Sania Yau Chief Executive Officer. All rights reserved 1

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1 Sania Yau Chief Executive Officer 1

2 Vision Who are we We strive to promote mental wellness for people in recovery of mental illness and for their families and the general public with the ultimate goal of equal opportunities, social inclusion, acceptance and full participation for all in the community. Mission We dedicated to pioneering and delivering people-focused, recoveryoriented, and evidence-based community mental health services with care and respect, innovation and continuous drive for excellence and professionalism. Core Value Care for People Excel for Quality 2

3 About New Life Established in 1965 NGO specializing in community mental health Serving 18,000 people in recovery (PIR) & their families annually > 1,000 staff members > 60 service units/projects in residential, vocational and community services 23 social enterprises 3

4 New Initiatives Family Support Services Supports parents and the next generation of families with people in recovery of mental illness or challenged with mental health problems Parent-child workshops & programs Employs I-FAST service model Shining H.O.P.E.S ( ) Seeing H.O.P.E.S ( ) 4

5 Endeavors in Family Intervention in Mental Health Service Shining H.O.P.E.S. for Family Wellness Funded by The Hong Kong Jockey Club Charities Trust A 3-year project - 1 June 2013 to 31 May 2016 In collaboration with existing services of the Association and community partners 3 main clusters: New Territories West, New Territories East, Kowloon 5

6 Clinical Observations Where we started Challenges faced by people in recovery of mental illness: family interaction, parenting, potential effects of MI on children Mental health care services tend to focus on individual intervention and medical orientation not holistic enough Multiple needs of families (not only the one with a diagnosis) Comparatively low motivation in help-seeking (awareness of interplay between mental state and family interaction) 6

7 Service Needs and Gap Where we started Medical care system (clinic bounded, deficits / symptoms orientation, seldom engage with the whole family, limitations in assessment of family interaction) Social welfare system (individual focused, confined by FSA, heavy caseload, training and support) Working with and between different systems - service coordination and interdisciplinary collaboration 7

8 What are our Beliefs Persons in recovery of mental illness can enjoy their human rights, including rights to be couples and parents Families have their own strengths and resilience in face of mental illness Systemic intervention matches the multiple needs of the families Preventive work preserves and promotes social capital of the second generation System collaboration offers holistic and effective care for the betterment of these families 8

9 Project Objectives Promote strength-based parenthood among PIR and enable positive parent-child relationship and family satisfaction; Empower parents and children by enhancing their strengths, resilience and wellness for mitigating and preventing the negative impacts of mental illness; Build up capacity among professionals for cultivating expertise in family-focused mental health care and systemic collaboration for rendering effective support to these parents and their children of the second generation 9

10 Conceptual Framework Integrative Family and System Treatment (I-FAST) Family-based treatment model (Lee et al., 2009) developed within the mental health system. Identifying an evidence-based and common factors treatment model that addresses practice realities of social service agencies, embracing workers existing expertise, and empowering capacity building at the organization level. 10

11 Conceptual Framework I-FAST identifies 3 common components including: Positive therapeutic alliance Second-order change in family interactional patterns System collaboration 11

12 Conceptual Framework Peer support is a core component in promoting recovery and self-efficacy among PIR through lived experiences. Emerging literature indicates that peer support model has been gaining effects in family programs for parents with mental illness (Reupert & Maybery, 2011; Dixon, 2011). 12

13 Work Approach and Implementation Process Community Family focused Intervention I-FAST Peer support Psychoeducation WRAP Narrative intervention Service/ Peer systems Family (Parents and Children) Individual (Person-inrecovery) Enhanced resilience Enhanced family Function, communication and satisfaction Enhanced parental efficacy Enhanced mental wellbeing 13

14 Target Groups PIR, their spouse and children under 15. In collaboration with Integrated Community Centre for Mental Wellness (ICCMW), Integrated Mental Health Projects (IMHP) in General Outpatient Department, Castle Peak Hospital, Kwai Chung Hospital, Child and Adolescent Units of HA and Integrated Family Service Centres (IFSC) run by SWD or NGOs. Receives family cases by referrals and self-approaches. 14

15 Team Structure Officer-in-charge 2 Counsellors 2 part-time Peer Nannies 1 Program Assistant 15

16 H.O.P.E.S. Holistic - Ownership - Partnership - Empowerment - Strengths - 16

17 Brief review of Shining H.O.P.E.S. Intensive counselling service for 171 families Home-based counselling, ranges from 8-20 sessions Office interviews 17

18 Parenting-oriented Service Parent-efficacy workshop Parenting skills enhancement workshops 18

19 Children-oriented Service Children positive psychology workshop Positive strengths building workshops for children Reduce self-stigma 19

