Navigating rocky terrain: a thematic analysis of mental health clinician experiences of family-focused practice
| Published date | 07 January 2020 |
| Pages | 71-83 |
| DOI | https://doi.org/10.1108/JMHTEP-04-2019-0022 |
| Date | 07 January 2020 |
| Author | Genevieve Leenman,Karen Arblaster |
| Subject Matter | Health & social care,Mental health,Mental health education |
Navigating rocky terrain: a thematic
analysis of mental health clinician
experiences of family-focused practice
Genevieve Leenman and Karen Arblaster
Abstract
Purpose –Approximately 20 per cent of Australian children live with a parent who experiences mental
illness. These children have poorer health and psychosocial outcomes than their peers. While family-
focused practice (FFP) can improve these outcomes, family-focused service provision is inconsistent.
The purpose of this paper is to understand clinicians’ experiences of FFP and associated workplace
factors.
Design/methodology/approach –In-depth interviews were conducted with ten community mental
health clinicians. Interviews were audio recorded and transcribed. Data were analysedusing thematic
analysis.
Findings –A global theme of ‘‘navigating rocky terrain’’ captured clinicians’ experiences of working with
families. The rocky terrain encompassed both family complexity and workplace barriers to FFP. Clinicians
navigated this terrain by using multiple strategies to support families, working in partnership with families
and other clinicians and services, and drawing on personal resources. Interactive approaches toenhancing
knowledge and skills were preferred over paper-based information. While an organisation-wide approachto
support FFP was beneficial, clinicians continued to feel challengedin implementing FFP.
Research limitations/implications –Workingwith families in which parents experiencemental illness is
affected by systemic issues at the family and organisational levels. Systemic approaches to both
delivering and supporting this work are required. Partnership working and organisation-wide capacity
buildingstrategies emphasising interactiveapproaches to learning appear to have positiveeffects.
Originality/value –This study explores the challenges of FFP in a real-world multidisciplinary context
where there has been a systemic approach to enabling thiswork. It highlights the challenges clinicians
face in family-focused practice in spite of substantial organisational supports and suggests some
approachesthat might be effective. This is a topicwhich has received minimal attentionin the literature.
Keywords Qualitative research, Mental health, Thematic analysis, Family-focused practice,
Children of parents with mental illness
Paper type Research paper
Background
Mental ill-health is common with almost half of the Australian population experiencing a
mental disorder at some stage in their life (Australian Bureau of Statistics, 2008). It is
estimated that one in five children in NSW, and over 1m children nationwide, are living in
families in which parental mental illness exists (Reupert et al.,2012). Children of parents
with a mental illness (COPMI) are considered vulnerable due to genetic predisposition to
mental ill-health, social disadvantage and exposure to environmental stressors (Reupert
et al.,2012
). They experience greater rates of psychological, developmental and
behavioural problems thanother children (Reupert and Maybery, 2007).
Due to these factors, parental mental illness is linked with social isolation, trauma and
stressful family dynamics (Foster, 2010). Also, children may be required to assume caring
Genevieve Leenman is
based at the Western
Sydney University,
Campbelltown Campus,
Parramatta, Australia.
Karen Arblaster is based at
the Faculty of Health
Sciences, University of
Sydney, Sydney, Australia
and Department of Mental
Health, Nepean Blue
Mountains Local Health
District, Sydney, Australia.
Received 12 April 2019
Revised 4 October 2019
Accepted 15 November 2019
DOI10.1108/JMHTEP-04-2019-0022 VOL. 15 NO.2 2020,pp. 71-83, ©Emerald Publishing Limited, ISSN 1755-6228 jTHE JOURNAL OF MENTAL HEALTH TRAINING, ED UCATION AND PRACTICE jPAGE 71
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