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Spiritual Approach in Family Therapy and Family Coping
Patient with Mental Disorder
Ah. YusufFaculty of Nursing, Airlangga University, Surabaya, Indonesia.
Mental Disorder
Problem with Behavior;Kognitive, afective,
psychomotor
Global Burden Desease
Family Coping
Objective &
SubjectiveBurden
Family Therapy
Spiritual
Health Belief
InteractionSupport
Mental Health STIGMA
Mental Disorder
Problem with Behavior:Kognitive, afective,
psychomotor
Global Burden DeseaseFamily
Coping Objective Subjective
Burden
Family Therapy
Spiritual
Health Belief
Interaction Support
Mental Health STIGMA
Modality Therapy
Mental Health Disorder in IndonesiaBasic Research in Health , 2013
Website: www.litbang.depkes.go.id
Mental Health Disorderin Indonesia
Lam
pung
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ulu
Kalba
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ut
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nesia
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arNTB
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1.2
6
11.6
Psychosocial Problem
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r
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pung
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t
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utRia
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bi
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sel
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a
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ar
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nesia
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Babel
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DIY0
0.050.1
0.150.2
0.250.3
0.07
0.17
0.27
Serious Mental Ilness (Psychosis)
East Java Population : 38.000.000. Adult :
70% X 38 mil = 26.600.000. ESTIMATE the Psycho-social Problem (East Java 6,4)
6,4 % x26.600.000 = 1.702.400 people
Disturbed: Quality of Live, Quality Work of Live, and Productivity
Psychosocial Problem (National 6,0)
East Java Population: 38 Mil Adult 70 %:
70% X 38 Mil = 26.600.000. person
ESTIMATE of PSYCHOSIS (East Java: 0,22 %) 0.22 % X 26,6 Mil = 58.520 People
ESTIMATE of PSYCHOSIS (National: 1,7/1000)
ESTIMATE LOSS of ECONOMIC: PATIENT X Regional Salary 58.520 client x 2.200.000 IDR = 128.744.000.000 IDR CARE GIVER 1 = 128.744.000.000 IDR
TOTAL: 257.488.000.000,- IDR/Month
Global Burden Desease
Potential Economic Loss
Mental Hospital in East Java Dr. Wediodiningrat Lawang : 600 bed Menur Mental Hospital : 300 bed Psychiatric Unit General H : 100 bed TOTAL : 1.000 bed
57.520 clientin Hospital with out Wall
(Homeless Psychiatric)
Big ProblemGovernment, Community, and
Family
Mal-Adaptive Coping & Mis Choise of Treatment
Homeless Psychiatric
Serious Mental Ilness with Stocks, 201320.0
18.2
16.014.3
12.0
8.0
4.0
0.0
10.7
City Village Indonesia
Website: www.litbang.depkes.go.id
Type of Stocks
◦Restrain◦Seclusion
◦Restrain + Seclusion
◦The End of Choice of Treatment Indonesian People for Client with Cronic
Schizophrenia
Restrain
Restrain in MH
Seclussion
Restrain + Seclussion
It’s Wrong Discrimination
Neglected & Violent of Human Right It’s Stigma in a part of Indonesian
Population
I’m so Sorry
Indonesia Concern
Solve: Mental Health Problem
No Neglected & Save Human Right
Now....
New.. Police
WHO Mental Health Action Plan 2013-2020 ASEAN Mental Health Taskforce Sustainable Development Goals 2015-2030 Police Statement:
◦ National Development Plan 2014-2019: Change of people structure, Epidemiologycal transition to increase of Healthy Elderly and prevent of Mental Ilness.
Target: increase public health status: decreasing un-infectious desease (heart attack, diabetes, stroke, hypertention, & mental health)
Indonesian Mental Health LawNo. 18 / 2014
New Spirit for: ◦POLICE REFORMATION◦SOCIAL INCLUTION◦COMPLETELY REMOVE OF STIGMA◦REDUCTION OF DISCRIMINATION◦PREVENTION OF VIOLATION OF HUMAN
RIGHT
MENTAL HOSPITAL
(ACT)
PRIMARY HEALTH CENTER(CMHN)
PATIENT/ FAMILY(SHG)
Revera
l &
Comm
unicatio
n
Syste
m
Mental Hospital – Public Health Care Center – Family & Community:
◦ Stressfull◦ Objective & Subjective Burden◦ Stigma ◦ Mis Knowledge & Choise of Treatment
Community Based ApproachFamily Treatment
Obstacle
PELATIHAN KADER KESWADI PUSKESMAS TUMPANG
COMMUNITY BASED APPROACH
Family Theraphy Psychodynamic & Bowenian Family
Therapies Experiental Family Therapy Behavioral & Cognitive – Behavioral Family
Thrapies Structural Family Theraphy Strategic & Systemic Family Therapies Solution – Focused & Narrative Family
Therapies
MODEL MAJOR THEORIEST
TREATMENT TECHNIQUE
Psychodynamic and Bowenian FT
Nathan Ackerman Transference Dream and Dayream Analysis Confrontation Focusing on Strengths complementary
Bowen Genograms Going Home Again Detriangulation Person to Person Relationship Differentiation of Self Asking Questions
MODEL MAJOR THEORIEST
TREATMENT TECHNIQUE
Experiential FT Virginia SatirCarl Whitaker
Modelling of Effective Communication Using “I” Messaging
Sculpting Choreography Play Therapy Filial Therapy Humor Touch Props Family Reconstruction Family Drawings Puppet Interviews
