December 11, 2006

Children With Mentally Ill Parents or Siblings - Special Education and Coping Program

The reading and planning materials for an Australian educational program designed for children with mentally ill parents or siblings is now available for download and use by anyone in the world. It is a collection of documents and educational approaches - that may be used together, or independently.

As we've reported in the past, Australia seems to be one of the leaders of the effort to prevent mental illness, with a specific focus on children. Earlier this year we covered two stories "Australian Study: Helping Children of the Mentally ill" and "Children with Mentally ill Parents".

In these stories we reported that the Children of a Parent with Mental Illness (COPMI) project found an estimated one million Australian children live in a household with a parent who is mentally ill. Moreover, research suggests that 40-60 percent of these children, or about 500,000 in Australia alone, are at risk of developing mental illness themselves.

In what we believe is the first program of its kind - Erica Pitman has developed this special educational and coping program in 1997 for children aged 8-12 years old, or young people aged 13-16 years old who have a parent or sibling experiencing a mental health problem (specifically schizophrenia, bipolar disorder or depression). A Study on the effectiveness of the SMILES Program was published in the American Journal of Orthopsychiatry in 2004.

With a little encouragement from us - Erica has now made the materials that she uses in her program available for families, social workers, educators and others around the world - and we hope that NAMI and Schizophrenia Society of Canada and other support groups around the world will talk to her about using it in their regional education programs. We also hope that psychiatry and psychology researchers will further the work already undertaken through the extensive evaluation of SMILES and identify ways to refine, adapt and improve these types of programs - so as to maximize their effectiveness in any given group of children.

For families and other people that would like to immediately benefit from this valuable effort at helping the children of the mentally ill - we encourage you to download the booklets below and begin today!

Erica Pitman, the author of the SMILES Program (Simplifying Mental Illness + Life Enhancement Skills), has generously provided the following downloadable resources to assist others to implement the program in their local area. She writes "I recommend that the program be delivered as it has been designed, over three consecutive days, using the suggested daily plan. This has proved to be a very effective format (see program evaluation contained in the information and guidelines section). The life skills activities are appropriate for use in individual counselling sessions, may be adapted for use with other populations and have all been used successfully with adults as well as children."

Why such a program?

When this program was developed in 1997, the needs of children living in a family affected by mental health problems were largely ignored. As the awareness of children's issues increased, so too did the demand for suitable intervention material and programs. The SMILES program was developed to meet these needs.

As these children are themselves potential consumers and our future carers, if not already in this role, it is vitally important that their needs are addressed at the earliest possible opportunity. The impact on their lives now and in the future can be devastating, however with appropriate intervention we can assist them to achieve more positive outcomes. Should you use any part of the program in any form or by any means please acknowledge the author, Erica Pitman, in full.

Who is the SMILES Program suitable for?

Children who have a mother, father, brother or sister experiencing a mental health problem (particularly schizophrenia, bipolar disorder or depression). It has been specifically designed for a group of 8-12 year olds, or a group of 13-16 year olds.

The program is not designed for children who have diagnosed problems themselves. The program will work best with a minimum of 8 and maximum of 10 children. Many of the activities are also suitable for use with a child in individual counselling sessions, if it is not possible to provide a group program. However, the benefit of the group experience is the shared peer interaction and the interaction with mentors (if available), plus it is time effective.

The SMILES Program is designed to achieve:
Increased ability to cope effectively
Increased resiliency
A new freedom for self expression
Development of creativity
Reduction in feelings of isolation
Increase in self-esteem
…… and much more!

This is achieved through:
Education about mental illness
Communication exercises
Interactive exercises
Artwork and music
Relaxation exercises
Problem solving
Peer support

This all takes place in a fun-filled, supportive and caring atmosphere.

Who facilitates the program? (see ‘Forms’ section for Facilitator Assessment Form and Mentor Application Form)

The program is designed to be facilitated by a psychologist, social worker,counsellor, teacher, youth worker, or someone with a similar background, who has a thorough knowledge of and experience working in the area of mental illness. It is also preferable that the person has training and experience working with children. The facilitator will require previous experience with group facilitation.

The co-facilitator may have a similar background to the facilitator, or be a student in any of the above professions, or a suitable person who lives/has lived in a family with someone experiencing a mental health problem.

It is important that the facilitator and co-facilitator develop a good rapport. During the early stages of planning it is important to establish clear roles and responsibilities for promotion, recruitment and running of the program. Discuss your facilitation styles, personality, how you will communicate with each other during the program, and the giving and receiving of constructive feedback. Also clarify roles and responsibilities with regard to debriefing and supervision.

