Family Therapy

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: 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.

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, 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.

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.