what you're about to see is a full session of a multif family group uh in the psychoeducational framework I think what most practitioners understand by Family psychoeducation is simply providing information but I think you're going to see that actually that's a small part of what this approach offers to families and consumers the real Crux of this approach is developing a family environment which supports recovery uh allows families to uh get support get advice get con consultation and some new skills for compensating uh for the kinds of problems that these illnesses uh present to families and consumers alike so this approach is really problem solving only what's different than other aversions of problem solving methodology is that many family members who start off as Str chers uh begin helping each other to develop new approaches that are often some ways uh new and novel and in some many many ways more effective than what clinicians could offer uh by themselves you almost have to be there to believe it uh to see it uh hopefully this example will give you some indication of just exactly how that occurs so as you'll see every multif family group session except for the first two really follows a similar format there's socialization as a go around to see in essence where each uh consumer and family stands U largely in a clinical context but in their life in general a problem is picked out that uh seems to be particularly amenable to this approach and then uh the rest of the session is really devoted to trying to work out an approach to that problem that can be offered back to the consumer and their family to try out in the next couple of weeks uh as all other sessions it also closes with social socializing and trying to figure out uh sort of what's been uh good about the last couple of weeks and also what's going forward uh likely to happen that seems to be promising for the folks in the group in general well I want to thank everybody for coming to group again today um it's nice to see everybody we got a full group everyone's here today um how's everybody been anybody anything special we've got someone new to introduce so we're honored to have Mary here Tom you want to introduce your sister this is my sister Mary Catherine right right nice to meet everyone yeah is everyone yeah and she's with us she's everyone's always welcome but you're with us specifically because your mom had car trouble yes right so you helped your mom get here today yeah how's the car John well it's being repaired even as we speak so it'll be ready on my way home so oh good good okay all right well I'm really glad you could come Mary and bring your mom and I'm glad too the cards were right my other my mother-in-law is here from Scotland oh so I had the coverage of with the child oh with the child yeah it was fate right we've heard a lot about you and the baby from your grandma and from Tom so yeah imagine that the grandmother imagine that a grandmother talking about child right so everybody here all the parents in this group are grandmother mothers we've heard about your grandchildren I've met your your grandchild so well El see I got any trips planned anything new fun coming up have a great granddaughter do in November a great granddaughter a great grandchild great grandchild I'm gambling on a daughter oh you are okay which you don't know you don't know well that'll be a milestone all right and welcome susette Katherine again you know I guess everybody's got to meet Katherine by now and she's she came early to the world yeah okay all right so how's how's a new family how's it how's the new how's it feel like being an uncle this is your first time being an uncle right yeah yeah yeah I guess it's pretty good yeah you were doing a great job holding her there before group started yeah very natural there Scott yeah that's that's sweet okay um one thing we need to one thing we do need to do today is um um the snack assignment list okay well let me pass around this the snack list okay star here yeah let me let me probably get it in order though that would make a little more sense wouldn't it because the next group is the 23rd of May which is not Memorial Day so there's that and there's the pen is it on Monday again it's going to be back to Monday yeah we're moving back to Monday well let see today is the 11th so um the 23rd is 10 days away on Monday Monday okay all right and the other thing I'm going to pass around um that I think I have enough copies of this one this is a newsletter I get the mental health letter about schizophrenia and about people trying to track down the diagnosis and how it's made and what are the some of the biology um it's you know you know written for everybody anybody could buy the Harvard Mental Health letter so I think I have a copy for everyone if I don't just let me know and I'll get you a copy and then this is the schizophrenia digest that I've been passing around I still get it for free I don't know why but it still comes so this one I have enough for you know one magazine per family so people feel free to take one of those okay yeah maybe we can do a better job with the drinks next time you apple juice and water that's perfect that's great okay well as all that stuff is going around um why don't we start um the go round we're just sort of checking in with everybody and seeing how you're doing on goals and things you're working on jobs um also We'll be asking and talking about any specific illness issues um anything we need to work on okay so we start with you Scott I guess everyone we always start with our right so what's going on with you uh I've been trying to get a job uh tell them about your interview I had an interview at uh you had an interview uhhuh yeah yeah at the old it's a older place with where older people go mhm for a nursing home or something like that okay and they hir me but uh they hired