The Facilitator Assessment Form has been provided to help determine the suitability of facilitators.

If available, it is valuable to have one or two mentors (older young people who have experienced mental health problems in their family) participate in the program. It is important that they have done a reasonable amount of their own 'healing'. The Mentor Application Form has been provided to help determine the suitability of mentors. A minimum team of two is required to run the program, however three to four people (facilitator, co-facilitator, two mentors or assistants) is ideal. If you do not have access to mentors then select appropriate assistants who may be interested in future facilitation
of the program. Assistants are also required to complete the Facilitator Assessment Form.

To download an Overview of the SMILES Program - click here (pdf)

To get the full packet - click on the link below:

Click here to Download the SMILES Program info-packet (5mb file, compressed in .zip format). For details on what is included in the packet - see this page - and scroll down to the descriptions of all the contents.

Adobe Acrobat Reader is required to view these documents from the SMILES program. It can be downloaded for free by clicking here.

Zip files should be saved to your computer before opening. These are not self-extracting zip files. Right click on the file download link above and select "Save Link as" or "Save Target As...".
If you do not have Windows XP, you will need a copy of WinZip to open this file. WinZip is available through shareware by following this link:

Background Details on the SMILES Program:

PROGRAM DESCRIPTION: 3 day program (9am-3pm), usually delivered during school holiday period, in conjunction with health services or appropriate non-government organizations. Minimum 8, maximum 10 participants. Resources included as part of the program: "Handle with Care - A Workbook About Mental Illness for 8-12 year olds"; "A Booklet for Young People about Mentall Illness"; Moonbeam - A Book of Meditations for Children" (or similar titles by Maureen Garth).

AIMS: To provide age-appropriate education about mental illness and life skills; to improve capacity to cope more effectively and increase resilience; to improve self-expression and creativity; to increase self-esteem and reduce feelings of isolation.

CONTENTS: Education about mental illness; communication exercises; problem solving; art work; music; interactive and relaxation exercises; peer support.

BACKGROUND: Developed in 1997 by Erica Pitman as a result of the increasing recognition that children in families affected by mental illness are a population 'at risk' for developing their own mental health problems. Erica has an Advanced Diploma of Applied Social Science, is a clincially registered counsellor with the NSW Counsellors & Psychotherapists Association Inc (CMCAPA) and a registered member of the Psychotherapy and Counselling Federation of Australia Inc (RMPACFA). Erica's professional work is enhanced by her own experience as the sibling of her deceased brother who struggled with epilepsy and childhood schizophrenia.

Additional SMILES Program Information and Related Resources

SMILE Program Background (October 2006)

Downloadable Materials for Families and Teachers with Children of Mentally Ill Parents

COPMI - Information for Parents and Families

Children of Mentally Ill Parents - Programs and Services Updates

Recommended Books

Preventing Schizophrenia - Books

Good Books for Families and Siblings With Mentally Ill Parents

Children's Books Related to Mental Illness

Additional Readings:

Remember The Kids When Parents Are Ill

Background Research Information:

The SMILES program: a group program for children with mentally ill parents or siblings. Am J Orthopsychiatry. 2004; 74(3):383-8 (ISSN: 0002-9432)

The extent and impact of parental mental health problems on families and the acceptability, accessibility and effectiveness of interventions
(.pdf file for download) Source: Social Care Institute for Excellence

Other studies that have been done on the SMILES program:

1. Pitman, E. & Matthey, S. (2002). Evaluation of the SMILES Program for children with mentally ill parents: Bankstown, Sydney (17-19 January 2001). South West Sydney Area Health Service: Sydney, Australia.

2. Pitman, E. (1999). SMILES (Explorations) Program Report. Mental
Illness Education - Australia (NSW) Inc: Sydney, Australia.

3. Pagnini, D. (2004). Carers' Mental Health Project (Stage 1): Final Evaluation Report. Carers NSW, Sydney, Australia.

4. Carers NSW Initial Longitudinal Follow-Up Results (the final
document is yet to be published by Carers NSW).


Thank you for this program. I am a community Psychiatric Nurse in KwaZulu Natal, South Africa. I am very involved in Children's work and in support for families coping with mental illness, especially schizophrenia. i want to look into making use of this programme in the near future

Posted by: Wendy ROBINSON at June 22, 2007 12:10 PM

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