Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-22T13:19:03.072Z Has data issue: false hasContentIssue false

Family Psychoeducation as an Evidence-Based Practice

Published online by Cambridge University Press:  07 November 2014

Abstract

Family psychoeducation programs have emerged as a strongly supported evidence-based practice in the treatment of schizophrenia and bipolar disorder. Over 30 randomized clinical trials demonstrated that psychoeducation programs reduce relapse, improve symptomatic recovery, and enhance psychosocial and family outcomes. Recent work supports family psychoeducation strategies for other disorders, including major depression, obsessive-compulsive disorder, and borderline personality disorder. This review summarizes the research evidence supporting prominent models of family psychoeducation. Professional and peer-led family education programs are also reviewed and differentiated from family psychoeducation. Directions for future research studies to enhance the evidence base and inform treatment recommendations are proposed. Finally, strategies for implementation of family psychoeducation in routine clinical practice are discussed.

Type
Review Articles
Copyright
Copyright © Cambridge University Press 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Solomon, P, Draine, J. Subjective burden among family members of mentally ill adults: relation to stress, coping, and adaptation. Am J Orthopsychiatry. 1995;65:419427.CrossRefGoogle ScholarPubMed
2.World Schizophrenia Fellowship. Families as Partners in Care: A Document Developed to Launch a Strategy for the Implementation of Programs of Family Training, Education, and Support. Toronto, Canada: World Schizophrenia Fellowship; 1998.Google Scholar
3.Lehman, AF, Kreyenbuhl, J, Buchanan, R, et al.The schizophrenia patient outcomes research team (PORT): updated treatment recommendations. Schizophr Bull. 2004;30:193217.CrossRefGoogle ScholarPubMed
4.Pitschel-Walz, G, Leucht, S, Bauml, J, Kissling, W, Engel, RR. The effect of family interventions on relapse and rehospitalization in schizophrenia–a meta-analysis. Schizophr Bull. 2001;27:7392.CrossRefGoogle ScholarPubMed
5.American Psychiatric Association Practice Guidelines for the Treatment of Schizophrenia. Washington, DC: American Psychiatric Association; 1997.Google Scholar
6.Bebbington, P, Kuipers, L. The predictive utility of expressed emotion in schizophrenia: an aggregate analysis. Psychol Med. 1994;24:707718.CrossRefGoogle ScholarPubMed
7.Randolph, ET, Eth, S, Glynn, SM, et al.Behavioural management in schizophrenia. Outcome of a clinic-based intervention. Br J Psychiatry. 1994;164:501506.CrossRefGoogle ScholarPubMed
8.Anderson, CM, Reiss, DJ, Hogarty, GE. Schizophrenia and the Family. New York, NY Guildford; 1986.Google Scholar
9.Pharoah, FM, Rathbone, J, Mari, JJ, Streiner, D. Family intervention for schizophrenia (Cochrane Review). In: The Cochrane Library. Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.Google Scholar
10.Dixon, LB, Lehman, AF. Family interventions for schizophrenia. Schizophr Bull. 1995;21:7392.CrossRefGoogle ScholarPubMed
11.Dixon, LB, Adams, C, Lucksted, A. Update on family psychoeducation for schizophrenia. Schizophr Bull. 2000;26:520.CrossRefGoogle ScholarPubMed
12.Baucom, DH, Shoham, V, Mueser, KT, Daiuto, AD, Stickle, TR. Empirically supported couple and family interventions for marital distress and adult mental health problems. J Consult Clin Psychol. 1998;66:5388.CrossRefGoogle ScholarPubMed
13.Falloon, IRH, Boyd, JL, McGill, CW. Family Care of Schizophrenia: A Problem-Solving Approach to the Treatment of Mental Illness. New York, NY: Guildford; 1984.Google Scholar
14.Falloon, IR, Boyd, JL, McGill, CW, Razani, J, Moss, HB, Gilderman, AM. Family management in the prevention of exacerbations of schizophrenia: a controlled study. N Engl J Med. 1982;306:14371440.CrossRefGoogle ScholarPubMed
15.Falloon, IRH, Penderson, J. Family management in the prevention of morbidity of schizophrenia: the adjustment of the family unit. Br J Psychiatry. 1985;147:156163.CrossRefGoogle ScholarPubMed
16.Zastowny, TR, Lehman, AF, Cole, RE, Kane, C. Family management of schizophrenia: A comparison of behavioral and supportive family treatment. Psychiatr Q. 1992;63:159186.CrossRefGoogle ScholarPubMed
