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Family Therapy

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Family Therapy

Family therapy, a form of systemic therapy, is a type of psychological treatment for patients with schizophrenia that involves a therapist and group sessions.

It involves family members and the patient and aims to improve their relationships and communication styles. This process also seeks to address stress in the home, reducing the level of expressed emotion (EE) and relapse rate in schizophrenia.

Ultimately, it addresses mental health by involving the patient and their caregivers and family members. Typically, family therapy lasts up to a year.

Family Therapy Schizophrenia systemic therapy StudySmarterFamily therapy: systemic therapy, Tyler Smith - StudySmarter Originals

What are the processes of family therapy in treating schizophrenia?

As with most therapies, family therapy identifies the problems with psychosis in schizophrenia to resolve them for the patient.It provides therapy by following the procedures described below.

Preliminary analysis

Here, a therapist interviews and observes families and households to determine the family’s problem areas and strengths. Where are things going wrong? Where are things going well? Can these be adequately addressed through family therapy?

Information transfer

The therapist encourages patients and their families to learn about the facts and causes of the disease, including the impact of medications and how issues such as added stress and unwarranted guilt can affect the patient AND the caregiver/family.This process is referred to as psychoeducation.

Psychoeducation: many problems related to schizophrenia in the family arise from a lack of education/information about the illness. The average family may not know what the symptoms of schizophrenia are and how to treat them effectively. This creates a climate of hostility fueled by ignorance and misinformation. It is essential to understand that this lack of education about the illness is not inherently the family’s fault.Family therapy aims to solve this problem by educating the family in question about the disorder.

Communication training

Since problems related to schizophrenia in the family are often the result of misunderstanding and the inability of patients and family members to express themselves appropriately, communication training aims to rectify this. To do this, patients and their families are encouraged to listen to each other, express their emotions safely and appropriately, and discuss things civilly.

Compromise and negotiation are important factors in family therapy and in setting personal boundaries for the mental health of all involved. Weekly meetings between family members are recommended to express concerns and resolve conflicts, which helps reduce expressed emotions (EE) and lower levels of anger and guilt. The lowered levels of EE and other factors help to reduce the symptoms of schizophrenia.

Being family-centred: family therapy aims to change the entire family’s behaviour, not just the patient, taking a lot of pressure off the patient and legitimately addressing issues that are out of their control.

Family Therapy Schizophrenia StudySmarterFamily, Flaticon

As a result, communication improves between family members, and they find a healthy balance between caregiving and self-care. As noted in previous articles, family members exacerbate problems with schizophrenia by resorting to certain negative behaviours. Excessive self-sacrifice is one of these problems. Family therapy encourages family members to address their mental health and not sacrifice it to focus on the patient.

This then leads to an improvement in problem-solving skills within the family. Patients and their caregivers or family members can anticipate problems because they know about the condition and have communicated effectively by establishing boundaries and triggering situations. This allows them to have solutions ready, rather than relying on reactionary solutions that may cause problems in themselves.

Evaluation of family therapy

There are pros and cons to consider as with all therapies when treating schizophrenia with family therapy. We must evaluate the psychological aspect and the effectiveness and effects of such a personal treatment style.

Strengths

  • Leff (1985) found in the follow-up of patients with schizophrenia that the relapse rate in patients receiving standard outpatient treatment was 50% within 9 months. However, the relapse rate within nine months was only 8% for those who received family therapy. This is a significant difference, showing that family therapy is an effective treatment for reducing relapse rates.

    • After two years, 50% of patients with family therapy had relapsed, while 75% of patients without family therapy had relapsed. Again, this suggests that family therapy helps reduce relapse rates. However, this may only be a short-term solution, as indicated by the 8% increase. Some families may not persevere with therapy, which could explain this increase in relapse.

  • Anderson et al. (1991) found that patients had a 40% relapse rate when treated with medication. However, only 20% of patients who received family therapy relapsed. When combined with family therapy, the relapse rate dropped to a remarkable 5%.

  • Pharoah et al. (2010) supported the idea that family therapy improves expressed emotions (EE) in a family.

  • Lobban (2013) found that family members felt they were coping better thanks to family therapy. Thus, family therapy reduces the pressures and resulting negative systems that develop due to poor support systems at home.

Weaknesses

  • Although studies generally show that family therapy reduces relapse rates in the short term, many studies emphasise that this effect diminishes dramatically after about six months and that improvement does not last longer than six months (Claxton et al., 2017).

  • Due to the lengthy process, as family therapy can last up to a year, symptoms or incidents (such as disputes or conflicts in the family) may cause patients and family members to drop out of therapy.

  • Family therapy focuses on treating symptoms and improving the patient’s home life. It supports family relationships and helps family members cope with symptoms, but it is not a cure.

