National Alliance for Mental Illness (NAMI) Family-to-Family

Primary Practice

Psycho-educational program led by peer families


The National Alliance on Mental Illness (NAMI) Family to Family is a psychoeducational program for family, significant others and friends of people living with mental illness. It is a 12-week course taught by trained families of individuals living with a serious mental illness for other family members. The model emphasizes education, support, self-care and problem solving. NAMI Family-to-Family is taught by trained peer family members who have participated in the program and been certified as trainers. The curriculum includes presentations, discussion and interactive exercises.

Target Population(s)

Caregivers of individuals with mental illness


NAMI’s Dr. Joyce Burland developed Family-to-Family in 1991. It is has been used widely across the country, with over 300,000 people having taken the course, and 3,500 individuals having been certified as trainers. Family-to-Family has been translated into many languages, and has been culturally adapted and used successfully for Spanish communities in America and in Mexico and Puerto Rico (called NAMI de Familia de Familia).


Improve the coping and problem-solving abilities of caregivers of individuals with a mental health condition.

Evidence of Outcomes

Evidence-Based Practice
A major randomized clinical trial of the program was conducted, showing that program significantly improved coping and problem-solving abilities of participants. The program is currently widely implemented and has fidelity.

Dixon, Lucksted, Medoff, Burland, Stewart, & Lehman (2011) conducted a randomized clinical trial with 318 participants in five Maryland counties. Participants were counties were randomly assigned to take FTF immediately or to wait at least three months for the next available class with free use of any other NAMI supports or community or professional supports. FTF participants had significantly greater improvements in problem-focused coping as measured by empowerment and illness knowledge. Exploratory analyses revealed that FTF participants had significantly enhanced emotion-focused coping as measured by increased acceptance of their family member’s illness, as well as reduced distress and improved problem solving. Subjective illness burden did not differ between groups.

Mercado and colleagues (2016) also conducted an evaluation of the program with 83 participants from New York. While this study did not use randomized assignment, it indicated improvements in family empowerment, family functioning, engagement in self-care activities, self-perception of mental health knowledge, and emotional acceptance as a form of coping. Scores for emotional support and positive reframing also improved significantly.

Additional Information

National Alliance on Mental Illness. (2013). NAMI Family-to-Family. Available at:

National Alliance on Mental Illness. (2014, March 21). NAMI Family-to-Family: Evidence Meets Experience. Retrieved 2017, from National Alliance on Mental Illness:


Dixon, L., Lucksted, A., Medoff, D., Burland, J., Stewart, B., & Lehman, A. (2011). Outcomes of a randomized study of a peer-taught Family-to-Family Education Program for mental illness. Psychiatric Services, 62(6), 591-7.

Dixon, L., Lucksted, A., Stewart, B., Burland, J., Brown, C. H., Postrado, L., et al. (2004). Outcomes of the peer-taught 12-week family-to-family education program for severe mental illness. Acta Psychiatrica Scandanavica, 109(3), 207–215.

Lucksted, A., Stewart, B., Forbes, C.B. (2008). Benefits and changes for Family to Family graduates. American Journal of Community Psychology, 42, 154–166.

Mercado, M., Fuss, A.A., Sawano, N., Gensemer, A., Brennan, W., McManus, K., Dixon, L.B., Haselden, M., & Cleek, A.F. (2016). Generalizability of the NAMI Family-to-Family Education Program: Evidence from an Efficacy Study. Psychiatric Services, 67(6), 591-593.