Family Therapy for CBT Flashcards
What are family therapies
Name given to a range of interventions targeting the family of someone with Sz
Who does NICE suggest recieves family therapy
‘All individuals diagnosed with Sz who are in contact with or live with family members’, and they stress that such therapy should be made a priority where there are persistent symptoms or high relapse rates
Why might family therapies be effective
Because of high EE families causing Sz
How is family therapy offered
In a period between 3 and 12 months and at least 10 sessions
What does Family Therapy aim to do
Reduce levels of EE in households. It does this by helping family members find ways to support a family member with Sz and resolve practical problems. The therapist encourages family members to listen to each other and openly discuss problems, helping to negotiate solutions
What difference can Family Therapy have
Garety estimated that the relapse rate for those who received Family Therapy was 25% compared to 50% without
What is a key study on family therapy
Pharoah et al, who reviewed 53 studies published between 2002 and 2010, chosen from across europe, asia and north america. They compared Family Therapy to drugs alone.
What did Pharoah et al find
Mental State - Mixed. Some patients mental state improved while others didn’t
Compliance with Medication - Family compliance improved compliance with medication
Social functioning - Although appearing to improve general functioning it did not appear to have effect on concrete outcomes like employment or living independently
Reduction in relapse rate - There was a reduction in risk of relapse and reduction in hospital admission during treatment and up to 24 months after
Who did the key study into family therapy
Pharoah et al
What is a methodological issue with the Pharoah et al study (eval)
In 10 of the 53 studies reported in the meta analysis they did not use any sort of blinding, so raters were aware of the type of treatment recieved. A further 16 did not mention whether blinding was used, This is a particular issue in follow ups where participants tend to unintentionally reveal the type of therapy they had
What are the economic benefits of Family Therapy (eval)
A NICE review of family therapy studies demonstrated that family therapy is associated with significant cost saving when offered to people with Sz in addition to standard care. The extra cost of the therapy is offset by the reduction in costs of hospitalisation because of the lower relapse rates. This continues after the therpy has been completed
Who said that Family Therapy saves the NHS money
NICE
How might Family Therapy also have a postive outcome on family members (eval)
Lobbam et al analysed the results of 50 family therapy studies that included intervention to support relatives. 60% of these studies reported a significant positive impact of the intervention on at least one outcome category for relatives, for example coping and problem solving skills. However methodlogical issues with these studies may negate the findings
Who said that families may also benefit from Familt Therapy
Lobbam
Why might family therapy not be worthwile (eval)
A study by Garety et al failed to show better outcomes for patients given sessions of family therapy over those who simply had carers but no Family Therapy. Both groups had suprisingly low relapse, very different to the no-carers condition. Researchers found that carers had low rates of EE, so Garety concluded that family intervention may not improve outcomes any more than a good standard of treatment as usual
Who claimed that Family Therapy wasn’t worthwile
Garety et al
