LYNE BRINDAMOUR, MSW...No matter what you say, what you feel, what you think or what you do, it is...

LYNE BRINDAMOUR, MSW

®

Original Cover Painting by Vancouver artist J Christian S.

ACKNOWLEDGEMENTSACKNOWLEDGEMENTS

Hylda Gryba, Coordinator

Children’s Support Program

B.C. Schizophrenia Society

Dr. Catherine LaRoche,

Child Psychiatrist

Director, Child and Adolescent Program

North Shore Health Region

Li Boesen, M.S., Executive Director

North Shore Childcare Resources Society

Editorial Consultant

The PACE Therapeutic Program Staff

Ann Tarves, Assistant Superintendent

North Vancouver School District No. 44

Project Co-ordination provided by

Miriam Webber, Director of Clinical

Programs on behalf of the Family Services

of the North Shore.

Family Services of the North Shore wishes to gratefully acknowledge thehard work and dedication of those who contributed to bringing thisworkbook to reality.

A workbook of this nature is never created without the involvement ofmany individuals. Family Services of the North Shore particularly wants toexpress appreciation to Lyne Brindamour MSW, a Family Counsellor in theIntensive Family Support Program. Lyne’s clinical experience has beeninstrumental in the creation of this workbook and contributed greatly tothe research and writing of this project.

We would like to acknowledge the following people for their contributions.Their expertise, opinions, ideas and thoughts were invaluable to us.

Copyright © 2000 by The Family Servicesof the North Shore

All rights reserved. The use of anypart of this publication reproduced,transmitted in any form or by any means,electronic, mechanical, photocopying,recording, or otherwise, or stored in aretrieval system, without the priorwritten permission of the ExecutiveDirector of the agency is an infringementof the copyright law.

Family Services of the North Shore acceptsfull responsibility for any errors and/oromissions in the text of this workbook.

I want to express my appreciationto my friend and husband, Dan andto my son Gabriel who have beenvery supportive of me while I waspreparing this workbook. I am alsograteful to the many parents whoshared their struggles and storieswith me. I learned from theircourage and determination.

Lyne Brindamour

Family Services of the North Shore wants to thank the parents who reviewed the material in this workbook.Their insights and suggestions were highly valued. We especially want to thank the children who contributedindividually or in a group, for enriching us with their comments, observations and opinions.

This workbook was published with the generous financial support of the following:

• Shoppers Drug Mart

• Sears Foundation

• Corporation of the City of North Vancouver

• Ms. Ellan Tallman

• Ms. Natalie Freeman

• Family Services of the North Shore

• Bond Reproductions Inc.

CONTENTSCONTENTS

PREFACE

Why We Developed a Workbook about Mental Illness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1How to Use this Workbook . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

SECTION ONE

About Mental Illness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

SECTION TWO

My Family . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

SECTION THREE

Coping Skills, Self-Care and Exercises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

GLOSSARY

Special words in this workbook have a * and are explained here . . . . . . . . . . . . . . . . . . . . . . . 29

EXTRA EXERCISES

Extra copies of many of the exercises are here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

PREFACEPREFACE

WHY WE DEVELOPED A WORKBOOK ABOUT MENTAL ILLNESS

We have worked with many fami lies where a parent or family member had a mental illness. Even though

mental illness caused a lot of distress in these families, the illness was not often identified as an issue by

the parents/caregivers and/or the professionals in the community.

A great part of our work is educational and access to educational materials dealing with various family

issues is usually available. However, we could not find specific information and educational materials for

children who had a family member with a mental illness.

This workbook was created specifically for children where a family member has a mental illness. It is our

hope that the issue of mental illness becomes easier for everyone to discuss. Our goal is to lessen the

stigma of mental illness.

1

HOW TO USE THIS WORKBOOK

“ Someone in My Family Has a Mental Illness” is designed to be used with children by counsellors, mental health

practitioners and other professionals in the community. It is also designed for parents and caregivers who wish to

educate their children about mental illness.

