| Although adults with severe mental illness---schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder, and severe anxiety disorders---can often achieve a considerable level of independence in their daily lives, most will continue to need emotional support and practical assistance from family members throughout their lives. Because individuals with severe mental illness are less likely than their peers to marry and to have children of their own, parents often serve as the primary family caregivers for their sons and daughters with severe mental illness. As these parental caregivers age, it is crucial for families to begin to discuss the role of well siblings in the care networks of their brothers and sisters with severe mental illness.;Based on a review of the existing literature on sibling caregiving for adults with severe mental illness, the author identified an unmet need for a therapeutic intervention that can bring families together to discuss future caregiving arrangements. While both parents and well siblings report considerable worry about future caregiving arrangements for an ill family member, they tend not to speak openly with each other about these concerns.;In this doctoral project, the author presents a new intervention tool that addresses the needs of family caregivers both for practical information and for support in beginning an honest discussion of a difficult subject. Mental health clinicians can use this flexible, time-limited intervention to facilitate "caregiving conversations" between parents, well siblings, and adults with severe mental illness. This intervention makes room for each family member to tell his/her own story about the impact of a family member's mental illness on his/her life, and invites each family member to state his/her preferences regarding future caregiving arrangements. In the context of the intervention, the relevant research findings are presented in a brief and useful format that clinicians can immediately bring into their practice. The intervention design incorporates elements of number of clinical/theoretical approaches: a psychoeducational model, a consultation model, family systems theory, a prevention focus, and a narrative therapy approach. |
