Psychological Treatments - Family Therapy

Question 1

Aims + How It Works/Helps:

Answer 1

• Takes place with families as well as the identified patient (one member of a dysfunctional family who expresses the family’s conflicts)
• Aims to improve quality of communication and interaction between family members
• Aims to reduce levels of EE, especially negative emotions like anger and guilt which create stress; important to reduce likelihood of relapse

Question 2

Pharoah et al (2010)

Answer 2

• Identified a range of strategies that family therapists use to try to improve the functioning of a family that has a member with schizophrenia
• These strategies work by reducing levels of stress and EE, whilst increasing the chances of patients complying with medication – this combo of benefits tends to result in a reduced likelihood of relapse and re-admission to hospital

Question 3

Pharoah’s et al (2010) - Strategies

Answer 3

• Reducing the stress of caring for a relative with schizophrenia
• Improving the ability of the family to anticipate and solve problems
• Forming a therapeutic alliance whereby they all agree on the aims of therapy
• Ensuring family members achieve a balance between caring for the individual and maintaining their own lives
• Reduction of anger and guilt in family members
• Improving families’ beliefs about and behaviour towards schizophrenia

Question 4

Burbach et al (2018)

Answer 4

• Proposed a model for working with families dealing with schizophrenia

Question 5

Burbach et al (2018) - Model Of Practice

Answer 5

• Phase 1 is sharing basic info + providing emotional and practical support
• Phase 2 involves identifying resources including what different family members can (and cannot) offer
• Phase 3 aims to encourage mutual understanding, creating a safe space for all family members to express their feelings
• Phase 4 involves identifying unhelpful patterns of interaction
• Phase 5 is about skills training such as learning stress management techniques
• Phase 6 looks at relapse prevention planning
• Phase 7 is maintenance for the future

Question 6

Evaluation - Evidence for effectiveness

Answer 6

• A review of studies by McFarlane (2016) concluded that family therapy was one of the most consistently effective treatments available for schizophrenia, especially with relapse rates being reduced by around 50-60%
• McFarlane also concluded that using family therapy as mental health initially starts to decline is particularly promising
• Clinical advice from NICE recommends family therapy for everyone with a diagnosis of schizophrenia
• Family therapy is likely to be of benefit to people with both early and ‘full-blown’ schizophrenia

Question 7

Evaluation - Benefits for all family members

Answer 7

• A review of evidence by Lobban and Barrowclough (2016) concluded that these effects are important because families provide the bulk of care for people with schizophrenia
• By strengthening the functioning of a whole family, family therapy lessens the negative impact of schizophrenia on other family members and strengthens the ability of the family to support the person with schizophrenia
• Family therapy has wide benefits beyond the obvious positive impact on the identified patient