Psych therapies 1- family therapy

What is family therapy? Why does it involve the patient?

A form of psychotherapy involving the whole family and patient (if practical). Those with schizophrenia are often suspicious about their treatment and actively involving them helps to reduce these symptoms of paranoia

How long does family therapy last?

9 months-1 year

What does family therapy try to reduce?

• stress levels

• Feelings of guilt/anger/stress

• Negative communication (e.g. double bind, mixed messages)

• Levels of criticism, control and hostility (EE)

• Relapse

What does family therapy hope to increase?

• Levels of tolerance through increased communication and setting realistic expectations

• Understanding of schizophrenia

• Skills for family to use after the end of therapy

• patient’s and family’s ability to anticipate problems and solve them, including helping them to understand the medication routine

How does family therapy reduce the symptoms of schizophrenia?

• improves relationships and communication patterns (e.g. safe space family meetings, active listening, positive reinforcement etc.)- reduces instances of double bind and stress which reduces symptoms (e.g. disorganised speech/thoughts, paranoid delusions)

• Lowering levels of expressed emotions- in therapy family asked to set reasonable expectations and appropriate levels of involvement- reduces levels of exaggerated control and involvement- decreases stress for the sufferer- reduces relapse rates and symptoms like paranoia associated with high EE

• Reducing stress- increases likelihood of patient complying with medication- reduced likelihood of relapse and hospital readmission

AO3- effectiveness

P- Research support for the effectiveness of using family therapy to help reduce symptoms and prevent relapse

E- Pharoah et al: moderate evidence to suggest that family therapy significantly reduces hospital readmission over the course of a year and improves quality of life for patients and their families.

E- suggests family therapy leads to increases well being in patients, with an indication that better family relationships play a role in symptom reduction. Also demonstrates the effectiveness of the therapy for lowering the likelihood of relapse and improving the quality of life for individuals suffering from the disorder

L- effective

AO3- appropriateness

P- may be a more appropriate treatment for some sufferers than others

E- ✅

• Family interventions in early psychosis- significantly reduce relapse and readmission rates.

• Particularly useful for younger patients who still live at home with their families and require support.

• Also useful for those who cannot speak coherently- family members may be able to assist and act as an advocate

E- ❌may not always be an appropriate form of treatment for all sufferers and families

• Demanding for sufferer and caregivers-

  • have to get whole family together at the same time, difficult for dysfunctional families

  • Requires time, money, transportation, motivation and energy

• Challenging to unpick family dysfunction

• Severity of symptoms may prevent some sufferers from participants in family therapy and lead to high dropout rates

L- family therapy should be carefully considered in relation to the appropriateness for each individual and family

AO3- useful applications

P- Family therapy has many useful applications in treating schizophrenia

E- can reduce dysfunction within the family, leading to reduced stress and relapse rates

E- However does not reduce symptoms and is demanding on the individual and family- may not feel able to carry out daily tasks/work

L- reduces relapse rates (positive economic implication)- prevents the further cost of care

AO3 - interactionalism/positive economic implications

P- an advantage of this therapy is the considerable economic benefits

E- family therapy is often not widely available due to its time consuming and costly nature. However a NICE review of family studies demonstrated that when it was implemented in combination with other treatments such as drug therapy it was associated with significant cost savings

E- extra cost of family therapy offset by a reduction in cost through preventing the need for further and long lasting treatment (drug therapy =reduces symptoms + creating a more supportive family environment = reduced relapse rates)

L- family therapy reduces relapse rates and therefore prevents the cost for further care e.g. family therapy may prevent the individual requiring medication or in extreme cases hospitalisation in the future. Interactionist approach is the most effective and affordable way to treat schizophrenia