A 29 years old male patient admitted to the psychiatric ward with the diagnosis of schizophrenia and obsessive compulsive disorders. He had these problems three years and was hospitalized twice before and this was his third time of hospitalization. He came to the hospital with the complaints of low self esteem, excessive masturbation, hallucinations and religious delusions. During the initial visits with the patients it was hard to identify the root cause of all these problems, but it was clear when patient stated that “I live in a separate room at home moreover my family didn’t allow me to talk with relatives when they visit us and they locked the door. Moreover I personally observed that during my whole clinical weeks his father just came once and talk with his son only one minute and left. By seeing all of this and communicating with my client I personally feel that there is problem in family dynamics. Along with that I also think that there is lack of proper parenting which led him to low self esteem, lack of confidence etc.
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introduction 91
In this paper I will discuss that how important is to have healthy family dynamics and the role of parents in maintaining family dynamics effectively to ensure the proper mental growth of the individual. Relationships among family has great role in personal development. According to Mathew(1999)Family relationships in general and the parent-child relationship in particular have a pervasive influence on the psychological, physical, social, and economic well-being of children” these relationships are not just help to maintain good social and interpersonal relationship but it has great role in person psychological growth.
Pakistani context 143
In Pakistani societies there is a significant value of family in one’s life. we live mostly in a extended family it helps everyone to communicate with each other effectively and maintain a healthy family dynamics which omit the component of isolation from the society. According to Sousa, A.D. (2009), “in countries like Pakistan family is the major support system for the patient that is mentally ill but at times the patient is often deprived of psychiatric treatment due to family burdens that exist.” But on contrary, due to some myths present in our culture which have become the part of our thinking like believe in bad evil. Thus parents don’t bring their children to mental care settings instead they send them to religious faith healers for expulsion of so called bad evil. This more often leads to the social isolation of the victim of mental illness. Even it has been found that in Pakistani culture parents do not let their children socialize with others because of their illness which ultimately results in internal stigmatization of the victim. This further leads to internal conflicts and may result in guilt.
Critically analyse 223
“The family plays multiple roles in the treatment process, course of the illness and in relapse prevention. It is therefore of utmost importance than in our routine practice we delve into family dynamics and work on this aspect of psychiatric illness. Psycho-education and family therapy must be entwined in routine psychiatric treatment programs and shall go a long way to reduce family burden and relapse-prevention in schizophrenia and other mental disorders.” (Sousa, A.D., 2009)
Family dynamics is the integral part of everyone’s life and it helps to live life effectively without having extra stressors. But if have problem in their family system or the family dynamics are not working properly the person may end up with mental illness. As I have previously mention that the family system of my client is not effectively working so as a disturbed family system my client facing problems like low self esteem, lack of confidence, guilt and emotional immaturity. This component of personality is developed during the initial period of anyone life. And during this time there is need of proper parenting and the parental support. Along with that as my client is having a internal conflicts y so there is more need for parent’s support because these persons don’t talk more and usually don’t express their emotions. Moreover during the early childhood the child learns how to express their emotion. But if parents would not be able to attend this specific need of the child this may lead to emotional immaturity as my patient was facing the same problem.
Moreover except the parents their age group and sibling also play an important role. Good relationship with the peers and siblings helps the individual to maintain a good relationship with the society and it brings the positive attitude in the individual.
There is multiple factors that how disturbed in family dynamics lead to the mental problem of the individual of the family. The family system illness model briefly highlight what factors led to this problem and what are the ultimately solutions of this problem
This model is focus on the three dimensions ‘psychosocial Types’ of illness and disability; major developmental phases; and key family system variables. It focus on the individual holistically. It tells us that how the psychosocial environmental affect the family dynamics which ultimately lead to the individual. According to Rolland and walsh (2006) “It attends to expected psychosocial demands of a condition through its various phases; family systems dynamics in relation to individual and family developmental issues; multigenerational patterns of coping with illness and loss; and belief systems, including influences of culture, ethnicity, spirituality,and gender”
Strategies 461
Before going to work upon the patient who has impaired family dynamics system, firstly family assessment could be done by exploring the issues and problem which is family facing and identify the maladaptive behavior which they are using as the coping strategy. Along with that we need to explore the relationships among the family so we can create a base ground upon which we need to work for our patients.
