Barn till föräldrar med psykisk ohälsa kallas ibland för de osynliga barnen. Beardslee familjeintervention (BFI) är en hälsofrämjande preventiv metod för barn till föräldrar med psykisk ohälsa. Den har en viss evidens för positiva långtidseffekter för barn och familjer när föräldern har depression. Barnen har nu uppmärksammats ännu mer p.g.a. att lagstiftningen har skärpts från och med 1 januari 2010. Det gäller skyldighet för personal inom hälso- och sjukvård att ge information, råd och stöd utifrån barns behov. Mot bakgrund av detta var syftet med denna studie att undersöka föräldrars upplevelser och erfarenheter av BFI samt få med barnperspektiv genom att  till samma föräldrar ställa frågor som berörde deras barn. En kvalitativ metod med öppna breda frågeställningar har använts. Materialet analyserades med en kvalitativ innehållsanalys. Sex föräldrar, som under 2010 hade genomgått BFI, intervjuades. De viktigaste resultaten från intervjuerna var att kommunikationen i familjen hade påverkats positivt med öppnare dialog. Tidpunkten av BFI var mycket viktig, att personalen, enligt föräldrarna, kunde prata med barnen på rätt nivå och att metodens flexibilitet och möjlighet till uppföljning uppskattades av föräldrarna.

Syftet med studien var att undersöka föräldrar och barns upplevelser av deltagande i en Barnkraftsgrupp (4 föräldrar och 5 barn). Att ta reda på hur dessa familjers väg till gruppen såg ut, hur deltagarna upplevde Barnkraftsgruppen, vilken betydelse frågestunden hade för deltagarna, vad det innebar för deltagarna att träffa gelikar och se hur deltagarnas förväntningar på framtiden såg ut. Genom kvalitativ metod har föräldrarna intervjuats individuellt och barnen i fokusgrupp. Med utgångspunkt från Grounded Theory har resultatet analyserats. Genom studien har barn och föräldrars egen upplevelse av att deltagit i Barnkraftsgrupp kommit fram. Föräldrarnas mål med deltagande att få ökad förståelse för sin sjukdom och att barnen skulle få ökad förståelse och mer kunskap om sjukdomen ansåg föräldrarna var uppnådda i och med att barnen hade börjat diskutera sjukdomen och föräldrarna såg Barnkraft som början på en process. Nyckelord: Barnkraft, stödgrupp, Beardslees familjeintervention, kvalitativ metod.

It has been known for many years that the children of parents with mental illness run a high risk of developing psychiatric and other problems both during their childhood and later in adulthood. Meeting and providing support for the patients’ children has, however, been a neglected area in adult psychiatry until today. Recent supplementary legislation in the Nordic countries obligates the professionals in health services to take account of the needs for information and support of the children and their families when a parent suffers from a serious illness. Beardslee’s preventive family intervention (FI) is the first family-based and structured method used in psychiatric services in Sweden. The method has some evidence of positive long-term effects for the children and families with parental depression. The purpose of this thesis was to investigate the FIs safety and feasibility in Sweden (paper I), its’ perceived impact for the families (papers I, III and IV) and also to examine the process of the FI from the perspective of the ill parent, the other parent and the children (papers II, III and IV). The studies were conducted in naturalistic settings. The data in paper I was collected by using a questionnaire to parents and children (117 parents and 89 children responded) one month after an FI. Paper II comprises interviews with ten parents, suffering from depression, about their decision process for participation in an FI. In papers III and IV the data from 25 interviews with parents and 14 interviews with children about the experiences of the FI is presented. Seventy five professionals from 29 psychiatric units had conducted the FIs for the families that participated in the studies. The data was analyzed by descriptive statistics and chi2 (I), Grounded theory (II and III) and Qualitative content analysis (IV). The results in paper I showed that the overall satisfaction with the FI was high for both parents and children. Ninety three percent of the answers from parents to questions concerning the satisfaction with the FI were positive, and 71 % of the answers from the children. The reported perceived impact of the FI was also predominantly positive. Feelings of guilt decreased for 89 % of the children who had had feelings of guilt towards the parent prior to the FI. Knowledge about the parent’s illness was perceived to increase for 74 % of the children. There were a few negative answers about the impact of FI from the children; five children experienced increased concerns about the parent and three children reported a lower level of well-being after the FI. In paper II the interviews with the depressed parents revealed ambivalence in the decision to participate in an FI. The parents longed for knowing how their children were feeling, how they thought about the illness and if it had harmed them. On the other hand, the parents were anxious about hearing the answers to their questions, as feelings of shame and guilt were associated with these. Exposure to outside opinion was also both relieving and scaring. The examination of the parents’ experiences continued in paper III. The process of opening up the dialogue about the illness with the children was demanding. To listen to the children’s experiences, to find the words to speak about the illness to the children and finally to be able to start to talk about it in the family session required a solid base of confidence and security in the professionals and in the method. The FI as a method seemed to provide favorable conditions for an establishment of an alliance with the parents. The children’s experiences of the FI are presented in paper IV. Most of the children described a sense of relief because of better knowledge about the parent’s illness and increased communication in the family and thus they also felt released from some worry for the parent. They could spend more time with their friends and did not need to take so much responsibility at home. Parents and children in the same families described the changes in similar ways, indicating mutual understanding in the families. The parents experienced themselves as stronger in their roles as parents and less ashamed. In summary, the families are satisfied with their participation in FI, they report a positive impact and the number of perceived negative effects is low. The children describe a sense of relief from concerns about the parent’s illness.