Collaborative roles family

Family members are an essential part of any collaborative team (McDaniel et ah, 1995). We involve family members early and consult with them often because they have an enormous impact on health and illness and on how the patient relates to the collaborative team (McDaniel et ah, 1995). When a patient with depression or anxiety is seen for the first time, the family members have been on the front lines as the de facto health care specialists. They have been witness to the unpredictability and anguish associated with mental illness and have probably adjusted their behaviors in many ways to accommodate and change the course of the illness. They may have been the reason a patient is seeking treatment. Family members are a source of valuable information and play a critical role as partners in treatment. 

Family members come to treatment with a variety of beliefs about mental illness and medication. These beliefs play a significant role in shaping a family s response to illness and the willingness to support a treatment regiment that has been recommended by a collaborative team of professionals (Rolland, 1995). For example, family members may come to therapy with one of the following beliefs ... 

Another major barrier for family-provider collaboration is a perceived lack of mutuality. Some families have indicated that there is an imbalance of power in the mental health care of their child, resulting in their input not being valued or incorporated into treatment (Simpson et al., 1999). Rather than feeling like an expert on their child s needs, families have described feeling like they have only a token role in service planning. Families also have reported concerns about confidentiality (Simpson et al., 1999), resulting in a reluctance to share information and to engage in the therapeutic process. This lack of full participation and disclosure may inhibit the provision of quality care. 

A final barrier to family-provider collaboration relates to the role of the clinician in shaping family participation in school-based mental health (Bickham et al., 1998 McKay et al., 1996). Some clinicians have not been trained to work with families and may not feel comfortable collaborating and participating in the shared-learner model. Clinicians also may not feel supported by the larger systems in which they work, and may not feel they have the necessary time or resources to appropriately involve families. 

Epstein, J. (1992). School and family partnerships Leadership roles for school psychologists. In S. L. Cristenson J. C. Conoley (Eds.), Home-school collaborations Enhancing children s academic and social competence (pp. 499-515). Silver Spring, MD National Association of School Psychologists. 

One innovative staff role created by this collaboration was that of five School Mental Health Advocate positions. Each regional School Mental Health Advocate, a master s-level trained therapist with school mental health experience, was assigned to a state Public Health district office to work closely with local schools, parents, health professionals, and mental health providers. These critical community partners have provided essential technical assistance, training, and support to schools, families, and communities to expand regional understanding and local capacity to provide collaborative prevention, early intervention, and treatment for students. 

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