At-home and online mental health treatment is becoming an increasingly vital component in supporting patients with complex mental health needs; allowing them to receive personalised, discrete care in the comfort of their own homes. With home assessments and live-in or daily visits from mental health nurses and other care specialists, mental health treatment can be delivered both in person and online by a dedicated team of experts. This all contributes to enhanced accessibility, familiarity and privacy, as well as the ability to be deeply tailored to each patient’s unique wants and needs.
The popularity of home-based mental health treatment is on the rise (1). Attending a residential or outpatient clinic can be challenging, such as during times of illness or if patients have disabilities, personal crises or work commitments, as well as stigmas, transportation issues, or childcare responsibilities (2). Home-based mental health treatment effectively addresses these obstacles, providing a more convenient and private solution (2).
And one of the main cornerstones contributing to the efficacy of at-home mental health therapy lies in the involvement of family and friends. This can significantly bolster the therapeutic process by providing a unique layer of support and understanding that is essential for recovery.
Why is family and friends’ support for at-home mental health treatment crucial?
The importance of family support in mental health treatment cannot be overstated. The interactions and relationships we have with family members greatly influence our overall wellbeing – something that is especially true for patients with mental health challenges (3), where involving families in the treatment process has both short- and long-term benefits. For instance, a 2014 study involving more than 200 veterans with serious mental illness found that increased family participation improved patient outcomes by reducing severity of symptoms and increased speed of recovery (3).
The psychological benefits of a supportive environment at home during mental health treatment are profound. Those living with specific mental health conditions have been shown to experience notable benefits when engaging family members in the treatment process. For patients with schizophrenia, family involvement has been shown to lessen residual psychotic symptoms and help with the early detection of relapse warning signs (4-5). For those living with depression, early family intervention can reduce the severity of depressive episodes (6). Furthermore, family engagement can lead to fewer relapses, longer durations between relapses, and improved adherence to medication and treatment plans (3, 7-10). And, perhaps most importantly, such benefits endure over time if family engagement is actively maintained (8).
Strategies for involving family members and friends in therapy sessions
Since involving family members and friends in therapy sessions can significantly enhance the effectiveness of home-based mental health treatment, almost all mental health policies and guidelines recommend some form of family participation (11). This can range from basic functions such as simply providing insight to more specialised interventions like family therapy (12). The level and type of family engagement depend on the unique characteristics and needs of each patient-family unit, as well as their motivation and willingness to be involved (3). The below outlines some practical strategies that therapists may take to involve family members and friends in a patients’ therapy programme (3):
Psychoeducation
Helping loved ones with mental health conditions can be very emotionally and mentally draining (13-14) since family members experience the challenging behaviours associated with certain conditions (15). Psychoeducation can dispel myths and misconceptions, help family members better empathise with the patient and avoid blaming them for their symptoms, and provide guidance on problem-solving skills and crisis management. This, while simple, has been shown to significantly reduce relapse and rehospitalisation rates (15)
Family assessment and therapy:
Assessing the family helps determine the types of services needed for the family system and the need for monitoring and support, so that appropriate options and recommendations can be explored and offered (3). Family therapy may be targeted at dysfunctional systemic issues and maladaptive interactions between family members (16), which could be perpetuating factors for the patient’s challenges.
Collaborative goal setting:
Engaging family members in setting treatment goals can increase their commitment to the therapy process. This involves discussing and agreeing on achievable goals for the patient’s recovery, ensuring everyone understands their role. Collaborative goal setting helps align the efforts of the patient and their family, fostering a united approach to treatment.
Regular check-ins and providing feedback:
Scheduling regular check-ins with family members can help monitor the progress of therapy, gain insight into behaviour and wellbeing between sessions, and address any concerns. These check-ins provide an opportunity for family members to give feedback, ask questions, and adjust their involvement as needed.
Mental health professionals therefore play a crucial role in preparing family and friends for therapy sessions (17) – something that can involve several steps:
- Identifying and inviting family members: often, initial discussions involve discussing the benefits of family involvement, and working to identify family members who can provide support.
- Fostering clear communication: its important that everyone avoids using clinical terms and medical jargon, instead using plain language to ensure understanding of conditions and symptoms, as well as the goals and expected results.
- Helping manage emotions: mental health treatment can evoke strong emotions and even conflict within families. Focus here will be strongly on mitigating these challenges, and offering guidance on how to manage emotions constructively.
Preparing your home and family for mental health treatment
Creating a conducive home environment is crucial for the effectiveness of at-home mental health treatment. A well-prepared setting can enhance the therapeutic process, making it easier for patients to engage fully and benefit from their sessions:
- Create a quiet, private space: establish a quiet area, free from distractions for therapy sessions. This space should be comfortable and private, fostering comfort, security and open communication.
- Involve family members in preparation: engage family members in the preparation process by explaining the importance of their role in support. Discuss how they can help create a positive environment and respect treatment schedules.
