Handout 1 (Collectivism)
Culturally Informed Therapy
Role of the Therapist:
• Coordinate, guide, and assist
• Reduce tension in family relationships and Improve sense of cooperation and team spirit
• Increase understanding and acceptance of illness
• Increase spiritual and philosophical coping resources
• Improve family’s internal communication
• Assist family in developing adaptive problem solving strategies
• Assessment of each member individually
• Provide education regarding nature of illness, and treatment prescribed, specifically
• Spiritual and existential coping techniques
• Communication skills
• Problem solving
• Strategies for specific problems
Expectation of Family Members:
• Quality attendance and participation
• Active role playing
• Completion of all homework assignments
Family can expect me to provide:
• Quality attendance
• Thoughtful systematic intervention
• Strict confidentiality except with supervisor
• A comfortable working environment
• Homework materials
• Telephone consultation *The format for this handout was drawn largely from Miklowitz, D. J. &
Goldstein, M. J. (1997). Bipolar Disorder. A Family Focused Treatment
Approach. The Guilford Press. New York.
Handout 2 (Collectivism)
1. What does the word family mean to you?
2. What does it mean to you to identify as a member of your particular
3. What is the structure of your family (e.g., Is there a hierarchy? Are
there alliances or conflicts between certain members? Does one
member tend to serve as spokesperson or moderator?)
4. How do you see your role in the family?
5. Are you satisfied with that role?
6. How do you contribute to your family? 7. Do you think you could or should be contributing more or
Cont. Handout 2 (Collectivism)
8. What is the role of other members in your family (discuss each
9. How do they contribute to the family?
10. Do you think they could or should be contributing more or
11. What is your ideal family?
12. How does your actual family compare to your ideal family? Handout 3 (Education)
Symptoms of Schizophrenia
Common Positive Symptoms (behavioral excesses)
• Hallucinations (e.g., hearing voices, or seeing, smelling, or experiencing
sensations that are not actually present)
• Delusions (thoughts that most other people in your subculture would
regard as totally implausible)
• Odd thinking and speech (e.g., vague, metaphorical, over-elaborate
• Suspiciousness or paranoid ideation (e.g., beliefs that others are trying to
• Ideas of reference (e.g., beliefs that others are talking about you)
• Inappropriate affect (e.g., laughing uncontrollably for no reason or upon
hearing sad news)
Common Negative Symptoms (behavioral deficits)
• Constricted or flat affect (e.g., restricted smiling or facial expression) • Poor hygiene (e.g., failing to bathe, wearing disheveled clothing)
• Disinterest in close friends or confidants
• Poverty of thoughts (e.g., difficulty finding words to express oneself)
• Slowness of movement
• Lack of motivation or drive
Handout 4 (Education)
HOW DO PEOPLE GET SYMPTOMS OF
• People are born with a genetic predisposition to
o The rate of schizophrenia in first-degree relatives of people
with schizophrenia is 8-10%
o People have a “biological vulnerability” to develop it (i.e., a
tendency for the nervous system to become overactive
when under stress). Vulnerability changes due to
maturation, hormones, etc.
o The environment may become more stressful (e.g.,
increases in social or job demands, life events). A
stressful environment may interact with a biological
vulnerability o Drug abuse (PCP, alcohol, marijuana, cocaine) can set off
an existing biological vulnerability
o Coping skills may be inadequate to deal with
Handout 5 (Education)
HOW CAN THE FAMILY HELP?
• Assist in obtaining treatment & rehabilitation services
• Support the use of medication
• Maintain tolerant & low key home atmosphere
• Reduce performance expectations to realistic level
• Encourage participation in treatment and low stress
activities *This handout was drawn largely from Miklowitz, D. J. & Goldstein, M. J.
(1997). Bipolar Disorder. A Family Focused Treatment Approach. The Guilford
Press. New York.
At the end of the last session in module 2, each participant will be asked whether
or not they are religious and if they would like their religious or spiritual beliefs to
be addressed as part of the next treatment phase. Depending on their response,
they will be given either a copy form A or form B of handout 6 of module 3.
Participants will be asked to reflect on the questions on the form, and to come
prepared to discuss their responses in the following therapy session. These
handouts will then be used to guide the first session of module 3 and will
generate a discussion of healthy and non-healthy religious/spiritual or
existential/philosophical coping techniques to address in the second and third
sessions of module three.
Handout 6A (Spirituality)
1. Is religion or spirituality important to you?
2. What do these terms mean to you? 3. What is your concept of God or a higher power?
4. What is your main religious or spiritual identity?
5. In which religious tradition were you raised?
6. What effect does religion/spirituality have on you today?
Cont. Handout 6A (Spirituality)
7. What is the role of prayer or meditation in your life?
8. What is the primary content of your prayers or your main thoughts
9. What religious/spiritual beliefs and values are important to you? 10. What religious rituals and practices are important to you?
11. Do your religious and spiritual beliefs influence the way you look at
problems, such as mental illness, and the way you think about your health?