Counsellors, mental health practitioners and other professionals in the community are advised to obtain permission from

parents and caregivers before using this workbook. Parents and caregivers may want to review the contents prior to

giving their consent. Before using this workbook, it is recommended that children know the specific name of the mental

i l l n e s s and the family member who is affected by it.

This workbook explores the symptoms of the major mental illnesses so that they can be understood by children aged

seven to fourteen. It can be adapted for different age groups depending on their stage of development and level of

maturity. The adult working with the children can use simpler explanations for younger children and expand with more

formal language for older children.

This workbook can be used in a variety of ways to educate children and their families. Here are some possible suggestions:

– Counsellor and child together

– Counsellor, parent/caregiver and the child

– Counsellor with the parent/caregiver

– Parent/caregiver and the child

– Various family members where everyone from siblings, parents and grandparents all learn together

Due to the complexity of the issues in this workbook, we recommend that it be completed over several sessions.

This workbook requires the use of various materials. The counsellor needs to have a supply of markers, crayons, coloured

pencils, elastic bands and scissors.

2

THE WORKBOOK IS DIVIDED INTO THREE SECTIONS

SECTION ONE

contains a general discussion about the concept of mental illness for children who may never have discussed this topic.

SECTION TWO

focuses on the personal experiences of the child who has a family member with a mental illness. This section allows the

child to name the illness, to identify who has it, and to discuss the symptoms of the particular illness. Children will have

the opportunity to explore the range of feelings they may have. This section encourages them to ask questions and to

look at treatments that are currently available.

SECTION THREE

introduces the idea of coping skills and self care to children. This section includes practical

suggestions and various exercises for children to do. You may want to demonstrate

these exercises by doing them along with the children. There are two copies

of each exercise. The extra copies can be found at the back of the

workbook, the idea being that children might like a separate copy of

their favourite one. This section also helps children to identify the

specific supports available to them in their community. An extra

copy of the page which includes the names and phone numbers of

important people in their community, can be found at the back of

the workbook as well. The character in the book suggests that

children might want a copy to carry with them.

3

You are not alone.

SECTION 1SECTION ONE

You, like many other children, have a family member who has a mental illness.

This workbook was written to help you have a better understanding of mental illness.

You may have a lot of questions to ask and hopefully this book will answer some of them.

4

Let’s start by talking about your family.

Families are all different. They come in all shapes and sizes.

Draw , write or tell about your family.

Did you�forget�anyone?

C

5

Yup, youcan useeither word.

Do "act" and"behave" meanthe same thing?

We are all human. We all have a body and a brain.

The brain controls how we think, feel and act (behave).

Here is a picture of the body including the brain.

6

Because we are talking about mental illness, we are going to talk about the brain.

Here are two pictures of the brain. One of the pictures shows a healthy brain and the other one shows a brain

with a mental illness.

People with a mental illness have a chemical imbalance* in the brain. They sometimes have problems with

how they think, feel and behave. Remember they cannot help it. They have an illness that affects the brain

and it is not their fault.

Feel ing Thinking

Acti ng Thi ng

??

i

ae

v i ngB

??

??

? h Fei ng

??l ?

?? k?

??

?

A healthy brain

has all its

chemicals in

balance.

A brain with a

mental illness has

a chemical

imbalance.

7

SECTION 2SECTION TWO

His/her name is _________________________________ and he or she is my ______________________________.(father, mother, sister, uncle…)

_________________________________ has a mental illness called ____________________________________.(name of the person) (name of the i llness)

The signs of _______________________’s illness are problems with thinking, feeling and acting.(name of the person)

Can you think of some examples of problems with:

Thinking. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Feeling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Acting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

The thoughts, feelings and behaviours all go together. How the person thinks and feels, makes her or him act in a certain way.

We're talking�about the�real stuff�now.

Now let’s get personal and talk about the person in yourfamily who sometimes has a problem with how they think,feel and act.

