FAMILY MINDED
PRACTICE –
DEVELOPMENTS IN
ADULT SERVICES AND
MENTAL HEALTH
Jerry Tew
Reader in Mental Health and Social Work
University of Birmingham
LEVELS OF ‘FAMILY MINDEDNESS’
1.
2.
3.
Predominantly individual focus with other
family members being consulted and/or
expected to provide support
Focus on ‘axial relationships’ (Cornford et al.,
2013) – i.e. dyads such as parent-child, carervulnerable adult in which one party can tend to
be seen primarily in relation to their designated
role (as carer or parent)
Focus on family as a relational network of
significant others

Flexible user-centred definition of who is to be considered ‘family’
WHAT’S BEEN GOING ON?
ADULT SERVICES


Often ‘family support’ in relation to older people
and adults with disabilities has tended to mean
an assumption that families provide support,
rather than families need family-oriented support
Families taken for granted (but not pathologised)
in individually focused processes of assessment,
care management and reablement
However…
Care Act 2014
CARE ACT 2014 AND GUIDANCE: THE CARE
ACT AND WHOLE-FAMILY APPROACHES


‘Practical guidance for practitioners working in
adult social care in relation to carrying out
assessments and developing plans which consider
the needs of the whole family’
Principle of wellbeing (i.e. not primary focus on
risk / deficit)
Step one: Think family.
Step two: Get the whole picture.
Step three: Make a plan that works for everyone.
Step four: Check it’s working for the whole family.
 ‘The
interdependencies and interconnections
between family members mean that what
happens to one affects everyone else. Caring
is a universal activity and an important part
of family relationships.’
 ‘Whole-family
approaches can be key in
maximising the impact of resources and
identifying opportunities to support carers,
and to ease the very real risks to health and
wellbeing that caring can bring.’

‘Level 3’
‘MEMORANDUM OF UNDERSTANDING’ TO AID
JOINT WORKING BETWEEN CHILDREN
AND ADULT SOCIAL SERVICES


‘Local authorities to adopt a whole system, whole
council, whole-family approach, coordinating
services and support around the person and their
family and considering the impact of the care
needs of an adult on their family, including
children.’
Specific consideration of young carers in a whole
family context (with explicit tie-in with Children
and Families Act 2014)
WHAT’S GOING ON?
JOINING UP CHILDREN’S AND ADULT
MENTAL HEALTH SERVICES
‘Think Family’ Pilots – SCIE
 Organisational
focus
 Progress patchy across
implementation sites
 Could be a lever for whole systems
change within and across
organisations
WHAT WORKS?
Interagency ‘Team around the family’
Or
Family support team with embedded
mental health expertise and key
worker / co-working model?
WHAT ELSE IS GOING
A BIT OF GEOMETRY

Triangle of Care (Carers’ Trust / RCN)

mental health
dementia

‘Level 2 ‘– but can be lever towards Level 3


ON?
Circles of Support www.circlesnetwork.org.uk
‘Family’ does not have to mean blood relatives
 Mainly learning disabilities, but also older people and
sex offenders


‘Level 3’
WHAT ELSE IS GOING
ON?
MODELS FOR ENGAGING WITH FAMILIES
- MAINLY MENTAL HEALTH / WIDER
APPLICABILITY

Family therapy
Systemic
 Behavioural
 Integrated




Family Group Conferencing
Open Dialogue
www.opendialogueapproach.co.uk
Family recovery / intensive family support
REFERENCES




Cabinet Office (2007) Reaching out: think family.
Analysis and themes from the Families At Risk
review. London: Cabinet Office Social Exclusion Task
Force
Carer’s Trust / RCN (2013) The Triangle of Care.
Carers Included: A Guide to Best Practice for
Dementia Care
http://www.rcn.org.uk/__data/assets/pdf_file/0009/549
063/Triangle_of_Care__Carers_Included_Sept_2013.pdf
Cornford, J., Baines, S. and Wilson, R. (2013)
Representing the family: how does the state ‘think
family’? Policy & Politics, 41 (1): pp. 1–18
DH / LGA / ADASS / Children’s Society / Carers’
Trust (2015) The Care Act and whole-family



SCIE(2012) Think child, think parent, think family: final
evaluation report
http://www.scie.org.uk/publications/reports/report56.pdf
Tew, J, et al (2012) Whole family approaches to reablement
in mental health: Scoping current practice. School for Social
Care Research http://www.familypotential.org/wpcontent/uploads/2015/06/Whole-family-approaches-toreablement-in-mental-health-Scoping-of-currentpractice.pdf
Tew J et al (2015) Can whole family approaches contribute
to the reablement of people with mental health difficulties?
School for Social Care Research: Research Findings
http://www.sscr.nihr.ac.uk/PDF/Findings/RF20.pdf