20 Peer Nanny Service Child-minding in groups and home visits Family Pal Link networking and support groups 20

21 Family Wellness and Fun Program Respite moments Cultivate intimacy and cohesion 21

22 Family Tree of Life Narrative Therapy as the theoretical Framework odrawing trees to symbolize the life of the families orecording the resilient experience ounfolding strengths of families obuilding the intimacy among family members obuilding positive stories of families 5 times in the entire project 83 participants All families join by their children 22

23 Community and Public Education Exhibition of Family Tree of Life A platform for community members to listen to the stories of families of PIR Community members echoed and feedback to families stories Facilitate echoes between people s lives 23

24 System Collaboration Present to community partners on project rationale, content and intervention Worked jointly with GOPD and IMHP to coordinate and provide psychoeducational parenting workshops and to identify potential service users Collaborated with ICCMW of the Association to deliver groups and counselling service, also stationed at the centres for consultation and progress exchange with staff 24

25 Training and Clinical Consultation Integrated Family and System Therapy (I-FAST) Dr. Lee Mo Yee and Mr. David Grove from Social Work College, Ohio State University provided professional consultation Mr. Grove provided supervision and consultation for staff a supervisory levels Dr. Wong Oi Ling, Clinical Supervisor of AMFT offered clinical supervision for practitioners Other training included structural family therapy and narrative therapy 25

26 Knowledge Sharing and Transfer Seminar of Discovering Families 'Strength and Recovery in 2015 Seminar of Family Well-being in 2016 Experienced family therapist, psychiatrists, social workers, academia are invited to deliver speeches 26

27 Family Story Book Energizing the Wheel Gears of Family Integration of mental health service and family intervention Family Stories Sharing by Peer Nanny 27

28 Demographic Data (1): Parents Gender Age 87% 13% Male Female 3% 2% 22% 21% 52% above 28

29 Demographic Data (2): Parents Diagnosis Marital Status Depression 13% 19% 52% Anxiety Schizophrenia Psychosis 6% 3% 27% 6% 58% Married Divorced Separated 4% 2% 4% 6% Adjustment Disocrder Other emotional problems TBC Widowed Single 29

30 Demographic Data (3): Families No. of Children Age of Children 40% 11% 2% 47% % 12% 22% 24% 24% above 30

31 Demographic Data (4): Families Children with Special Needs Presenting Problems Nil Child raising and Parenting 10% 9% 4% 15% 62% ADHD ASD Multiple Disabilities Others 2% 32% 32% 20% 14% Marital Conditions Emotional or behavioural Problems of Children Adjustment Problems Parent-child Relationship 31

32 Project Effectiveness (Quantitative) (till 30 April 2016) Analysis of Evaluation Evaluation tools 1. Family Adaptability and Cohesion Evaluation Scale (FACES) IV 2. Chinese Parent Sense of Competency Scale (PSOC) 3. Resilience Scale 4. Symptom Checklist-10R (SCL-10R) 32

33 Project Effectiveness (Quantitative) (till 30 April 2016) Among the 126 closed family cases, 63 families have completed the evaluation, including 88 parents and 14 children. 32 pairs comparable questionnaires were used for analysis. 33

34 Project Effectiveness (Quantitative) (till 30 April 2016) Items Change Significance (p<0.05) Effective size (Cohen s D) Parental Satisfaction 0.015* Parental Efficacy 0.019* Resilience 0.011** Cohesion 0.000** Flexibility 0.003** Enmeshment 0.005** Chaotic 0.026* Mental symptoms

35 Interviewees: Mother More awareness of emotional changes, understanding the need of adjusting life, more rest and selfappreciation; more positive to problem solving More understanding toward ADHD, knowing how to appreciate and praising children; more positive attitude toward ASD More understanding on the role as a father and kept a good relationship with him; father-child relationship improved; children are happier and more active to play with me, send me message Maintained a good relationship with family and friends; will actively approach service if needed; Improved relationship with in-law 35

36 Interviewees: Father More communication Learn how to embrace and understand; closer relationship with children; understand them more Relationship of nuclear family improved; received more support from them Children understand mother more and more willing to take up household chore Shoulder more household chore and bring children outside home for leisure 36

37 Interviewees: Children Parents hit me less; more smile; more willing to listen to me; less picky on my mistakes; mother became more energetic, less lying on bed and happier Better relationship with classmates; more friends; like to go to school more; sometimes playing with cousins; sometimes chatting and hanging around with classmates Love to get along more with mother; more chances to chat; less quarrel; mother accept me more Dream: an accountant; skiing athlete; fashion designer 37

38 Interviewees: Collaborating Parties Clarify with families their roles and responsibilities; Improve communication; Consolidate network around Effective in engaging and building rapport with families; Consistent and clear goal; Intervene according to families pacing; Actively proposing evaluation plan Clear division of labour; Straighten out communication and collaboration More resources; Staff are passionate 38

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