  • It is difficult to say directly that family therapy is the cause of lower relapse rates. As Claxton et al. (2017) illustrated, studies tend to ignore the high variability within families studied and the highly specialised nature of specific treatments, such as family care and standard outpatient treatment.

  • In standard outpatient care and family care, patients meet regularly with clinicians and teams so that families may feel adequately supported without extensive family therapy intervention. It is difficult to say whether family therapy is more effective in its own right.


Family Therapy - Key takeaways

  • Family therapy, also known as systemic therapy, is a form of psychological treatment for patients with schizophrenia that involves a therapist and group sessions.
  • The therapy consists of a preliminary analysis, information transfer and communication training.
  • Preliminary analysis is a phase that includes interviews and assessments of the patient and family. Information transfer involves psychoeducation, which informs family members about the disorder, and communication training encourages appropriate communication within the family (being family-centred) to avoid problems with EE, stress, and guilt.
  • Family therapy is effective in reducing relapse rates and helping families feel they can cope with the disorder and relieve the affected patient/family member.
  • Because of the lengthy processes involved in family therapy, families tend to drop out of treatment, making family therapy a short-term solution rather than a long-term one. There are also problems with the methodology in studies that are not as robust and only treat symptoms. It is not a cure.

Frequently Asked Questions about Family Therapy

Family therapy, also known as systemic therapy, is a form of psychological treatment for patients with schizophrenia that involves a therapist and group sessions. It implies involving the family with the patient in their treatment plan to address issues at home.

Ultimately, the goals of family therapy are to identify issues at home that are exacerbating the patient’s schizophrenia, improving communication. It aims to help treat the symptoms, stop relapse, and educate the family about the condition. 

The techniques usually involve the family and mean using preliminary analysis to identify the issues at home, encouraging information transfer through psychoeducation and communication training through being family centred. It helps reduce relapse rates of patients and helps patients manage their symptoms at home with the help of family.

It is essential as it helps both the patient and their families come to terms with the disorder, in this case, schizophrenia, and aids in treating the disorder.

Family therapy involves family members the patient lives with or is around frequently; individual treatment focuses solely on the patient.

Final Family Therapy Quiz

Question

Define family therapy.

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Answer

Family therapy, also known as systemic therapy, is a form of psychological treatment used for patients with schizophrenia, involving a therapist and group sessions.

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What is the average length of family therapy?

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Answer

Usually, family therapy lasts for up to a year.

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What are the goals of family therapy?

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Answer

Family therapy intends to improve patient and family relationships and communication styles. This should address issues such as stress in the household, reducing levels of expressed emotion (EE) and relapse rate in schizophrenia. 

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Question

What are the processes of family therapy?

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Answer

Preliminary analysis, information transfer, and communication training.

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What is preliminary analysis in family therapy?

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Answer

This is where families and households undergo interviews and observations with a therapist to identify the problem areas and strengths of the family.

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What is information transfer in family therapy? 

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Answer

This is where the therapist encourages patients and the family to learn about the facts and causes of schizophrenia. This includes the influence of drugs and the effects issues such as additional stress and unwarranted guilt can cause for the patient AND the caregiver/family members. 

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What is psychoeducation in family therapy?

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It is the process of educating the family involved about the disorder and the effects of outside influences on it.

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What is communication training in family therapy?

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Communication training is the process of teaching family members how to communicate with each other without relying on negative behaviours and exacerbating symptoms/feelings of stress and guilt. This is for the patient and the family members.

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What do we mean by being family-centred in family therapy?

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Answer

Family therapy intends to change the whole family’s behaviour, not just the patient. This removes a lot of pressure from the patient and justifiably addresses issues outside their control. It reduces levels of EE, self-sacrifice in family members, and conflicts within the household.

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What is the strength of family therapy?

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It reduces levels of relapse rates in patients with schizophrenia.

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What is a weakness of family therapy?

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It is a lengthy process, and families can drop out due to the severity of symptoms or unresolved conflicts.

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What did Leff (1985) find?

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Answer

In patients with schizophrenia, those with standard outpatient care had a relapse rate of 50% within nine months. However, those who had family therapy had a relapse rate of only 8% within nine months. After two years, 50% of patients with family therapy relapsed, and 75% without family therapy.

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What do the results of Leff (1985) suggest?

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Answer

Family therapy is an effective treatment when reducing rates of relapse. However, it may only be a short-term solution.

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What did Claxton et al. (2017) find in their study?

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When looking at family therapies reduction effect on relapse rates, after around six months, this effect reduces dramatically, and evidence of improvement was not sustained past six months.

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What did Lobban (2013) find?

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Answer

Lobban (2013) found that family members felt they were coping better thanks to family therapy. Thus, family therapy reduces the pressures and resulting negative systems that develop due to poor support systems at home.

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