Family Therapy - Effectiveness / Appropriateness

Question 1

What are the 3 points for effectiveness & appropriateness?

Answer 1

1. Garety et al (2008)
2. The NICE review of family intervention studies (2009)
3. Pharoah et al (2010) Meta-analysis of 53 studies on FT
4. Methodological problems of Pharoah et al’

Question 2

What did Garety et al (2008) do?

Answer 2

looked at the outcomes for:

1. pt receiving family therapy
2. pt receiving care but no family care
3. pt w/ no carers

Question 3

What was Garety et al’s (2008) findings?

Answer 3

1. Lower relapse rates for patients receiving FT & receiving care but no therapy
2. Carers showed low levels of EE

Question 4

What did Garety et al suggest from his findings?

Answer 4

good care is important rather than family therapy

Question 5

Is Garety et al’s research effective / appropriate?

Answer 5

NOT effective

NOT appropriate

Question 6

Garety et al grave point

Answer 6

reduced application

Question 7

What did NICE’s review show?

Answer 7

use of family therapies are associated w/ significant cost savings when offered to people in addition to standard care

Question 8

Is NICE review effective / appropriate?

Answer 8

Effective, therefore is appropriate for 2 reasons:

1. Helps patients
2. Has a positive economic implication by reducing costs

Question 9

NICE review grave point

Answer 9

Good application

Question 10

How many studies did Pharaoh et al study?

Answer 10

53

Question 11

What countries were involved in Pharaoh et al study?

Answer 11

Europe

Asia

North America

Question 12

What were the dates of the studies examined in Pharaoh et al study?

Answer 12

2002 - 2010

Question 13

Pharaoh et al - effectiveness of mental state

Answer 13

mixed findings

Question 14

Pharaoh et al - effectiveness of compliance with medication

Answer 14

FT increased compliance w/ meds

Question 15

Pharaoh et al - effectiveness with social functioning

Answer 15

general improvement

BUT not much evidence of increased independant living or employment

Question 16

Pharaoh et al - effectiveness with relapse & re-admission

Answer 16

reduction of relapse risk & hospital admission

up to 24 months later

Question 17

Name the 2 methodological problems w/ Pharoah et al’s meta-analysis study

Answer 17

1. Lack of random allocation in China

2. Possible observer bias

Question 18

Pharaoh et al - why is lack of random allocation in China a methodological problem?

Answer 18

not all the variables may of been controlled in the research

Question 19

Pharaoh et al - why is possible observer bias a methodological problem?

Answer 19

There is no ‘blinding’ used to prevent observers knowing which condition the patients were in,

its possible results were biased

Question 20

Pharaoh et al meta-analysis - effective / appropriate

Answer 20

although there is mixed support for FT…

Positive effects on compliance + reduced relapse show effectiveness & appropriateness

Question 21

Pharaoh et al meta-analysis - grave point

Answer 21

Good application

Question 22

Pharaoh et al meta-analysis method -grave point

Answer 22

Reduced internal validity due to poor design