In Brief

From the stressed and frustrated looks of caregivers in her clinic waiting room, psychologist Michelle Sherman, PhD, knew something needed to be done to help the family and friends of veterans being treated for serious mental illnesses.

What has since sprung from her concern is the Support and Family Education (SAFE) Program: Mental Health Facts for Families. The program is being piloted where Sherman works--the Veteran Affairs (VA) Medical Center in Oklahoma City--and was chronicled recently in Professional Psychology: Research and Practice (Vol. 34, No. 1). SAFE's 14-session curriculum was created to teach skills for coping with mental illnesses and to comfort veterans' family members. It is geared mainly for people caring for veterans with any psychiatric diagnosis but includes particular guidance on dealing with posttraumatic stress disorder.

"The program came from a sense of compassion for all these family members who would wait for their loved ones during appointments," Sherman says. "There's a real commonality of needs among these family members who frequently have so little information and so little support, so the group format is ideal for facilitating both peer and professional support."

The 90-minute, monthly sessions include a group discussion period, a presentation by a VA psychologist and a question-and-answer period with a psychiatrist. Of the 115 participants at the VA center in Oklahoma City over the last three years, about 40 percent were wives to veterans and 12 percent were their mothers.

Previous studies have shown that family participation in well-designed psychoeducational programs can reduce patient relapse rates and improve adherence to treatment programs. But they also benefit caregivers; knowing how to effectively cope with a patient's behaviors reduces reports of psychosomatic symptoms and burnout.

Data collected on the SAFE program for more than three years show 65 percent of program participants return for multiple sessions. The data also show significant positive correlations between the number of workshops attended and both understanding of mental illness and awareness of VA resources. In addition, program attendees felt they were better able to take care of themselves--which Sherman says benefits their charges as well as overall family functioning.

"The satisfaction rate of the participants is very high," Sherman says. "But there's more to it than just what we give them in the program. Through contacts made in the sessions, they're able to develop friendships that add ongoing support."

Given, for example, that less than 10 percent of families of schizophrenia outpatients in the United States get any educational support, Sherman says she hopes that interest in the SAFE program and others like it will grow around the country.

"What really needs to happen now is broader dissemination and implementation of these programs to more hospitals and clinics," she says.


Further Reading

For more information on the SAFE program curriculum, visit