If there is problem in patient family system or there is lack in parents support. So the second step is to maintain the good family dynamics or brings the positive attitude of parents towards the individual. The first thing which works is the family therapy. According to Townsend, M.C. (2005), “Family Therapy is a type of therapeutic modality in which the focus of treatment is on the family as a unit. It represents a form of intervention in which members of a family are assisted to identify and change problematic, maladaptive, self-defeating, repetitive relationship patterns.” So if any person has problem in family system there is need to first correct this system which ultimately helps to improve the condition of the mentally ill person. Along with that if we focus on the family so it will ultimately decrease the relapse rate, reduce the need for hospitalization and also help in medication management and compliance. “Family members hold a huge wealth of information about the client’s behaviors, their moods, and the stability of these things. When it’s a psychotic illness, perception of reality is impaired, so family members who often live with or near the client can help piece together what’s been going on.” (Frisch, N.C., & Frisch, L.E., 2005). It’s all due to the strong bonding of family with their members, so to appropriately manage the patient condition and prevent from relapse we need o focus on the family based approach. “Most psychotherapists would agree that apart from drug treatment and CBT, family-focused interventions are the most beneficial form of therapy” (Mohr, W.K., 2003)
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Moreover due to the lack of awareness of the family members or parents, the family didn’t accept that their child has some type of mental problem. This led them to delay in the treatment. Along with that in our society the stigma is associated with the mental illness. This is also the one reason that the family is reluctant to go in the mental health care setting. So to prevent from this we need to provide the proper awareness to the family and other people at the society level that these individuals are same as us, so that the delay in identification in problem should be prevented. Along with that the support of the family and society helps them to recover soon and live a healthy life.
Personal feeling
I personally feel that support of the family matters allot and specially for the mentally ill patient. patients who having mental illness is the unfortunate eole because they become dependent upon the others person. Keeping ourselves on the patient position make us very depressive . so we can’t imagine that how much psychological ain they are suffering. Moreover after dwealing with the mentally ill atient and communicating with them. I emphasize that they are same as us and we need to treat them holistically. Along with that I feel that there is very less family suort yto these eole se we need to sensitize the eole at community and also institutional level so that these eole live their life effectively and haily
My feelings and thoughts regarding family therapy lies in the fact that family is a word which is very close to my heart because I am living away from my family for more than 10 years. I know what my family meant to me. I can’t forget the rituals of bedtime stories, hugs, holidays and daily meals shared together with my siblings, which used to provide me a sense of warmth, structure and safety. These rituals and traditions, not only create memories and leave a family legacy, but create our first path in life, the one that is positive. Family therapy is a very useful therapy which should be applied on any patient. I think this therapy is beneficial for not only psychiatric patients but all the other patients who are hospilaized due to any reason. I learned many things after writing paper. I reviewed a lot of literature including benefits of the therapy as well as different researches. This will help me a lot in my future work and practice.
Conclusion / Recommendation
Literature and researches strongly emphasis on the role of family support for psychologically ill patients. There is a profound impact of family support on patient’s health outcomes. So in developing countries like Pakistan much emphasis should be given on the importance of family support and all the social entities have to take practical steps in this regard and to promote awareness programs for general population regarding promoting family support in mental illnesses.
People with mental illnesses are the most unfortunate members of our society because, in mental illness a person become much dependent on others. Unfortunately, there is less support offered for them on social and family level. The treatment and recovery of patients from their respective mental illnesses depends up on both the medical professionals and social support of the patients. In hospital, the staff provides personal support which is called hands-on care while family members offer psychosocial support to the patient which is one of the most important factors of patient’s recovery from psychological illness (Joseph E. Gaugler, 2005). It is doubtless that family has an integral role in management of psychologically ill patients. We all know that if there is proper and effective family and social support available to the patients can lead to positive outcomes like improvements in quality of life, and physical and emotional wellbeing (Laudet et al, 2000). Family support can work on all the three levels primary, secondary, and tertiary levels so help patients. It means if the family support system is strong and there are coherent interactions among the family member it can avert many stressors which can escort to mental disorders. Further, if a psychologically ill patient has effective family support at hospital or during treatment can enhance the recovery process of patient. Proper family support can also contribute effectively in the rehabilitation of patients and can prevent relapse and further hospitalization.
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