Psychological Therapies for SZ: Family Therapy

Question 1

outline family therapy for SZ:
- family therapy/aim

Answer 1

psychological therapy

family therapy = based on the idea that patients returning home from institutional psychiatric care are more likely to relapse if they return to families that show high ‘expressed emotion’ (eg. hostility or over-involvement).

Aims to make family life less stressful -> reduce risk of relapse.

Combatting course of SZ, not cause.

Question 2

outline family therapy for SZ:
- process

Answer 2

Psycho educateion programme

Sessions educate families about risks of high EE, and enable them to understand SZ better.

Enable families to reduce expressions of anger/guilt, whilst also having more reasonable expectations for patient behaviour.

Taught about the warning signs to look out for to help prevent relapse.

Family interventions usually form part of an overall treatment package (multi-therapy, multi-agency) and are commonly used in conjunction with routine drug treatment and other forms of therapy eg CBTp.

Question 3

evaluate family therapy for SZ:
STRENGTHS

Answer 3

P) support for effectiveness from NICE (2009)
E) relapse rate in a family therapy condition was 26% compared to 50% relapse in a control group receiving standard care.
E) FT more effective at preventing relapse than any therapy that only targets individuals.

P) Support for effectiveness from Pharoah et al (2012)
E) meta-analysis: compliance with medication was higher in patients where family therapy had been used compared ‘standard’ care.
L) family therapy may be effective in helping ensure patients stay on their medication

P) more appropriate than drug therapy
E) psychological therapies (FT and CBT) can be easily adapted to
the needs of individual patients and families (idiographic approach) unlike biological therapies eg. drugs which treat every sufferer in a similar way (a nomothetic approach).
L) more appropriate therapies due to vast individual differences between sufferers.

P) more appropriate than drug therapy: no side effects

Question 4

evaluate family therapy for SZ:
LIMITATIONS

Answer 4

P) psychological therapies only address the symptoms not causes. E) eg. argued that SZ has a biological cause eg. dopamine imbalance
E) family therapy/CBTp only combat symptoms (course of SZ) rather than its underlying cause
L) limited short term solution; only appropriate to use in conjunction with biological therapies eg drugs

P) negative effect on economy, less cost effective/impractical compared to drugs

P) less appropriate due to effort/time required from patients/family, eg. family may be unavailable/unwilling