Family Participation During Residential Mental Health Treatment: An Interview with Breanne Dargon
Creative and experiential modalities are emerging as vital components of comprehensive mental health treatment programs, opening up new paths to healing that go beyond traditional talk therapy. Kayla Karesh discusses how, by harnessing the power of art and a variety of experiential therapies, you can broaden the scope of recovery in a way that leads to deep integration and lasting change.
Breanne Dargon understands this well. As a licensed marriage and family therapist and Program Director at Hanbleceya, she sees the vital role families play in the recovery process every day. And, just as importantly, she understands the vital role treatment can have on the lives of each member of the family. In this interview, she explores the value of family involvement in mental health treatment and what that involvement looks like at Hanbleceya.
Family Involvement at Hanbleceya
Hanbleceya offers intensive long-term treatment for people living with mental illness. It is a unique program, typically spanning 12-18 months, that focuses on helping people recover from psychological crises, manage ongoing illness, and develop independent living skills within a therapeutic community. But the focus of the program isn’t solely on the client; rather, healing must happen across the entire family system in order to produce the best outcomes. “We think of the family’s involvement as a crucial piece in the recovery process,” Dargon explains.
Although the client is the one who is physically living here, participating in the daily programming and needs the most support managing their mental illness, we also consider the family to be the ‘client.’ The family’s involvement is as important as their loved one’s participation in the program. That is where the change happens; in order for the client to heal, the family has to be involved.
Indeed, a growing body of research shows that family involvement in mental health treatment leads to significantly higher chances of the client living a stable, successful life even in the face of chronic illness.
In order to foster involvement, Hanbleceya offers comprehensive family programming that provides the education and support necessary to understand what you and your loved one are experiencing and create new behavioral patterns that nurture both your family member and yourself. This includes traditional family therapy at least once a week along with biweekly psychoeducational groups attended by multiple families. In these groups, you learn how to work better with your loved one while learning how to support yourself. Additionally, bimonthly support weekends offer educational seminars and process groups for families along with family sessions. This programming remains available to families after their loved one has left residential care through the Extended Services program and sometimes even thereafter, allowing families to maintain and build on the progress made in treatment as your family member transitions back into their everyday environment.
But on-site family support isn’t the only important element of caring for the family. “From the beginning, we assess family members’ needs for their own individual therapy and support groups,” Dargon says. “Due to the high level of stress our families are under, we often find ourselves needing to coordinate care. For example, we may ask for releases to be signed that allow us to speak to the mom’s therapist to make sure we are working in concert.” You may also be referred to outside support groups, such as Al-Anon or your local chapter of the National Alliance on Mental Illness (NAMI) .
While Hanbleceya offers multiple points of support for family members, what each person’s family involvement looks like may be different, as each treatment plan is individualized. The pace, techniques, tone, and delivery are all tailored to your family’s needs and your loved one’s diagnosis. Simultaneously, family dynamics play a vital role in determining the course of involvement, such as in the case of split families.
“Hopefully everyone is able to come together if we have divorced or separated families, but sometimes that’s just not always possible,” Dargon explains. “In those cases, we can have separate assessments and then follow up with maintaining boundaries and having separate family sessions. We definitely want to create a safe space for families to allow the healing to happen.”
The Challenges Families Face
Many people imagine that once their loved one is in treatment, the hard part is over. But in fact, there are numerous challenges families can face during and after your loved one’s time in residential mental health treatment. “One of the major challenges they often have is acceptance of the magnitude of their loved one’s illness. It can be difficult to accept that this is a lifetime illness,” Dargon says. “It doesn’t mean that they’re not going to see their symptoms dramatically improve, and at times, dissipate. But like many might expect, managing and treating mental illness is a process that takes time. We find that managing your expectations of treatment and the timeline upon which healing can happen can be difficult for many people.”
Then there are the challenges you face within yourself during your involvement in the treatment process, including making the changes that are needed to successfully move forward as a family. This includes examining and altering damaging emotional, cognitive, and behavioral patterns that interfere with recovery, such as enabling behaviors, feelings of shame, and difficulty letting go of control. “Family roles and patterns have been in place for a long time, and it takes time to make changes in those behaviors,” Dargon notes.
