7. psychological therapy: family therapy

NICE recommend that family therapy is offered to all individuals with schizophrenia

• Gareth estimate the relapse rate for individuals who receive family therapy is 25% rather than 50%

Procedure

• improves communication, reduces stress and helps the family to support the person

• Usually given alongside antipsychotics

• Structured interventions involving family

• 3-12 months, at least 10 sessions

• Reduce expressed emotion in the household to reduce relapse

• Include: psychoeducation, building supportive alliances, reducing emotional intensity, problem solving skills, setting realistic expectations, boundary setting, open communication

Study - Pharoah

• Meta analysis of 53 studies to investigate the effectiveness of family intervention

• Compared outcomes from family therapy to ‘standard’ care (antipsychotic medication alone)

Found that those receiving family therapy were

• mental state - mixed findings, some reported an improvement

• Compliance with medication - increased

• Social functioning - did not have much of an effect, e.g living independently or employment

• Reduction in relapse - reduced during treatment and the 24 months after

• So overall findings were inconsistent

APE

• appropriate - socially sensitive, puts a lot of responsibility on the family

• Practical (costs) - state does not need to pay so much as the family provide most of the care. Also reducing relapse rates reduces costs for hospitals

• Effective - evidence, McFarlane found relapse rates was reduced by 50-60%