It’s important to consider everything through the lens of the person and family. This includes aspects of your own practice. It also includes other issues that you may not fully control, such as the person’s access to reliable transportation or the number of other appointments the person must manage outside your office. At every step of the process, support the person and their family’s comfort and engagement. Consider things like: the organization of the environment, the availability of appointments, or the language and processes you use when speaking or documenting. Keep things comfortable and welcoming. Adapt them as needed or possible to fit the person or family’s actual needs.
All things should flow from the person’s stated goals and their strengths. Actions and goal setting should have a recovery/resiliency focus. When the person relies on family or wants family involved, their views and needs should shape plans and actions as well. Often the processes for understanding a person’s goals and strengths in a mental health setting is not very comprehensive. It often focuses on symptoms and symptom control. However, for most people experiencing these conditions, they are more concerned with their lives. A psychiatrist or even case manager may have very little understanding of the totality of a person’s life. They may not recognize or acknowledge the person is a parent or spouse. They may not understand what valued social roles a person desires to claim. Person and family-centered practices support a broader more person-directed approach to recovery.
Understanding how people rely on others to get by is important. People who are successful in life have other people in their corner. Whether these important supporters are legal family or chosen supporters, they are often key to people’s recovery. However, without support for their own needs, they may not do very well in this role. Supporters come from all different backgrounds and experiences. They may understand very little about what is happening or what can be done. They may be socially isolated due to community stigma that spreads to them as loved ones of a person with mental illnesses or co-occurring disorders. They may be a strong supporter of the person, but not a supporter of mental health or substance use treatment. Exploring this with the person in ongoing ways is important. Keep in mind, in crisis, people can be very negative about family involvement but feel differently later. Encourage people to develop crisis plans or use advance directives to communicate their preferences in this area. Don’t assume that these feeling never change.
Continually review your practices for cultural responsiveness. Are materials you share in a familiar and common language? Is the person and family literate? Is information paced appropriately, including time to process or develop trust? Does the process you use make sense to the person and their identified family members? Every person and family comes with a unique expression of their culture. Even if you share the same external characteristics with people, it does not mean you see things in a similar way. Keep learning more about yourself and what you bring to the table. Keep learning about others and diversifying your perspective. Work diligently to meet the cultural needs of those that come to you. Continue to grow in these skills through-out your career.
Environments and processes that are trauma-informed are more likely to be person and family-centered. This is because they recognize the value of maximizing choice and control and the person’s comfort and trust. They also include specific ways of assessing the impact of potential trauma and help people get to clinical level support as needed. Unprocessed trauma can make it very difficult for people to recover. Trauma-informed environments can help.