Family Institute for Education, Practice & Research Research to date

The Family Institute is conducting several research and program evaluation projects as we seek to address one of the issues that plague the service system – how to “translate the science into practice” and infuse research based family interventions into real world clinical settings. The evaluation work of the Family Institute reflects three broad areas:

1) Better understanding factors related to implementation and uptake of family-based services for adults with severe and persistent mental illness (SPMI) in real-world clinical settings.

2) Better understanding the answers to a range of questions related to the development, adaptation and refinement of specific family services, such as Consumer Centered Family Consultation (CCFC).

3) Better understanding mental health clinicians’ and family members’ experiences related to their attitudes, relationships and interactions with adults with severe mental illness.

Evaluation projects to date include:

Factors related to the implementation and fidelity of multiple family psychoeducation groups

Summary: Although the positive impact of psychoeducational multiple family groups (PMFG) for people with schizophrenia and their families has been well documented over the past several decades, this practice remains grossly underutilized in routine clinical practice. This implementation and research project aims to study factors related to the implementation and practice fidelity of PMFG in over 30 mental health agencies. The project aims to better understand questions such as: Do two different training approaches differ in terms of implementation success by agencies?, and What organizational and staff characteristics are most strongly related to whether an agency successfully starts a family-based EBP at the agency?

Partners: New York State Office of Mental Health; National Alliance on Mental Illness of New York State (NYS); NYS Conference of Local Mental Hygiene Directors

Funding: New York State Office of Mental Health

Program evaluation of the implementation of a new model of engaging consumers and families: Consumer Centered Family Consultation

Summary: Partnering with families while also ensuring that the consumer is at the center of all decisions remains a challenge for practitioners who work with adults with severe and persistent mental illnesses. Consumer Centered Family Consultation (CCFC) is a brief, education-based engagement and consultation service that is designed to promote collaboration among adult consumers of mental health services, members of their family or social network, and service providers to support each consumer’s recovery. Fifty agencies opted to participate in an initiative to implement the CCFC approach. The clinical and training aspects of the initiative began in 2006 and finished at the end of 2008, while the program evaluation components have been ongoing since 2006. Several important question areas were addressed via a Mixed-Methods program evaluation approach, such as:

• AGENCY PARTICIPATION AND STAKEHOLDER CHARACTERISTICS: How many agencies initially “signed on” to participate in the initiative? Were there any drop-outs? What were the characteristics of participating agencies, administrators, clinicians and consumers?
• TRAINING AND CONSULTATION: How many training events took place statewide? What was the average number of clinicians trained per agency? To what extent were administrators and clinicians satisfied with the Family Institute training and dissemination activities?
• IMPLEMENTATION PROCESS: Did each agency designate a “program champion” to lead CCFC implementation efforts? How hard did administrators believe it was going to be to implement the CCFC approach at the beginning of the initiative?
• CCFC MODEL IMPLEMENTATION: To what extent was the model perceived to be appropriate for consumers at agencies? Do clinicians they expect to conduct CCFCs in the future? How many CCFC engagement conversations and actual CCFCs occurred during the initiative? What proportion of clinicians reportedly conducted at least one CCFC?
• IMPACT OF CCFC PRACTICE: Does the provision of CCFC relate to changes in the amount of clinicians’ contact with families following the CCFC? To what extent does the CCFC approach assist staff in helping consumers in managing their lives and illness? Do staff members see positive changes in consumers as a result of consumer participation in CCFC?

Partners: New York State Office of Mental Health; National Alliance on Mental Illness of New York State (NYS); NYS Conference of Local Mental Hygiene Directors

Funding: New York State Office of Mental Health

Characteristics of staff who participated in a statewide rollout of family psychoeducation: Initial reports of burnout levels, overall job satisfaction, family blaming attitudes, and contact with families

Summary: It is well known that all staff members who participate in trainings to foster clinical practice changes will not actually implement those practice changes. There may be several different factors related to whether clinicians incorporate a new innovation into their routine clinical practice. This project aimed to better understand the baseline characteristics of mental health clinicians who participated in a statewide rollout of psychoeducational multiple family groups (PMFG). The descriptive study examines staff attitudes toward family involvement, burnout levels, overall job satisfaction, family blaming attitudes, and level of contact with families. For instance, to what extent do clinicians in non-academic, real world community organizations still believe that families are to blame for the onset and course of SPMI?

Partners: New York State Office of Mental Health; National Alliance on Mental Illness of New York State (NYS); NYS Conference of Local Mental Hygiene Directors

Funding: New York State Office of Mental Health

Understanding consumers’, family members’ and clinicians’ views about Consumer Centered Family Consultation

Summary: Partnering with families while also ensuring that the consumer is at the center of all decisions remains a challenge for practitioners who work with adults with severe and persistent mental illnesses. Consumer Centered Family Consultation (CCFC) is a brief, education-based engagement and consultation service that is designed to promote collaboration among adult consumers of mental health services, members of their family or social network, and service providers to support each consumer’s recovery. Fifty agencies opted to participate in an initiative to implement the CCFC approach. The clinical and training aspects of the initiative began in 2006 and finished at the end of 2008, while the program evaluation components have been ongoing since 2006.

In early 2009, upon completion of the training initiative, a series of semi-structured interview protocols were developed to enable the Family Institute’s evaluation team to visit a sample of agency sites and interview Key Informants including clinicians, family members and consumers who took part in the initiative. The project aims to better understand several aspects of the CCFC model, such as: how this approach impacted the lives of consumers and families; the extent to which the approach is acceptable and feasible to clinicians; what are successful strategies (from the perspective of multiple stakeholders interviewed) to engage consumers and families to participate as active partners via the CCFC approach; and what, if anything, people would change about the CCFC model. Data analysis regarding the audio taped and transcribed interview data from the interviews is ongoing.

Partners: New York State Office of Mental Health; National Alliance on Mental Illness of New York State (NYS); NYS Conference of Local Mental Hygiene Directors; Columbia University’s Center for Practice Innovation

Funding: New York State Office of Mental Health