some families, the program may need to use the services of a tele-interpreter service or its counterparts.
With respect to staffing, this approach is designed to largely replace individual meetings with consumers. Usually additional staffing will not be required until the program involves a very high proportion of the agency’s consumers who are appropriate for the intervention. Most licensed mental health practitioners can learn to work within this model quite effectively. That includes social workers, psychiatric nurses, psychiatrists, psychologists, occupational therapists, and case managers.
What do consumers and families think of FPE?
The best answer lies in participation rates. In a major research demonstration project in six cities in New York State, providing services in both single- and multifamily formats, the drop out rate amongst very ill consumers from state and city hospitals was about 25% after two years. Most of the multi-family groups kept meeting for years afterwards. The major political problem faced by that project was that after several months of providing services, there were often complaints from families and consumers that more families were not being offered this service. Many mental health agencies that have offered these services for a period of time find that practitioners, consumers and families do not want them to end. However, the common challenge is finding the ongoing support very useful in improving the consumers functioning and community participation.
How can FPE be implemented successfully?
Creating a positive environment in a mental health system for the implementation of FPE by mental health agencies is a critical role of the PMHA. Family psychoeducation usually takes place in community mental health centers. Frequently, the work begins while the individual consumer is hospitalized and continues after discharge to outpatient services. People from a variety of disciplines have proven to be very effective practitioners of family
psychoeducation, including social workers, psychiatrists, occupational therapists and even some expert family members.
How can the PMHA assure that agencies will faithfully adhere to FPE principles?
The implementation resource kit includes a fidelity measure that assesses how closely the program implementation follows the approaches that have achieved results in the studies cited in the review. This checks both the agency’s and the practitioner’s adherence to standards. How successful a program using an Evidence Based Practice, such as FPE, is in improving outcomes depends, in part, on how closely the program follows the EBP model. Programs that only partially adopt the model or that are allowed to drift back into old ways of providing care may not produce the beneficial outcomes associated with FPE. This will be especially true if agencies and their practitioners view and interact with the family in ways that imply that the family is at fault.
What are the costs?
For the services
The direct financial costs of providing FPE is about $350 per year, per consumer in staff time for an ongoing multifamily group when using a masters level practitioner (based on East Coast salary levels). The ongoing multifamily group sessions require about one hour of staff effort per month per consumer, after the initial engagement and education sessions.
Family Psychoeducation Toolkit