentioned in the Chicago Tribune article.

  • Ask people you trust about resources. Talk to your friends, a family physician, a spiritual leader, and family members about substance use treatment programs, counselors/therapists who specialize in addiction, or community programs tailored to you or your family members’ needs. For example, Dual Recovery Anonymous is a peer-run 12-step program for people experiencing addictions AND mental health problems.
  • Check out your local hospital. Many hospitals offer substance use treatment (e.g., detox, outpatient treatment). Contact your local hospital’s psychiatry department to see what options are available. In the Portland area some hospitals that offer substance use treatment are Providence and Cedar Hills.
  • Check out peer support organizations.
    • 12-step organizations for individuals with addictions (AA, NA) and for family members (Al-Anon, Nar-Anon) offer support and have information on substance use treatment programs in your community.
    • People who prefer not to use the 12-step approach are encouraged to check out SMART Recovery, an alternative to the 12-step approach that uses evidence-based principles to help people overcome their addictions. SMART Recovery also has meetings and resources for family members (SMART Recovery Family Resources). SMART Recovery has a list of national providers and substance use treatment programs that use CRAFT or therapies similar to CRAFT.
  • Check out your state’s department of health website. The websites for your state’s department of health often include a list of mental health and substance use treatment centers that are licensed by the department of health to provide these services. In Oregon, go to:  http://www.oregon.gov/OHA/addiction/index.shtml.
  • If you are experiencing domestic violence, or there is threat of domestic violence, contact local or national domestic violence agencies.