MODEL MAJOR THEORIEST
TREATMENT TECHNIQUE
Behavior and Coqnitive Behavior FT
Gerald PattersonNeil Jacobson Behavioral Parents
Training Marriage / Couple
Therapies Education Functional Family
TherapBehavioral Parents Training
Marriage / Couple Therapies Education
Treatment of Sexual Dysfunctioning
Functional Family Therapy
Education Communication and Problem Solving
Strategies Operant Conditioning Contracting Classical Conditioning Coaching Contigency Constracting Extinction Positive Reinforcement Quid pro Quo Reciprocity Shaping Systematic Desenitization Time Out Chatting Premack Principle Disrupting Irrational Thoughts Thought Stopping Self Instructional Training Modelling and Role Playing
MODEL MAJOR THEORIEST
TREATMENT TECHNIQUE
Strucutural FT Salvador Minuchin
Joining Disequilbrium Techniques Enactment Working with Spontaneus
Interaction Boundary Making Intensity Restructuring Shaping Competence Diagnosing Adding Cohnitive Constructions
MODEL MAJOR THEORIEST
TREATMENT TECHNIQUE
Strategic and Systemic FT
Jay Haley (Strategic)
Reframing Directive Paradox Ordeals Pretend Positioning
Mara Selvini Palazzoli (Systemic)
Hypothesizing Positive Conotation Circular Cuestioning Invariant/Variant Prescriptions Rituals
MODEL MAJOR THEORIEST
TREATMENT TECHNIQUE
Solution-Focused and Narrative FT
Steve deShazerBill O’Halon(Solution Focused)Michael White(Narrative)
Externalization of the Problem Influence (Effect) of the Problem
on the Person Influence (Effect) of the Problem
on the Problem Raising Dillemas Predicting Serbacks Using Questions Letters Celebrations and Certificates
Spiritual Approach
Family Theraphy, suitable with Indonesian Culturally
Someone with severe stress will seek comfort and strength from God
The core of all the values of human spirituality is prayer
Prayer contains the component of direction, obedience, and acceptance (DOA)
Spirituality
Direction, Obedience & Acceptance: Mental Ilness is can be Solve
Patient with Mental Ilness:◦ 33 % total recovery◦ 33 % social recovery◦ 33 % permanent in mentally ilness
Stressfull (Family with Schizophrenia)
That all of considers of this is the will of God. This is a good thing, just not a helplessness and despair families
BE PATIENCE
TRUST
Patience is not weakness, it is the power of patience
Patience is not apathy but a zest for life Patience is not sentimentality but
perseverance Patience is not pessimistic but optimistic
Patient is not silent but patience is unyielding struggle
BE POSITIVE ALWAYS
PATIENCE
BE POSITIVE ALWAYSIf you think you have huge tension,
look at them.
If you think your job is tough,how about him?
If you think your salary is low,how about her?
If you think you don't have many friends, ask yourself if you have one sincere friend?
If you think study is a burden,how about her?
When you feel like giving up,think of this man.
If you think you suffer in life, do you suffer as much as he does?
If you complaint about your transport system, how about
them?
If your society is unfair to you, how about her?
Don’t Forget.. Pray to Allah
If you asked Allah for one thing and received another
TRUSTAllah will give You
Cactus & CaterpillarrPhylosophy
Don’t Forget
Once there was a man who asked to Allah for a
flower & a butterfly
Once there was a man who asked to Allah for a
flower & a butterfly
But instead Allah gave him a Cactus....But instead Allah gave him a Cactus....
....and a
Caterpillar.....and a
Caterpillar.
The man was sad, he didn’t understand why his request was mistaken.
The man was sad, he didn’t understand why his request was mistaken.
Then he thought:Oh well, Allah has too many people to care
for...
Then he thought:Oh well, Allah has too many people to care
for...
And decided not to question.And decided not to question.
After some time, the man went to check up on his request that he had left forgotten.
After some time, the man went to check up on his request that he had left forgotten.
To his surprise, from the thorny & ugly cactus a beautiful flower had grown.
To his surprise, from the thorny & ugly cactus a beautiful flower had grown.
And the unsightly carterpillar had been transformed into the
most beautiful butterfly.
And the unsightly carterpillar had been transformed into the
most beautiful butterfly.
Allah always does things right!Allah always does things right!
His way is always the best way,even if to us it seems all wrong.His way is always the best way,even if to us it seems all wrong.
If you asked Allah for one thing & received another, TRUST.
If you asked Allah for one thing & received another, TRUST.
You can be sure that He will always give you what you need at the appropriate
time.
You can be sure that He will always give you what you need at the appropriate
time.
What you want...What you want...
....is not always what you need!....is not always what you need!
ALLAH never fails to grant our petitions, so keep on going for Him without doubting or
murmuring.
ALLAH never fails to grant our petitions, so keep on going for Him without doubting or
murmuring.
Today’s THORN...Today’s
THORN...Is tomorrow’s FLOWER!
Thank You
Is tomorrow’s FLOWER!
Thank You