Home > Family focused practice in adult mental health care. A guidance document for the development of family-focused practice across Galway/Roscommon Adult Mental Health Services.

Galway Roscommon Adult Mental Health Service, Mental Health Social Work Department. (2022) Family focused practice in adult mental health care. A guidance document for the development of family-focused practice across Galway/Roscommon Adult Mental Health Services. Galway: HSE Mental Health Services.

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Family Focussed Practice is a method of care delivery that emphasises the family as a unit of attention as opposed to mental health practitioners working with an individual’s care needs alone (Grant et al., 2018; Foster et al., 2016). For the purpose of this document, Family Focussed Practice (FFP) refers to interventions that identify and address the needs of parents, adult siblings (siblings over 18 years) and children in relation to parental/adult mental illness. Research in relation to the effectiveness of Family Focused Practice found that:

  • It improved outcomes for parental mental illness, reduced the subjective and objective burden of care for families, and provided a preventative and supportive function for children (Foster at al., 2012, p.7).
  • It reduced the likelihood that parents will experience a relapse of their mental illness (Bauml et al.., 2006).
  • It reduced the need for hospitalisation for treatment of their mental illness (Hylan et al., 2008).
  • A meta-analysis of 13 individual, group, and family interventions for families with parental mental illness has found a reduced risk of children developing the same illness as their parents by 40% (Siegenthaler et al., 2012). These interventions have been found to increase parenting skills, strengthen knowledge of parents’ mental disorders, and strengthen resilience factors among adolescents (Siegenthaler et al., 2012).
  • Systematic reviews of prevention programs for the children of parents with substance abuse problems have found preliminary evidence on reducing children’s problems and improvements in positive behaviours, coping skills, and feelings, especially in longer programs that involved both parents and children (Broining et al 2012, Jarkestig, Beggeren and Hanson 2015).
  • Similarly, a systematic review of 19 psychosocial interventions for families with parental cancer found most interventions helpful (Inhestern et al., 2016). The interventions were found to support more open communication in the families and children reported to talk more openly about parental illness and have better coping strategies (Inhestern et al.., 2016). Studies also showed improvements in parents’ and children’s quality of life, mental health or distress (Inhestern et al., 2016).
  • A 2006 Cochrane Review of the effectiveness of Behavioural Family Therapy reported that individual family approaches gave a reduction in relapse rates, reduction in hospital rates, better adherence with medication, and reduced costs of care (Pharoah et al., 2006). The 2014 NICE guidelines in relation to the treatment of psychosis and schizophrenia in adults – recommends family treatment as a core treatment (Kuipers et al., 2014). It recommends that the family intervention is offered as early as possible and that it can be started during the acute phase.
  • Between 2018 and 2021 mental health services in the Republic of Ireland funded PRIMERA to undertake the first randomised control trial in relation to an evidenced based intervention – known as FAMILY TALK. A total of 86 families [139 Parents, 221 Children – across 15 sites] - took part in the study. According to Mulligan, et al. (2021) ‘over two thirds of the families reported substantial benefits from participating in Family Talk, including reduced stigma, giving children and partners a voice, increased service-user confidence, and improved family communication/relationships’ (p.2). 

They reported key enablers identified by families who participated included: • the intervention being delivered by competent, non-judgemental clinicians • the whole family approach • families readiness to engage. Barriers highlighted by the study included: • stigma • family crisis/relapse • service constraints • impact of Covid 19, • need for families to have greater support around the engagement and follow up phase. 

Norway, Finland and Sweden introduced legislation in 2010 to ‘promote mental health and disorder prevention for dependent children in health services for adults’ (Solantaus et al., 2010, p. 891). ‘Family Talk’ developed by Beardslee (2012) has been adapted in Norway and Finland to assist with implementing statutory requirements. Additional studies highlight greater work satisfaction for professionals engaging in Family Focussed Practice as a consequent of a more collaborative approach to working with families (Toikka and Solantus 2006; McDonald et al.., 2012). 

This document outlines the Galway Roscommon Adult Mental Health Social Work Department’s (GRMHSW Dept) contribution to the development of Family Focussed Practice over the past five years. It makes recommendations for future development as well as identifying the resources required. Our aim is to ensure it becomes embedded in practice, across Adult Mental Health Service.

Item Type
Publication Type
Irish-related, International, Guideline, Report
Drug Type
All substances
Intervention Type
Prevention, Harm reduction
July 2022
40 p.
HSE Mental Health Services
Corporate Creators
Galway Roscommon Adult Mental Health Service, Mental Health Social Work Department
Place of Publication

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