Family therapy Flashcards
What is the schizophrenogenic mother?
Domineering and insensitive mothers who are controlling and rejecting. This sets up lines of faulty communication between her and her child leading to excessive stress triggering psychotic thinking
What are high levels of expressed emotions?
These families express considerable emotional over involvement - high levels of concern and / or hostility towards the patient. These highly expressive family interactions affect the development of SZ rather than the onset.
What is family therapy?
Family therapy is an attempt to fix the faulty and dysfunctional dynamic of a family that may have caused schizophrenia.
It tries to alter communication practices within a family and trains people to express emotion in a more beneficial way
The therapy is aimed at helping the patient and their families develop constructive practical coping skills to minimise the chances of relapse. It can often take up to and over 20 sessions.
What are the aims of family therapy?
Improve positive and decrease negative forms of communication – co- operative and trusting r/ships
Increase tolerance levels and decrease criticism within the family dynamic
Decrease feelings of guilt and responsibility for causing the illness.
Therapists aim to hold an open forum about the effects the illness has had on the family.
The therapist educates about the symptoms, causes and prognosis and families discuss their experiences ( psychoeducation)
What is the process of family intervention?
First, the focus is developing cooperative and trusting relationships within the family. Noth the patient and the family meet in a supportive environment, where all family members are valued.
Next, the therapist educates the group about the symptoms, causes and prognosis of SZ whilst family members bring together their experiences of the disorder - psychoeducation
The goal of the therapy is to provide the patient and the family with a set of practical coping skills which enables them to manage everyday difficulties involved in SZ.
It is accepted that the family may occasionally feel anger and impatience, but they are taught how to express concern without resulting to high expressed emotion.
The family and the patient are also trained to recognise the early signs of potential relapse, so they can respond rapidly and reduce its severity.
What are some examples?
Cooperative trusting relationships - allow both the family and the patient to voice gratitude.
Educate - Get family members to attend mini-lectures to educate themselves on SZ.
Practical coping strategies - meditation, relaxation, journaling, exercise, breathing exercises.
How to express concern- counting back before speaking
Early signs of relapse - Attending mini-lectures that educate on relapse. Understanding daily structure to see early warning signs.
FAMILY THERAPY - Alternative treatment?
Vaughn and Leth studied SZ patients returning to high or low EE in the household. For patients living in high EE households, the relapse rate for those on medication was only 53% but for those in the placebo condition the relapse rate was 92%. May be that both family dynamics and biochemistry in terms of treatment options may be best as medication can help reduce symptoms and FT can reduce relapse by maintaining healthy relationships.
FAMILY THERAPY - Research evidence?
Leff found that families who engage in FT reduce critical comments and over involvement. 14% of patients in the FT group had relapses compared to 78% of those who did not receive any FT. It is therefore effective in tackling relapse and supporting the wider family in coping with SZ.
FAMILY THERAPY - Reductionist?
Basis is only environmental as it focuses on the impact of how events in the environment are experienced by SZ patients - which is only at the social-/interpersonal level. This ignores treatments which are based on biological factors such as using AP medications at the neurochemical level of biology. This implies that more than one level of explanation should be looked at to treat complex disorders.
FAMILY THERAPY - Research evidence 2?
Xiong randomly allocated 63 Chinese patients with SZ to either drug treatment or drug treatment with FT. They found 61% of the drug treatment only group relapsed compared to only 36% of the drug treatment and FT group. Implies that it is a useful strategy regardless of cultural setting.
FAMILY THERAPY - Methodological flaws?
We cannot establish cause and effect between FT and reduction in FT symptoms as there could have been many variables that could have led to less relapse such as the fact that patients were still taking APs alongside so the impact of these may have impacted relapse rates to some extent.