- Set clear boundaries and schedules: Establish clear boundaries regarding therapy times to minimise interruptions. Inform family members about the therapy schedule and request their cooperation in maintaining a quiet environment during these times.
Effective communication with family and friends
Effective, open and honest communication with family and friends is pivotal in ensuring the success of home-based mental health treatment. But there are strategies to help patients and their families navigate these conversations smoothly:
Offer advice on how to communicate about treatment
Patients ought to share their treatment plans with their family and friends, explaining why they have chosen at-home mental health care and how it will work. This transparency can foster a supportive environment and reduce misunderstandings.
Explain the therapy process and the role of family members
It’s important for those receiving treatment to clearly articulate the therapy process and the specific roles that family members and friends will play. Explain that while the primary focus is on recovery, family involvement can provide crucial emotional support and stability.
Managing expectations and addressing concerns
Encouraged discussions around potential outcomes of the therapy, setting realistic expectations about the pace of progress. Address any concerns or anxieties that family members might have by providing them with information about the therapy, its benefits, and how it can improve the mental wellbeing.
Encourage active listening and empathy
Advise family members to practice active listening, showing empathy and understanding towards the patient’s experiences and feelings. This can create a more supportive and nurturing environment, which is conducive to effective treatment.
Common questions and answers
How do I tell my family that I need therapy at home?
Open and honest communication is crucial. Start by explaining the benefits of home-based therapy, such as the comfort of being in a familiar environment and the flexibility it offers. Address any concerns they might have by sharing information about how this approach can significantly enhance treatment outcomes.
What can I expect from home-based mental health care?
Home-based mental health care involves undergoing treatment programmes from your home. This can include live-in mental health nurses and other care specialists, home assessments, and daily visits from a variety of mental health and wellbeing professionals. The familiar environment can help foster feelings of relaxation, comfort and familiarity, which can facilitate quicker recovery and a more effective therapeutic relationship. Family and friends can play a supportive role, providing additional emotional and practical assistance.
How can my family support me during my mental health treatment at home?
Family support is vital in home-based mental health care. Family members can offer practical help, such as managing appointments and creating a conducive environment for therapy. Emotional support and encouragement are also crucial. Encourage your family to be patient, understanding, and to actively participate in your recovery journey.
What are the benefits of home-based mental health treatment?
Home-based mental health treatment offers numerous benefits, including the comfort and convenience of receiving care at home. This approach allows for personalised and flexible treatment plans tailored to individual needs, often leading to higher satisfaction and better outcomes. Patients can maintain their privacy and feel more at ease, which can enhance the effectiveness of therapy.
How do I prepare my home for mental health therapy sessions?
Creating a conducive environment is essential for effective home-based therapy. Designate a quiet, private space for sessions to ensure minimal distractions. Make the area comfortable and welcoming, with adequate lighting and seating. Ensuring that this space is consistently available can help create a stable and supportive setting for therapy.
The support of family and friends plays a crucial role in enhancing the effectiveness of at-home mental health treatment. By involving loved ones in therapy sessions and preparing the home environment, patients can benefit from a more comprehensive and personalised approach to care. This not only improves treatment outcomes but also fosters a supportive and understanding network around the patient.
We encourage healthcare professionals to consider the strategies discussed to better involve families and friends in their patients’ mental health care. By doing so, we can collectively work towards more effective and compassionate mental health treatment at home.
If you or someone you know needs support, don’t hesitate to reach out to our friendly team today.
References
- https://www.psychiatry.org/news-room/news-releases/new-nationwide-poll-shows-an-increased-popularity
- https://www.goodtherapy.org/learn-about-therapy/modes/home-based-therapy
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8801858/
- https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/abs/behavioural-family-management-in-schizophrenia/C5F4ECA0115658F5081CDFA0B57A4EF0
- https://jamanetwork.com/journals/jamapsychiatry/article-abstract/481583
- https://www.tandfonline.com/doi/abs/10.3109/09638239209034511
- https://www.tandfonline.com/doi/abs/10.1080/10973439908408388
- https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/abs/salford-family-intervention-project-relapse-rates-of-schizophrenia-at-five-and-eight-years/F819E1C408065D41325342698C904543
- https://www.sciencedirect.com/science/article/abs/pii/S0006322300009318
- https://journals.lww.com/psychopharmacology/abstract/2011/02000/the_role_of_the_family_and_improvement_in.15.aspx
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623469/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4187461/
- https://www.tandfonline.com/doi/pdf/10.5175/JSWE.2008.773247702
- https://psycnet.apa.org/fulltext/2003-05349-011.html
- https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/interventions-to-improve-the-experience-of-caring-for-people-with-severe-mental-illness-systematic-review-and-metaanalysis/95BEF17E32C066256A17D70DA0EB8EBC
- https://europepmc.org/article/med/23148002
- https://www.bestnotes.com/how-to-involve-families-in-your-clients-behavioral-health-treatment/
