Schizophrenia: Family therapy Flashcards
What does family therapy look to achieve in families with a SZ patient?
Reduce the levels of negative expressed emotion in a family through interventions to reduce the chance of relapse.
Who and what is recommended about family therapy?
NICE recommend family therapy should be offered to all SZ patients who live with or are in contact with family members.
How does family therapy reduce the chance of relapse?
Educational element: family given info about disorder and ways of managing it. Improving communication, lowing EE, adjusting expectations, expanding social networks.
What is specifically involved in family therapy interventions?
Psychoeducation
Forming alliances between family members
Anticipating problems
Reducing emotional climate
Reducing expressions of anger and guilt
Who provided evidence for the effectiveness of family therapy?
Pharoah et al.
How did Pharoah et al. investigate family therapy effectiveness?
Meta-analysis 53 studies (natural).
Europe Asia and North America 2002-10. Compared outcomes of family therapy to standard care.
What did Pharoah et al. find?
Mixed results on range of outcomes. Positive outcomes for preventing relapse and improving medical compliance.
Less predictive in other outcomes such as mental state.
AO3: Family therapy
+Effective
+Advantages of family therapy in terms of Issues and Debates
-2 methodological limitations of Pharaoh’s study
-Economic implication
(+AO3) Why is family therapy effective?
Improves certain outcomes such as preventing relapse.
Suggested this is not due to improvements in specific clinical markers e.g. social functioning, but due to increased medical compliance.
This increases the change of patients complying with medication scheme. Suggests family therapy would be ineffective alone, but has value in medical compliance.
(+AO3) What is an advantage of family therapy in terms of issues and debates?
Uses a holistic approach to the complex disorder that is SZ.
Recognises it is influenced by biological, environmental and social factors, so takes a multilateral approach.
Understands context of individual, whilst working with standard care.
Overall helps long-term recovery as it addresses most aspects of the disorder, explaining low relapse rates.
(-AO3) Outline 2 methodological limitations of Pharoah’s study.
Although all 53 studies claimed to have used random allocation, many were completed in China. China has been found to stage studies to appear to use random allocation, but did not. Reduces validity.
10 studies at least did not use blinding. Possibility of observer bias - internal validity.
(-AO3) Describe the economic implication of family therapy.
Considerable economic benefits according to NICE review.
Significant cost savings when used with standard care. Reducing relapse reduces rate of hospitalisation.
Offsets costs of family therapy.
Shows importance of offering family therapy to the individual and the benefits to the economy.
