Family Therapy

Question 1

How it works: (Pharoah et al. (2010)):

Answer 1

• It aims to improve the quality of communication and interaction between family members. It works on the basis that family dysfunction is responsible for explaining schizophrenia.
• Reduces negative emotions (e.g. anger and stress).
• Improves the family’s ability to help in their treatments.

Question 2

Burbach (2018): Model of how family therapy should be implemented:

Answer 2

1. Share basic information and get background on family relationship.
2. Identify what the family can and cannot offer.
3. Create a safe space with mutual understanding.
4. Identifying unhelpful patterns of interaction.
5. Skills training (e.g. stress management).
6. Relapse prevention planning.
7. Maintenance for the future.

Question 3

Evaluation everything

Answer 3

• McFarlane (2016): found that it is great at relapse prevention – reduced by 50-60%.
• NICE recommends it.
• Lobban and Barrowclough (2016) note that it helps the whole family, which in turn helps the patient. Strengthening family lessens the impact of schizophrenia.
• It doesn’t cost as much because the family do the work.
• Again, it doesn’t cure the disorder.

Question 4

eval token economy

Answer 4

• TE is really behaviour modification based on operant conditioning. Tokens are secondary enforcers. This allows patients to gain primary reinforcers.
• Matson et al. (2016)
  1. TE improves quality of life within the hospital
  2. Normalizes behaviour and makes their experience in hospitals more similar to the outside world.
• TE must be at the time of the behaviour (not like a monthly salary). It has to benefit the person after the activity.

Question 5

eval Strengths:

Answer 5

• Glowacki et al. (2016) – a review of seven articles showing the effectiveness of TE. All of the studies showed a reduction in negative symptoms.

Question 6

Weaknesses:

Answer 6

• Ethics: gives even more power to the professionals.
• They are the gatekeepers of all pleasure and freedom. The issues have been illustrated by legal challenges against institutions that use TE.
• Makes more sense to use alternative therapies that do not have the ethical issues. Chiang et al. (2019) notes that occupational therapies such as Art therapy is a good and ethical alternative. NICE recommends it.
• Difficult to continue once outside of an institution. However, it might be the therapy that allows them to leave the hospital in the first place.