Shifting an agency’s paradigm: Creating the capacity to intervene with parents with mental illness

ABSTRACT Parenting is a key life role for many adults living with serious mental illness who are, most likely, supported best in their treatment and recovery efforts when their family context is taken into consideration. However, providers and agencies traditionally serving individual adults may be challenged in working with adults who are parents as they begin taking family roles and members into account. In this article, the implementation of the Family Options intervention for families living with parental mental illness is described, along with critical domains of challenge that emerged while shifting the host agency’s paradigm from focusing on individuals to focusing on families. Ethnographic interview data regarding implementation were obtained from multiple perspectives at multiple points in time over 2 years (n = 100), in the context of a larger developmental hybrid design (implementation and outcomes) study. Results from rigorous thematic analysis suggest the importance of attending to workforce, organizational, and community capacities in shifting an agency’s paradigm to adopt a family-focused intervention; in implementing the intervention with fidelity to the model; and in anticipating replication of the intervention to build the evidence base.