MENTAL HEALTH
MULTIDISCIPLINARY TREATMENT : THE KEY TO THRIVING IN A MULTIPLE DIAGNOSIS FAMILY
Brian Briscoe , MD , & Kathryn Trudeau
The COVID-19 pandemic introduced a high level of stress into most American families ’ daily lives . Seemingly overnight , mothers and fathers across the country had to learn how to homeschool their children and continue to work full time . Many lost loved ones . Many lost jobs and stability and struggled economically . In a family already living with mental health problems , this creates a cascade of misery : if one person in the family has been affected by a mental illness , the stress is magnified tenfold . If two persons in the family have a mental illness , the stress is magnified a hundredfold .
Mental illness has a systemic effect on the health of the entire family . Optimal treatment looks beyond the “ diagnosis ” of a single isolated patient , considers the entire family system in which the patient is embedded , and adopts a comprehensive , holistic , multidisciplinary approach to care .
A multidisciplinary team is composed of different professionals working together , utilizing complementary skills , united by a common purpose , performance goals and approach . 1
What does it look like in action ?
A 45-year-old Jane Smith * described her scenario : “ When my primary care doctor suggested I might be depressed , I did not believe him . I ’ m a successful entrepreneur , and my business now has over 100 employees . Our home is large and comfortable , and we have no problems paying for our son ’ s private school . Yet , I still struggled at home . The kitchen , the laundry , all my systems just fall apart , and I wondered if it ’ s causing my son ’ s behavioral problems . After school , he ’ s unmanageable , which triggers my husband . He was already stressed about problems at work , and Trevor ’ s * behavioral problems
were just too much . My husband ’ s yelling , my son ’ s upset , and I ’ m left wondering if I ’ m feeling sad , guilty or angry . Our life is perfect on the outside , but I often end the day breaking out into tears .”
The Smith family ’ s troubles compounded when , after their son was diagnosed with ADHD , Jane ’ s husband , John ,* had himself evaluated and found out that he has ADHD also . John didn ’ t believe that ADHD was a real medical illness , so he has refused to seek help .
Sadly , these kinds of situations are all too common in families that appear on the outside to “ have everything going for them .” The good news is that multidisciplinary treatment and family therapy makes a big difference .
In the case described above , Jane struggled with depression , unrealistic expectations placed on her by her husband and unsubstantiated feelings of guilt . Family therapy was an excellent outlet for her to recognize that her husband ’ s expectations were not realistic . She learned about setting healthy , appropriate boundaries with her husband and her son regarding their behaviors . She brainstormed several solutions to the “ unorganized household ” ( e . g ., hire help , delegate chores to son and husband , etc .) and worked through her feelings of guilt and inadequacy .
Because John was struggling with untreated ADHD , family therapy was an opportunity for him to accept and better understand his son ’ s condition , recognize the need for his treatment , and learn how to communicate better with his wife . He eventually decided to start medication for ADHD ( prescribed by a psychiatrist / MD ) and work with an ADHD coach to help him get back on track in the workplace . He kept his job and got promoted after two years .
John and Jane agreed to work together with a family therapist to learn more about a concept called Positive Parenting , an evidence-based approach to parenting children with ADHD . 2 Getting on the same page on the approach to parenting their son has helped
8 LOUISVILLE MEDICINE