you good well they they didn't hire me but I I don't have any way to get out there it's hard it's eight miles from oh so it's kind of not close I said to Scott well how are you going to get there uhhuh it's you know is it a job that you want well I like it but it's it's it's a job where in the past that I've uh I've done things like this before it's not something new to me it's in cooking and doing things like that but it's and also had a job interview over at the animal control center M so that's volunteer that's not paid uh yeah yes yeah so it sounds like um the animal control would be it's more like what you like you talk about that a lot doing that kind of stuff and you're in the training program for the vet tech so yeah my biggest concern is with Scott is and I know not everybody has a physical illness on top of their Mental Illness but is learning how to address the issue before it gets so far gone that he has to go to the emergency room did that make sense mhm cuz he lets it get his Curren diseas get so so blown up that he winds up in the emergency room instead of addressing it when it was bothering him like two weeks ago uhhuh yeah it was bothering me when I went down to my dad's right really and he doesn't say anything so all right did anybody know about I was taking I told Dr Miller but I was taking antibiotics right well cuz you'd just been through a flare up yeah month or six weeks ago yeah yeah I actually it has it was there for like 5 years I didn't have any problems with it uhhuh but now it's like every three or four weeks I had something wrong uhhuh yeah but learning how to address it when it's first bothering him instead of when it's so bad he can't see on the pan anymore right right are there things you can do to do that okay right we can sort of put that on the list and think about things to do with the problem solving all right well Jim how you doing really well uh I went to the NAMI Walk uh and oh that's right that's happened since we met last yeah that was fun David I don't know his last name but David and I decided to go together around the uh around the park as like around the lake is it the same place it was last year Centennial Park well I I wasn't there last year this new to me this year so and uh we had a a bottle of water and generally enjoyed ourselves good okay it's how far is it 2.4 miles 2.4 miles saw a lot of people coming back the other way you know didn't finish it and came oh really and came turned around okay well anything going on for you on the job front not really I uh I missed the uh job uh Workshop that supposed to do with Tim MH yeah I'm just having a little bit of a problem there you know like working things out with them right now with with Tim your job coach okay what what do you think the problem is what's going on uh I just don't want to do it you know I don't feel like it's absolutely necessary for me to do it's you just don't want to work or you just don't want to do the workshop I don't want to do the workshop I want to work sometime yeah okay I might go there and there tomorrow I'm not really sure right it was something that was supposed to happen like every day this week or something for two hours a day or something Caris how you doing um your next Heth better I'm still don't know about what work I'm going to regular work I'm going to pursue hopefully you'll find a place I don't know are you looking forward to your trip yeah a chance um yeah get out I never find out if he does full-time farming or not now fulltime Billy Billy yeah does it is fulltime oh yeah he his other job is it going Orchard his cousin has a pistachio nut farm a small one but he's he's he's fulltime now he doesn't wish we had we could land around where Brad lives in masses way in FIS County I dreamt of planting an orchard there land got developed yeah so you're going to do some work on a farm or just just see yeah whatever he needs sir I think I heard something about getting some dental work maybe maybe yeah that's right in Mexico think he might that was for you Kurt right yeah I don't think so you don't think so okay well sounds like your teeth aren't bothering you well no you having any pain or problems with your teeth there's no pain it's just you he just needs a bridge if I mean that I think that's what they're talking about you could use a bridge could use a bridge I guess all righty well Tom how you doing anything new for you how's your housemate situation pretty good I know some about your house me situation how how are you doing with it so far so good about the same as normal okay they're a little bit older in this house uh it's a little bit more uh uh hunger going around MH people are bigger they want to eat more right yeah my appetite's not that big but I spend my money too fast usually uhhuh by the end of the month right so you need some money management help yeah maybe on my Independence card uhhuh so you're running out of money before you got too much month left at the end of the money okay you got spend uh about my whole $130 check by by three weeks oh okay three and a half weeks that's bad $130 in 3 weeks I don't think that's bad everybody needs help well Betty sounds like we've got several things we've talked about today that we could we could work on the problem solving because now we're going to move on to picking a problem to work on um let's see you want to go over them with me you were taking notes yeah um the first one had to do with um you know whether to take a paid job or an unpaid job right Scott's choices Scott um also addressing sematic issues before they become a crisis right right you know that's something that a couple of people brought up right Carol brought that up too um thinking about Jim looking at the uh whether he should go to the workshop making that decision um based on the fact that he was not very motivated to do that and he had some