8

Draw, write or tell about the first time you knew your__________________________________________ was sick.(father, mother, sister, uncle…)

Remember mental� illness is an illness�l ike any other.

9

Sometimes the person who has __________________________ needs to go to the hospital because he/she(name of i llness)

needs special care.

Did this ever happen in your family?

Draw, write or tell about it:

I wouldfeel sad.

It's scary whensomeone hasto go into thehospital.

10

When someone in your family gets sick, there may be many changes.

What changed for you?

Draw, write or tell about it.

11

Children may have a lot of feelings when someone in their family has a mental illness.

M Check off the feelings you’ve had:

EMBARRASSED M SCARED M ANGRY M CONFUSED M GUILTY M

OVERWHELMED M SAD M WORRIED M FRUSTRATED M __________ M

✔

12

Sometimes children have a lot of feelings that they keep inside. They may want to keep it a secret that someone

in their family has a mental illness. They may not want to talk about it, but talking can help children feel better.

Another good way to make you feel better is by writing or drawing about your feelings.

M Check off what would work for you:

1. TALKING MWho would you choose to talk with? ____________________________________________________________

His/her name is ______________________________________________________________________________

Why did you choose that person? ______________________________________________________________

Any others?__________________________________________________________________________________

2. WRITING MWhat would you choose to write in?

Journal ?

Notebook?

Any others?__________________________________________________________________________________

3. DRAWING MWhat would you choose to draw with?

Crayons?

Paint?

Any Others? ______________________________________________________

✔

13

Do you have any other ideas?

Sometimes children think it is their fault when a family member gets sick.

No matter what you say, what you feel, what you think

or what you do, it is not your fault.

Even if you are told that it is your fault,

remember it is not, no matter what.

Remember that ____________________ sometimes has a problem with how he or she thinks, feels and acts.(person’s name)

Remember it is not their fault either. They have a mental illness.

14

Phew, it's�not my fault!

Sometimes children have questions they want to ask about mental illness. Here

are some questions other children have asked:

IS IT SOMETHING I CAN CATCH?No you cannot catch it. It is not a germ.

IS IT HEREDITARY*?It can be hereditary, but most people won’t get it.

WILL_______________________GET BETTER?(person’s name)

With the right medications most people get better.

IS THERE A CURE?No, there is not a cure now, but doctors and scientists

are getting closer to finding a cure. By the time

you are a grown up they may have found one.

DO YOU HAVE ANY OTHER QUESTIONS?There's a lot�to learn about�mental illness.

15

What kind of help or treatment is there for a person who has a mental i llness?

HOSPITALIZATION

Sometimes people who have a mental illness have to go to the hospital because they need special care.

In the hospital, they receive treatment in a safe and supportive place.

MEDICINE

Another treatment is medicine. There are special medications that are given to people who have a mental

illness. These medications help people with the way they think, feel and behave. These medications can be

antipsychotics*, (also called neuroleptics). antidepressants* and tranquilizers*, all of which are prescribed

by a doctor.

THERAPY

Another treatment is called therapy. In addition to medication the person who has a mental illness often

sees a therapist. This person can be a psychiatrist, a psychologist, or a counselor. The therapist helps the

person to understand disturbing thoughts and feelings and to find better ways to deal with them. The therapist

can also provide family support.

Do you know�of anything else�that might be�hel pful?

16

SECTION 3SECTION THREE

We have talked about feelings, answered some questions and looked at some of the treatment for mental

illness. When someone in a family has a mental illness it's difficult for everyone in the family. Here are some

things you can do to help yourself feel good.

Check off the things that help you MM Talk to someone you trust.

M Play a game you like.

M Do sports.

M Eat healthy foods.

M Get a good sleep.

M Hug a special stuffed animal.

Anything�else you can�think of?

✔

Care for a pet.

17

Here are some exercises you can do for yourself when things are especially

difficult in your family.

They can be found on the pages following.

