Family therapy Flashcards
Aim
It aims to reduce levels of expressed emotion, particularly negative emotions, such as anger and guilt which creates stress which in turn reduces the relapse rate. It also aims to improve the families’ beliefs about and behaviour towards schizophrenia. Finally, it tries to ensure that family members achieve a balance between caring for the individual with schizophrenia and maintaining their own lives.
How long is family therapy
3-12 months for at least 10 sessions.
Who came up with family therapy
Pharoah
Pharoah’s study
Compared 53 studies on family therapy to standard care (i.e. antipsychotic medication) alone. They found that results were mixed in terms of an improvement in the overall mental state of patients. They found that the use of family therapy increased patients’ compliance with medication. Family therapy did not show much improvement on social functioning such as living independently or employment. However, there was a reduction in risk of relapse and a reduction in hospital admission during treatment in family therapy and 24 months after.
Evaluation
Effectiveness
P - One strength of family therapy is evidence of its effectiveness.
E - A review of studies by William McFarlane concluded that family therapy was one of the most consistently effective treatments. Relapse rate reduced by 50%-60% typically. 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.
E - This means that family therapy is likely to be of benefit to people with both early and ‘full blown’ schizophrenia, therefore It is a suitable treatment for all types of patients with schizophrenia.
Counterpoint: However, the authors suggest that the main reason for its effectiveness may have less to do with the interventions themselves and more to do with the fact that it increases medical compliance. As such, this undermines the evidence. It suggests that the beneficial effects are not the result of family therapy itself, but because family therapy means patients are more likely to take their drugs (which are effective).
Helps all family members
P - A further Strength of family therapy for schizophrenia is it has benefits for all family members.
E - Lobban et al. analysed the results of 50 family therapy studies that had included an intervention to help relatives. 60% of these studies reported a significant positive impact on at least one outcome category for relatives, e.g. relationship quality and coping. By strengthening the function 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.
E - This means that family therapy has wider benefits beyond the obvious positive impact on the identified patient.
Counter: However, the researchers also concluded that the methodological quality of the studies was poor, making it difficult to distinguish effectiveness from ineffective interventions in terms of family members.
Economic benefits
P - Another strength of family therapy is that it has considerable economic benefits associated with the treatment of schizophrenia.
E - The NICE review of family therapy studies demonstrated that it was associated with significant cost savings when offered to patients alongside the standard care. The extra cost of family therapy is offset by a reduction in the costs of hospitalisation because of the lower relapse rates associated with this form of intervention. There is also evidence that family therapy reduces relapse rates for as significant period after completion of the intervention.
E - This means that the cost savings associated with family therapy would be even higher.