scheduling conflicts um Carol brought up issues around having a lot of tension um with her children her grown children and trying to sort of being in the middle of that and uh also the repeat issue of smoking you know um I think Tom brought up um money management and uh it sounds like he's going to be coming into some money if he helps his mom with the move um and then Curtis um it sounds like your folks wanted you to have some dental work done but you'd rather get some boots and um you know you're you're you're taking a trip for for three weeks which is a two oh just two so you'll be away for for a while yeah so you know at the very beginning we talked some about the tolerating the airplane ride so that's coming up in July so maybe that's something well anybody like to volunteer to work on the problems you know that came up for them anybody want to volunteer should we you know I think certainly that kind of problem the you know how to get prepared for an airplane trip is something that we could do um I think there's lots of helpers and pointers and things we could talk about there um Scott we could talk about the whole decision around the job if you'd like um you know Jim talking about sort of helping motivated so I could see us working you know certainly on those two problems and any anybody would like to volunteer well I was wondering Dr Miracle if when Tommy gets on the airplane he could have some medicine to make him maybe sleep or relax right or well that's certainly one of the solutions and I don't think that we' Tommy is not afraid of flying ahead time right and have it ahead of time right I'm not worried about it mom because I I used to fly home all the time remember I know honey but you know you can't sit still for an hour let alone it's very confined in an airplane you haven't been in an airplane for a long time and it's a 6-h hour flight out I think it's a little quicker coming back and Tommy doesn't realize how you know the seats are small now on the airplane yeah and he's big right and they don't really like you running up and down the aisles so much anymore they used to be a lot more lenient right well I will say one thing Tom once you take off anywhere in DC you can't get out of your seat for a half hour it's against the law well well Tom this I think a lot of people have ideas would you be willing to do the problem solving with this would you be willing to be the focus of the group today and talk about that I guess okay all right is that all right all right okay um okay so why don't we do that g to go you know the problem solving exercise we're going to go through this Define the problem we're going to list all the possible solutions which we already sort of started people have come up with a couple already um we're going to sort of go through a discussion of each the pros and cons of each solution and then we're going to Tom you and your family are going to choose the best one the one that suits you and the one that fits best with what you want um and we're going to make plans to carry out the solution make sure you you know all the steps you got to take notice how the leader spends quite a bit of time and uh a lot of care defining the problem in collaboration with her colleague this is really one of the hardest diffic and most difficult uh skills to learn in this approach but it's also one of the most crucial notice that the the problem definition itself is quite detailed it's quite behavioral it's really highly relevant to an issue that could be quite destabilizing for this young man that is flying cross country um facing you know going into possible withdraw uh from nicot nicotine and smoking and all of that um this is really an excellent example of the kinds of things that we found most effective and we hope you'll follow that as you uh practice in this uh model let me Betty's going to be keeping track of this um and writing it down so we can send you home time with what we're all right okay all right all righty let's go let me just move that okay all right so how are we going to Define this problem what's the best way to define the the problem sort of sitting still sitting still without cigarettes without smoking or sit still that's perfect in an airplane for you know 6 hours extended period in the in the plane but you know well that's flying time it's probably going to be more like 7 yeah I mean if you think about the way airplanes are these days I mean the way airports are and that you have to be ready two hours ahead and you have to go sit at the gate and there's no smoking in any of the airports so you're looking at even you know more than six hours now obviously you know it's only six hours in the plane so the other you're going to be moving around but so that's a lot and then we're talking about without smoking yeah that's and that's going to be very very hard okay are you going to the gate with them I'm going with them oh the whole way we're going together so I told him I I I I think I'm going to give him a patch okay you know one of those cigarette patches you or you know I might have another solution San Diego is it really six hours all right so this is the point where we get you know we sort of have a kind of a free discussion of everybody who wants the weigh in can about all the different solutions so we've already heard um let me write this D if I can spell today all right we've already heard get a patch a nicotine nicotine replacement my husband smokes as well and we've we've actually just finished quite a long journey uhhuh which was 15 hours wow and um that's that's a challenge for him MH um and he uses the lozengers commit lozengers right because I think you get more of a hit with the nicotine and those it's also something to do and yeah um but it would probably be something you might even want to practice with one daytime just go all day with the lozengers and see