Breaking through marginalisation in public mental health care with Family Group Conferencing: shame as risk and protective factor

From January 2011 until December 2012, forty Family Group Conferences (FGCs) will be studied in the public mental health care (PMHC) setting in the province of Groningen, the Netherlands. Research should yield an answer to whether FGCs are valuable for clients in PMHC as a means to generate social support, to prevent coercion and to elevate the work of professionals. The present study reports on two case studies in which shame and fear of rejection are designated as main causes for clients to avoid contact with their social network, resulting in isolated and marginalised living circumstances. Shame, on the other hand, is also a powerful engine in preventing clients from relapse into marginalised circumstances for which one needs to feel ashamed again. An FGC offers a forum where clients are able to discuss their shameful feelings with their social network; it generates support and helps breaking through vicious circles of marginalisation and social isolation. Findings of these case studies confirm an assumption from a previous study that a limited or broken social network is not a contraindication, but a reason for organising FGCs.