Dear Director

We are so tired and now our daughter’s Case Manager and Therapist both recommend that we try Family Based Mental Health Services (FBMH). We have already been through Outpatient Therapy, In-Home Behavioral Services, Trauma Therapy, and of course regular Medical Management with her Psychiatrist.   Why will this help if nothing else has so far? 

By the way, our daughter is only 9 years old.  We adopted her when she was 18-months-old.  She was drug exposed as a baby and experienced neglect.  But we had no idea she would end up like this: always arguing with us and her siblings, hoarding food, and even setting traps for me in our home.  

Very truly yours, Two Exhausted Parents 

Our Guest Director Answers

Hello Two Exhausted Parents, 

Your struggles are common, so before we get into the reasons Family Based therapy might be helpful for your family, let’s be real about how exhausting parenting really can be, especially for families with children with special needs and/or a trauma history. By the time families arrive at the point where FBMH services are offered, they often feel at the end of their rope and wonder if trying another form of therapy is worth it.  

Your family sounds like you are at your wit’s end as to what to do to help your child. I want to acknowledge the hard work you have put in to care for your child’s needs and validate the struggles you have experienced together. Your child’s experiences of trauma, neglect, and drug exposure affected your child and family more than you had anticipated. This sounds like it has been a very challenging road. 

The various therapies you have tried are common to families referred to FBMH services. Others like you have gone through similar routes before arriving here. Family Based therapy is different than the therapies you listed in significant ways. First, unlike in-home behavioral services that focus primarily on your child, FBMH therapists visit your home to explore patterns within the family system and ways to be more effective in managing the stressors of caring for your child. Your Family Based team works to help you establish your family’s goal of the change you want to see happen in your family, with specific tasks for your child to learn coping and increased resilience, but most of all, FBMH works to help you as caregivers become your child’s source of emotional support through learning to listen, validate, and guide your family toward self-soothing experiences, develop structure within the family, and build relationships both inside and outside of the home. Other ways FBMH services can be helpful is giving you and your partner space to be heard, come together to develop a cohesive partnership, and explore ways to better manage your child’s behaviors. 

Other forms of therapy you have tried such as outpatient therapy may still be applied during participation in FBMH therapy if there is a trauma diagnosis. Outpatient therapy is designed to work with the individual, not the family. This serves to help the identified patient, but does not serve to look at family interactional patterns that may be contributing to problems that can be worked on as a family. Medication management often compliments therapy, but does not take the place of therapy. There is only so much a medication can do. Learning new ways of living and being is much more effective for creating change and change that lasts when medication is part of a complete program.  

Family Based therapy provides services that work with your family in the community. The team works with other agencies and programs such as your child’s school to access emotional and/or academic supports, with your county case manager to collaborate on getting needs met, with you and your child during crises, including follow up if your child needs hospitalization or other residential treatment, and works to follow through with appropriate discharge planning for your child/family.  

There are families that need to repeat a round or two of FBMH therapy and this is not looked at as failure, but rather a continuation of the ongoing work required to build a more effective way of living as a family.  Family Based Mental Health therapy requires a willing, parent to commit to participating weekly in sessions and to do the work it takes to create positive improvements for your family as a whole. Priority is placed on helping you manage your child’s symptoms and behaviors while looking at ways you as caregivers can more effectively manage your own reactions and strong emotions that may lead to stress and tension in the home.  

If your clinician or CMU worker has recommended your family for Family Based services, they may be seeing your family as a good fit for getting some needed help in caring for your child and learning to manage your family’s needs. We understand that you feel like you have tried everything, and can sense your exhaustion and overwhelm by your letter. Family Based services may be the services you need to begin to look at ways your family can work together as a team to help you function in ways that promote increased communication between family members, increased understanding of your child’s problems, and ways of looking at individual needs of family members to create a more cohesive family system. 

  • As the editor of this Newsletter, a big thank you goes to Franicina Fantauzzo, as the Guest Director for this month’s edition. She is an integral, fabulous, and competent member of JFS’ Family Based Mental Health team.
For more information about Family Based Mental Health Services through JFS, contact the front desk at 717-233-1681 
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