Let’s try them all and see what would work for you

18

ANGRY FEELINGS

It’s okay to feel angry. Everyone does sometimes. But it is not okay to hurt yourself or others. Here is an

exercise you can do when you are feeling angry.

Think about what is making you angry.

I am angry because ____________________________________________________________________________(describe what is making you angry)

Take a deep breath. Hold it for a few seconds.

As you breathe out, let the angry feelings out.

Remember it is okay to be angry and you can use this exercise anywhere.

I am really�angry and I don't want�to hurt�anyone.

19

I can blow my belly�out really high!

BREATHING EXERCISE

This is a breathing exercise and it may help you relax.

Sit or lie down in a quiet place.

Close your eyes.

Place your hands on your belly.

Imagine a balloon in your belly.

Take a deep breath in through your nose and to the count of three, fill your balloon and push your belly out.

Then breathe out to the count of three as you let your belly go in, and the balloon empties out.

Do five more of these on your own.

Remember, this is a different way of breathing and it is very good for relaxation. You can do this exercise as

long as you want.

20

MUSCLE RELAXATION

When we have a lot of worries, our body parts may get tight. They may start to ache. This muscle relaxation

exercise may help you to feel loose and get rid of these aches.

Follow these steps:

Sit or lie down in a quiet place, with your hands by your side. Close your eyes.

Breathe in slowly and tighten all your muscles in your face, forehead, eyes, and your mouth.

As you breathe out, let all the muscles in your face, forehead, eyes, and your mouth go soft and loose.

Breathe in slowly and raise your shoulders up to your ears. Make them hard and tight.

As you breathe out, let your shoulders go soft and loose.

Breathe in slowly and clench your fists hard and tight. Feel your arms get hard and tight.

As you breathe out, open your hands and let your arms go soft and loose.

Breathe in slowly and tighten all the muscles in your stomach by pulling your belly in towards your back.

As you breathe out, let your belly go soft and loose.

Breathe in slowly and point your toes toward the cei l i ng.

As you breathe out, let your feet go loose and soft.

21

If you still feel tight�you can do this�exercise again.

I can snap aloose elastic bandon my wrist!

I can picturea stop signin my head!

STOP!

HOW TO GET RID OF WORRIESWhen we have a lot of thoughts that worry us, sometimes it is hard to concentrate. Here are some ideas that

may help you get rid of some of the worries.

1. Think about something that worries you.

Picture a stop sign in your mind.

Say “STOP” in your head.

Then think about your favorite activity or sport and picture yourself playing and having fun.

If you cannot stop thinking about your worries, talk to ______________________________________________

(person you trust)

2 Think about something that worries you.Place a loose elastic on your wrist.

Snap the elastic and say “STOP” in your head.



(person you trust)

22

IMAGINE

Here is an exercise that may be helpful to you when you are upset.

Sit or lie down in a quiet place. Close your eyes.

Picture yourself in your favorite place. If you can’t think of a favorite

place you can make one up.

Take a big breath and when you are ready, breathe out.

Keep breathing slowly in and out.

Now keeping your eyes closed and breathing in and out,

picture yourself doing your favorite thing in your favorite

place.

Keeping your eyes closed, look around your favorite place.

What do you see? How does your body feel?

Any special smells?

Try to stay in your special place for a few minutes.

When you are done, take a big breath and as you breathe out,

open your eyes and look around.

When you are ready you can get up and

go on with your day.

23

Your Community

You are�part of a�community.

FIRE FIGHTER

SOCCER PLAYER

POLICE

TEACHER

DOCTOR

LIBRARIAN

24

You are a part of a community. A community is the place where you live.

There are many people and places in your community that can be helpful to you.

Draw a picture of your community.

25

Write down the names and phone numbers of people in your community that could be helpful to you.

NAMES PHONE NUMBERS

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Who else do you know that could be helpful to you?

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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26

I can write withboth my hands!

I can standon my head!

You are a special person in your family.

Draw, write or tell something special about yourself:

27

Pretend you had three wishes.

