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3. Schizophrenia - Psychological Therapies > Family Therapy > Flashcards

Flashcards in Family Therapy Deck (7)
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What is family therapy?

It aims to improve the quality of interaction and communication between family members. It is concerned with reducing stress within the family (in particular levels of expressed emotion) that might contribute towards a patient's risk of relapse.

It is part of an overall treatment package commonly used in conjunction with drug treatment and outpatient clinical care.


What are some of the strategies that family therapy typically involves?

• Help family member to be more tolerant and less critical of their schizophrenic relative
• Improve positive communication and decreasing expressions of negative communication such as anger between family members


Why does family therapy reduce the likelihood of relapse?

It reduces the levels of EE. Whilst increasing the patient's compliance with taking their medication. This combination results in a reduced likelihood of relapse and readmission to hospital.



Is there any evidence to support the effectiveness of family therapy?

Left et al compared relapse rates when receiving family therapy compared to routine outpatient care for schizophrenics with families high in expressed emotion.
• In the first 9 months of treatment 50% receiving routine care relapsed compared to just 8% of those receiving family therapy.
• After 2 years this rose to 75% relapse for those receiving routine care compared to just 50% for family therapy patients

This suggests that family therapy is comparatively effective in preventing relapse especially in the short term.

Xiong et al randomly allocated 63 Chinese patients m either drug care or drug care + family therapy. After one year 61% of the drug treatment only patients had relapsed compared to 33% of drug + family therapy.

This suggests that family therapy forms an effective treatment when combined with antipsychotic drugs.



Does family therapy have any economic benefits?

It has considerable economic benefits associated with the treatment of schizophrenia.

The NICE review demonstrated that FT is associated with significant cost saving. The extra cost of providing someone with FT is offset by the reduction in costs of hospitalisation because of lower relapse rates with this form of intervention over time.

FT can also educate the family to help manage a patient's medication regime, decreasing the need for doctors to do this.

Thus making the treatment even more cost effective than standard drug treatment alone.



Is there any research against family therapy?

Some research questions whether family therapy is worthwhile.

Garety et al found no better outcomes for patients given FT compared to a group who simply had carers and no FT. Individuals in both groups were found to have unexpectedly low rates of relapse, compared to a control group who had no carers.

This suggests that, for many people, family intervention may not improve outcomes any better than a good level of standard drug treatment.



Does family therapy cure schizophrenia?

Psychological therapies such as family therapy improve quality of life but do not cure schizophrenia.

FT helps reduce stress for the whole family which shows it is useful to make the patients life more manageable, but is a weakness because it does not actually cure the disorder.

FT can be seen as reductionist as it only focuses on treating stress in the family which may act as a trigger for the disorder but does not actually treat the underlying cause. The evidence discussed highlights the importance of having a combined approach to treatment, one which combines drug treatment to stabilise the patient with some form of psychological therapy.