Family Therapy Flashcards
Define the term “family therapy”
Is the name given to a range of interventions aimed at the family (e.g parents, siblings, partners) of someone with a mental disorder
What is the use of family therapy?
Reduces relapse rates, by reducing high EE
What are the strategies used in family therapy?
1) psycho education - relatives understand illness and better able to deal with illness
2) form an alliance with relatives who care for the person with schizophrenia
3) reducing emotional climate
4) increasing relatives ability to solve problems
5) reduce anger and guilt of family members
6) maintain reasonable expectations among family members for patient performance
7) encouraging relatives to set appropriate limits while maintaining some degree of separation when needed
What does NICE recommend about family therapy?
- all individuals diagnosed with schizophrenia who are in contact with or live with family members should use family therapy
What did Garety find about differences in relapse rates between those who had family therapy and those who never?
25% for family therapy compared to 50% for those who receive standard care alone
Why is family therapy beneficial?
It improves relationships within the household he has the therapist encourages family members to listen to each other and openly discuss problems and negotiate potential solutions together
Outline the procedure of Pharoah et al (2010) study on family therapy
- reviewers 53 studies between 2002-2010
- studies chosen were conducted in Europe, Asia and North America.
- Compared family therapy to standard care (antipsychotic medication alone)
Outline the findings of Pharoah et al (2010) study on family therapy?
1) Mental state - was mixed
2) Compliance with medication - use of family therapy increased patients compliance with medication
3) Social functioning - some improvement. But family therapy didn’t have much of an effect on living independently or employment
4) Reduction in relapse rates and readmission - reduction in the risk of relapse and a reduction in hospital admission during treatment and in the 24 months after
AO3
Is family therapy effective?
P: Improvements in mental health and social functioning but may not be a direct result of family therapy
E: main reason for effectiveness = increases medication compliance
E: main benefit for therapy = medication use, which improves social functioning and mental state
AO3
What is the methodological limitation of Pharoas study?
P: there was lack of blinding - methodological quality was compromised in those studies where raters were not blinded to the condition to which participants had been allocated
E: 10/53 studies didn’t use any form of blinding, I.E raters were aware of the type of treatment received (family therapy or standard care) by the participants they were rating.
E: The lack of blinding is particularly problematic in studies with longer follow ups where participants tend to unintentionally reveal the type of therapy they had received
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What is a benefit of family therapy?
P: economic benefits
E: NICE - family therapy = significant cost savings when added to standard care
The extra cost of family therapy is offset by a reduction in costs of hospitalisation because of the lower relapse rates associated with it.
- family therapy = reduces relapse rates for a significant period after completion of the intervention
E: means that the cost savings associated with family therapy would be even higher
AO3
Does family therapy also benefit the family members of the patient
P: positive impact on family members
E: Lobban et al (2013) - 50 family therapy studies. 60% = positive impact on family, included coping and problem solving skills, relationship quality (including EE)
E: However the researchers also concluded that the methodological quality of the studies was generally poor, making it difficult to distinguish effective from ineffective interventions
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Is there a difference between those who receive family therapy and those who just have good carers?
P: A study by Garety et al (2008) failed to show any better outcomes for patients given sessions of family therapy compared to those who simply had carers but no family therapy
E: both groups - low relapse rates, contrasting markedly with the rates found in the ‘no carer’ group. Found - carers = low EE, which may reflect widespread cultural changes in carers knowledge and attitudes towards schizophrenia.
E: Garety et al - family intervention may not improve outcomes further than a good standard of treatment as usual