What would they be?

Draw, write or tell about them:

28

GLOSSARYGLOSSARYANTIDEPRESSANTS:

Medications that help people who are having problems with depression (feelings of sadness, often mixed with anger).These medications help people

feel, sleep and eat better. They also help people with their thoughts, behavior and low energy level because these change when a person is no longer

feeling depressed.

ANTIPSYCHOTICS:

Medications that help people who have schizophrenia, manic depression and other mental illnesses. These medications help people who are having

problems with their thinking. They also help calm their feelings and their actions because these change when a person can think more clearly and feel

less upset.

ANXIETY:

A lot of worry about things that may or may not happen. Anxiety can sometimes cause things like stomach aches, headaches, pains in other parts of

the body and shortness of breath.

BIPOLAR (MANIC-DEPRESSIVE ILLNESS):

This is a mental illness where the person has problems with their feelings. Feelings (moods) may go up making the person feel excited and high or go

down making the same person feel low and sad. These feelings can be very strong. The problems with feelings affect how the person is thinking and

acting. Sometimes, when the person is very sick, he/she can become psychotic.*

CHEMICAL IMBALANCE:

In order for the brain to work properly, all the different parts of the brain need to have the right chemicals in the right balance. Most of us have the

right chemicals. Sometimes a person has too few of these chemicals or the chemicals do not interact properly. Often chemical imbalances are a cause

of mental illness.

29

ELECTROCONVULSIVE THERAPY (ECT)

ECT is sometimes used when other treatments don't work for depression or other mental illness. This therapy does not cause pain. For a short time

after this treatment, the person may be confused and may also have some memory loss.

DEPRESSION (UNIPOLAR)

This is a mental illness where the person has problems with their feelings (moods).They can feel very, very sad, angry, discouraged or hopeless. These

feelings may affect how they are thinking and acting. When depressed, a person may have very little energy and become unable to do what they usually

can do.

HALLUCINATIONS:

Seeing or hearing things that nobody else can see or hear. The person who is having hallucinations really believes that he/she is hearing and seeing these things.

This may happen to people who have schizophrenia, bipolar disorder or problems from taking certain medications/drugs or drinking too much alcohol.

HEREDITARY:

The things we are born with that make us like our parents and close relatives. For example the colour of our eyes or hair, or how tall we will become,

are inherited from our parents. We can also inherit how physically or mentally healthy we will be.

LITHIUM:

Lithium is a medication that is used to treat bipolar disorder (also known as manic-depressive illness). It helps the person who has this kind of

disorder to have more balanced feelings (i.e. fewer high and low moods).

OBSESSIVE COMPULSIVE DISORDER:

This is a mental illness where the person has problems with stopping unwanted thoughts, feelings and actions. They may do things over and over and

may not be able to stop these thoughts or feelings even if they want to do so.

30

PANIC DISORDER:

This is a disorder where people have intense anxiety, sudden attacks of fears and all sorts of body changes like chest pain, shortness of breath and dizziness.

They think that something horrible is going to happen to them. They believe that they are really in danger. Sometimes they think they are going to die.

PARANOIA:

When people fear someone or something will harm them. It is usually a fear of something that will not happen but it is hard for them to understand

that this is so.

PHOBIAS:

When people have a fear of things like places, animals, water, high buildings etc. and avoid those things and places because their fear is so strong.

PSYCHOSIS:

When a person is out of touch with reality or is unable to tell the difference between what is real and unreal. For example, he/she believes that things

are happening when in real life they are not. It affects how they think, feel and behave. They may act strangely and talk to themselves.

POST TRAUMATIC STRESS DISORDER:

Sometimes after something terrible happens to a person it affects their memory. Sometimes they can’t remember details of the terrible event or else

have a really hard time forgetting about it. It often affects how they think, feel and act. Often they may not want to remember the terrible thing, but

they can’t help it.