how it feels right so getting a patch or some other type of nicotine replacement like the lenes and Joan you mentioned also you know have sort of as needed or PRN meds right I think that's important I mean we might not need to use them but if if you get real antsy the the last time I flew on an airplane and I'm not that big yet but the seats were so small I was miserable when we were flying back from Rome and Tommy is much bigger than I amh and you know his legs are going to cramp I just I know ahead of time I mean I'm I'm anticipating all the worst Tommy not and I should be anticipating the best know I'm going to come with a solution I think for this perhaps is um now try to get a bulkhead seat exit I could I tried I couldn't or an exit row seat you tried all right well okay I'll that there situation no well what you can do is just tell them you've got a circulation problem you have to get up every half hour and walk okay so that was um that's a good idea instead of give some of advanced go ahead wouldn't they know on the airplane that uh people run into the same kind of problems that would so great right so they I can probably get a rose seat or something like that well it sounds like your mom has tried to do that I don't know we got a spe very special deal which is why we're going uhuh and we are not going to get the bulkhead or the exit row seat row seat you going to get seat I'm going to try to get an i that's important but you can get an out easily right but we we just got such a great deal I mean I just couldn't afford not to go so I was about to advance warning to this to the flight attendant right no okay yes is it you're not going in Southwest are you Independence they just started right Dallas right some snacks for gum on the they want you on they even like have like in the a in airport meals to go where you can buy your meals in advance and take them with you be a good idea right okay take snacks though you peanuts they'll give you peanuts that's all they give right now what about um things like keeping yourself occupied Tom what do you Walkman what do you think about music books you taking this big trip what helped you um well I I watched uh Fox watch the TV oh that's I there'll be a movie right will they they will they have one on Independence just starting Southwest they don't there was uh they don't have movies on Southwest there was lunch or dinner don't listen to music with earphones do that is his ear his preference the meals right yes take the earphones when they off do you read Tom uh magazines sometimes Dr marac could the medication that Tommy's on have anything to do with his eyesight yes we going to have to have his eyes checked oh are you you having some problems with your eyes well I can't read that well and that's a new thing yeah yeah it could be that that that's wor worse for you on Zyprexa than it was on risper doll well I didn't reason I don't think it makes a difference uh because uh when I was on uh a spad doll I didn't even read uhuh I never I looked at the paper every once in a while but I I still couldn't read them my vision is too blurry when I when I look at the paper it just becomes blurry right so even on the other drug it was a problem yeah is wor problem we're going to go to the eye doctor the same right and Scott you've had that problem you just you were just telling me about it yeah I got to get my eyes checked like every three months yeah okay all righty well so we've got a lot of things bring earphones bring I guess a magazine puzle or search work all right cross word puzzle things that keep you occupied you know I think we can probably put a lot of those type of solutions together with one in one thing like you know pack make sure that you pack your carryon with all this stuff right so you know so carefully pack you know pack the carryon so that you got these things all right Tom any any other solution to make things come up with anybody's taking trips Scott you you take trips but in the car right yeah you just got done with a long trip but that was car so I guess you can stop and start and yeah yeah Kurt you're taking a trip well you guys went to Mexico you're going to Mexico that's a long how many hours is that Kurt about four three and you went to Old Mexico last year yeah right any you don't have any problems on the plane oh no time to Moscow actually yeah did have little tobacco problem you went to Moscow I come back come back while I didn't how long was how long were yeah a long time going to Moscow I was wondering about the smoking going to Moscow I mean is help my spine it's not really craving it f it basement what airline did you you're not allowed to smoke onlines let you smoke oh they still do M oh yeah actually Russ more strict actually kind actually I think smoke more in Russia they're more strict about trains and uh planes so you had a little trouble getting back from MOS CU well I get energy on Bas my neck it relieved tension there that was really it wasn't wasn't wasn't just graving it so Tom we talked about the the plane being difficult because of the smoking um the walking around you know you can you can do but they don't let you walk from first class back I mean from economy to first but fly eye doesn't have first class anyway so that's not going to be this so so that's good because you to have a whole plan right right you're all right we're all in economy together um so that's an issue you can get up and walk around and in fact people encourage it from a in order to prevent blood clots in your leg so they encourage that so that's okay and flying out of Washington Dallas you're not going to have that 30 minute restriction I don't think from National you can't when you fly in and out of national you can't um get up for 30 minutes after before takeoff or before landing but doas they don't do that right they don't but they don't encourage