Once your loved one has left residential care, it is also common to struggle with maintenance. “When someone transitions out of our programs, they still likely have a mental illness, they’ve just learned new tools to manage it and have learned how to live their lives more healthily. The family has learned new tools as well and even the maintenance of that can be a challenge.” Many find it difficult to respond in ways that are appropriate for this new phase of life rather than responding in a crisis mode.
The Benefits of Family Programming in Mental Health Treatment
Family programming in residential mental health treatment is designed to address the challenges inherent to the treatment process by offering meaningful support and guidance that nourish both you and your relationship with your loved one. One of the most important things a family can do, then, is put trust in the program and the process. “Letting go of a little bit of control can be very scary,” Dargon says. For many, however, that trust can be transformative, allowing you to relieve yourself from carrying the burden of mental illness on your own:
Families are learning how to support their loved one living independently. It’s a chance for them to practice with the scaffolding still up. For example, it’s a way for family members to see how it feels to have their daughter live in an apartment for the first time and recognize that she’s able to do that in a healthy and successful way. And that she might also struggle at times. Allowing families to learn how to sit with those struggles and difficult emotions is critical.
Having clients practice independent living skills during their time in residential care also helps families practice what it is like to have an independent family member. And you’ll likely make some mistakes along the way. But those mistakes become an opportunity to explore those behaviors in family therapy to help you gain insight and create change.
One of the most critical pieces in creating healthy transformation is re-imagining your own role within your family and learning how to care for yourself in that role. “We are huge on self-care. That’s a tremendous skill we’re always teaching, especially for the family members,” Dargon notes. “It’s not uncommon for me to prescribe parents to start going on date nights or take a vacation because that’s something that’s been completely put on the back burner. All of their emotional capacity went to their loved one before coming here.”
Not only do these things provide paths to self-healing, but they also send a strong message to your family member in care: it says to the client that the family trusts that they are going to be taking care of themselves. “It also sends a message that they don’t need to be the center of attention for families to move forward. When people are in crisis, they might need to be attended to, but when a client is here and doing the program families get a chance to focus on other things, including themselves.”
For many, working with other families through multi-family psychoeducation and process groups is vital to achieving these changes. “Families have reported that their individualized sessions paired with interactions with other families help them tremendously in overcoming challenges,” Dargon notes. Indeed, interactions with others who know what you are going through help to break through the isolation, shame, and self-blame so many feel. As such, the support and feedback you can experience with other families can be profoundly powerful and an integral part of creating a strong foundation for ongoing success.
Unlocking the Potential of the Family
At Hanbleceya, Dargon is witness to the transformative potential of family participation in mental health treatment every day. “We have absolutely seen a correlation between family involvement and success in treatment,” she says.
Part of that is undoubtedly due to the increased connectedness, new relationships, and repairing of old relationships that arise out of family therapy and multi-family groups. “I see new confidence both individually and in how it trickles into the family,” Dargon explains. “People say, ‘The holiday was so different because we weren’t on pins and needles waiting for somebody to act out. We actually enjoyed being together.’ We have folks who say, ‘I never really talked much to my sibling and now we’re checking in, we’re texting, that kind of thing.’”
But Dargon’s favorite change is seeing the new roles that emerge over the course of treatment.
Obviously, we are all meeting together because of the individual who happens to be in our program. That’s the reason we are all together in a session each week. But one of the big goals is getting the client in a more independent place and stepping out of the role of the ‘patient.’ When that happens, the cool part is that they get to take on a new role in the family. Suddenly they are supporting their mom in a way she was never able to receive before.
It also opens up space for each member of the family to reimagine a new and healthier role for yourselves, both within the family and in the broader picture of your life. By working together with compassionate clinicians, peers, and your loved ones, you can truly unlock your potential and create a strong foundation for renewed joy and self-discovery.
Hanbleceya offers long-term, comprehensive treatment for people struggling with mental health disorders as well as co-occurring substance use disorders. Contact us to learn more about our renowned San Diego-based program and how we can help you and your loved one start on the path to lasting wellness.