SCHIZOPHRENIA:

This is a mental illness where the person has problems with their thinking. These affect how they feel and behave. They may have strange behaviours

and see and hear often frightening things that no one else can see or hear. Sometimes they talk to themselves.

TRANQUILIZERS:

Medications that help people get rid of anxiety. They help them to worry less and feel calmer.

31

EXTRAEXERCISES

EXTRA EXERCISES

33

I am really�angry and I don't want�to hurt�anyone.

ANGRY FEELINGS

It’s okay to feel angry. Everyone does sometimes. But it is not okay to hurt yourself or others. Here is an

exercise you can do when you are feeling angry.

Think about what is making you angry.

I am angry because ____________________________________________________________________________(describe what is making you angry)

Take a deep breath. Hold it for a few seconds.

As you breathe out, let the angry feelings out.

Remember it is okay to be angry and you can use this exercise anywhere.

✁✁

I can blow my belly�out really high!

BREATHING EXERCISE

This is a breathing exercise and it may help you relax.

Sit or lie down in a quiet place.

Close your eyes.

Place your hands on your belly.

Imagine a balloon in your belly.

Take a deep breath in through your nose and to the count of three, fill your balloon and push your belly out.

Then breathe out to the count of three as you let your belly go in, and the balloon empties out.

Do five more of these on your own.

Remember, this is a different way of breathing and it is very good for relaxation. You can do this exercise as

long as you want.

✁✁

If you still feel tight�you can do this�exercise again.

MUSCLE RELAXATION

When we have a lot of worries, our body parts may get tight. They may start to ache. This muscle relaxation

exercise may help you to feel loose and get rid of these aches.

Follow these steps:

Sit or lie down in a quiet place, with your hands by your side. Close your eyes.

Breathe in slowly and tighten all your muscles in your face, forehead, eyes, and your mouth.

As you breathe out, let all the muscles in your face, forehead, eyes, and your mouth go soft and loose.

Breathe in slowly and raise your shoulders up to your ears. Make them hard and tight.

As you breathe out, let your shoulders go soft and loose.

Breathe in slowly and clench your fists hard and tight. Feel your arms get hard and tight.

As you breathe out, open your hands and let your arms go soft and loose.

Breathe in slowly and tighten all the muscles in your stomach by pulling your belly in towards your back.

As you breathe out, let your belly go soft and loose.

Breathe in slowly and point your toes toward the ceiling.

As you breathe out, let your feet go loose and soft.

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I can snap aloose elastic bandon my wrist!

I can picturea stop signin my head!

STOP!

HOW TO GET RID OF WORRIESWhen we have a lot of thoughts that worry us, sometimes it is hard to concentrate. Here are some ideas that

may help you get rid of some of the worries.

1. Think about something that worries you.

Picture a stop sign in your mind.

Say “STOP” in your head.



(person you trust)

2 Think about something that worries you.Place a loose elastic on your wrist.

Snap the elastic and say “STOP” in your head.



(person you trust)

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IMAGINE

Here is an exercise that may be helpful to you when you are upset.

Sit or lie down in a quiet place. Close your eyes.

Picture yourself in your favorite place. If you can’t think of a favorite

place you can make one up.

Take a big breath and when you are ready, breathe out.

Keep breathing slowly in and out.

Now keeping your eyes closed and breathing in and out,

picture yourself doing your favorite thing in your favorite

place.

Keeping your eyes closed, look around your favorite place.

What do you see? How does your body feel?

Any special smells?

Try to stay in your special place for a few minutes.

When you are done, take a big breath and as you breathe out,

open your eyes and look around.

When you are ready you can get up and go on

with your day.

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Write down the names and phone numbers of people in your community that could be helpful to you.

NAMES PHONE NUMBERS

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Who else do you know that could be helpful to you?

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LYNE BRINDAMOUR, MSW...No matter what you say, what you feel, what you think or what you do, it is...

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Transcript of LYNE BRINDAMOUR, MSW...No matter what you say, what you feel, what you think or what you do, it is...