Book contents
- Frontmatter
- Contents
- Editors
- Contributors
- Foreword
- Preface
- Introduction
- Completing an audit project
- I Disorders
- 1 Acute confusion: recognition
- 2 Antenatal and postnatal mental health
- 3 Attention-deficit hyperactivity disorder: provision of information
- 4 Bipolar depression: treatment
- 5 Bipolar disorder: management
- 6 Bipolar disorder: shared decision-making
- 7 Bipolar disorder: treatment
- 8 Chronic fatigue syndrome
- 9 Dementia: driving
- 10 Dementia: end-of-life care
- 11 Dementia: investigations
- 12 Depression: management in children and young people
- 13 Eating disorders: management
- 14 Epilepsy: management
- 15 Opiate dependence and pregnancy
- 16 Schizophrenia: family interventions
- 17 Schizophrenia: management
- 18 Schizophrenia: occupational achievements
- 19 Self-harm: assessment
- 20 Self-harm: assessment in children
- II Legislation
- III Physical health
- IV Record-keeping
- V Service provision
- VI Training
- VII Treatment
- Appendices
16 - Schizophrenia: family interventions
from I - Disorders
Published online by Cambridge University Press: 02 January 2018
- Frontmatter
- Contents
- Editors
- Contributors
- Foreword
- Preface
- Introduction
- Completing an audit project
- I Disorders
- 1 Acute confusion: recognition
- 2 Antenatal and postnatal mental health
- 3 Attention-deficit hyperactivity disorder: provision of information
- 4 Bipolar depression: treatment
- 5 Bipolar disorder: management
- 6 Bipolar disorder: shared decision-making
- 7 Bipolar disorder: treatment
- 8 Chronic fatigue syndrome
- 9 Dementia: driving
- 10 Dementia: end-of-life care
- 11 Dementia: investigations
- 12 Depression: management in children and young people
- 13 Eating disorders: management
- 14 Epilepsy: management
- 15 Opiate dependence and pregnancy
- 16 Schizophrenia: family interventions
- 17 Schizophrenia: management
- 18 Schizophrenia: occupational achievements
- 19 Self-harm: assessment
- 20 Self-harm: assessment in children
- II Legislation
- III Physical health
- IV Record-keeping
- V Service provision
- VI Training
- VII Treatment
- Appendices
Summary
Setting
This audit is particularly relevant to general adult and forensic psychiatry, in both in-patient and out-patient settings.
Background
It has been suggested that high levels of expressed emotion (criticism, hostility or over-involvement) in families of individuals with schizophrenia causes more frequent relapses. A Cochrane systematic review (Pharoah et al, 2006) suggested that family interventions may decrease the frequency of relapse, reduce hospital admission, encourage compliance with medication and decrease general social impairment. The 2009 guideline on the treatment and management of schizophrenia from the National Institute for Health and Clinical Excellence (NICE) strongly recommends the implementation of family interventions in schizophrenia.
Standards
The following standards are contained in the NICE guideline:
ᐅ Family intervention should be offered to all families who live with or who are otherwise in close contact with patients with schizophrenia. This can be started either during the acute phase or later, including in in-patient settings.
ᐅ Family intervention should:
▹ include the patient if practical
▹ include at least 10 planned sessions over a period of 3 months to 1 year
▹ take into account any preference for single-family rather than multi-family intervention
▹ take into account the relationship between the main carer and the patient
▹ have a specific supportive, educational or treatment function
▹ include negotiated problem-solving or crisis-management work.
Method
Data collection
A list of all patients with schizophrenia who were discharged within the past year was obtained from the medical records department. The sample size and the study period may need to be locally agreed. About 20 patients over 6–12 months was considered reasonable. Data were collected mainly from patient medical records. The patient's social worker and/or community psychiatric nurse (CPN) provided additional information.
The following were assessed:
ᐅ Did the patient have a diagnosis of schizophrenia?
ᐅ If so, was the patient living with or in close contact with his/her family? (‘Close contact’ is not defined in the NICE guidelines and so may have to be locally defined for the purposes of the audit.)
ᐅ If so, was the family intervention offered by the team and was it accepted or declined? (There should also be an assessment of whether the patient had the capacity to consent.)
ᐅ If a family intervention was undertaken, what was its nature and duration?
- Type
- Chapter
- Information
- 101 Recipes for Audit in Psychiatry , pp. 51 - 52Publisher: Royal College of PsychiatristsPrint publication year: 2011