17.Hogarty, GE, Anderson, CM, Reiss, DJ, et al.Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia. I. One-year effects of a controlled study on relapse and expressed emotion. Arch Gen Psychiatry. 1986;43:633642.CrossRefGoogle Scholar
18.Hogarty, GE, Anderson, CM, Reiss, DJ, et al.Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia. II. Two-year effects of a controlled study on relapse and adjustment. Environmental-Personal Indicators in the Course of Schizophrenia (EPICS) Research Group. Arch Gen Psychiatry. 1991;48:340347.CrossRefGoogle Scholar
19.Leff, J. Working with families of schizophrenic patients. Br J Psychiatry. 1994;164(suppl 23):7176.CrossRefGoogle Scholar
20.Leff, J, Berkowitz, R, Shavit, N, Strachan, A, Glass, I, Vaughn, C. A trial of family therapy v. a relatives group for schizophrenia. Br J Psychiatry. 1989;154:5866.CrossRefGoogle Scholar
21.Leff, J, Berkowitz, R, Shavit, N, Strachan, A, Glass, I, Vaughn, C. A trial of family therapy versus a relatives' group for schizophrenia. Two-year follow-up. Br J Psychiatry. 1990;157:571577.CrossRefGoogle Scholar
22.McFarlane, WR. Multifamily Groups in the Treatment of Severe Psychiatric Disorders. New York, NY: Guilford Press; 2002.Google Scholar
23.McFarlane, WR, Lukens, E, Link, B, et al.Multiple-family groups and psychoeducation in the treatment of schizophrenia. Arch Gen Psychiatry. 1995;52:679688.CrossRefGoogle ScholarPubMed
24.Dyck, DG, Short, RA, Hendryx, MS, et al.Management of negative symptoms among patients with schizophrenia attending multiple-family groups Psychiatr Serv. 2000;51:513519.CrossRefGoogle ScholarPubMed
25.McFarlane, WR, Dushay, RA, Deakins, SM, et al.Employment outcomes in family-aided assertive community treatment. Am J Orthopsychiatry. 2000;70:203214.CrossRefGoogle ScholarPubMed
26.Miklowitz, DJ, Goldstein, MJ. Bipolar Disorder: A Family Focused Approach. New York, NY: Guilford Press; 1997.Google Scholar
27.Miklowitz, DJ, George, EL, Richards, JA, Simoneau, TL, Suddath, RL. A randomized study of family-focused psychoeducation and pharmacotherapy in the outpatient management of bipolar disorder. Arch Gen Psychiatry. 2003;60:904912.CrossRefGoogle ScholarPubMed
28.Rea, MM, Tompson, MC, Miklowitz, DJ, Goldstein, MJ, Hwang, S, Mintz, J. Family-focused treatment versus individual treatment for bipolar disorder: results of a randomized clinical trial. J Consult Clin Psychol. 2003;71:482492.CrossRefGoogle ScholarPubMed
29.Emanuels-Zuurveen, L, Emmelkarnp, PM. Spouse-aided therapy with depressed patients. Behav Modif. 1997;21:6277.CrossRefGoogle ScholarPubMed
30.Van Noppen, B. Multi-family behavioral treatment for OCD crisis intervention and time-limited treatment. Crisis Intervention and Time-Limited Treatment. 1999;5:324.Google Scholar
31.Glynn, SM, Eth, S, Randolph, ET, et al.A test of behavioral family therapy to augment exposure for combat-related posttraumatic stress disorder. J Consult Clin Psychol. 1999;67:243251.CrossRefGoogle ScholarPubMed
32.Gunderson, JG, Berkowitz, C, Ruiz-Sancho, A. Families of borderline patients: a psychoeducational approach. Bull Menninger Clin. 1997;61:446457.Google ScholarPubMed
33.Solomon, P. Moving from psychoeducation to family education for families of adults with serious mental illness. Psychiatr Serv. 1996;47:13641370.Google ScholarPubMed
34.Solomon, P, Draine, J, Mannion, E, Meisel, M. Impact of brief family psychoeducation on self-efficacy. Schizophr Bull. 1996;22:4150.CrossRefGoogle ScholarPubMed
35.Sherman, MD. The Support and Family Education (SAFE) program: mental health facts for families. Psychiatr Serv. 2003;54:3537.CrossRefGoogle ScholarPubMed
36.Wynne, LC. The rationale for consultation with the families of schizophrenic patients. Acta Psychiatr Scan. 1994;90(suppl 384):125132.CrossRefGoogle Scholar
37.Burland, JF. Family-to-family: a trauma-and-recovery model of family education. New Dir Ment Health Serv. 1998;77:3344.CrossRefGoogle Scholar
38.Dixon, L, Stewart, B, Burland, J, Delahanty, J, Lucksted, A, Hoffman, M. Pilot study of the effectiveness of the family-to-family education program. Psychiatr Serv. 2001;52:965967.CrossRefGoogle ScholarPubMed
39.Dixon, L, Lucksted, A, Stewart, B, et al.Outcomes of the peer-taught 12-week family-to-family education program for severe mental illness. Acta Psychiatr Scan. 2004;109:207215.CrossRefGoogle ScholarPubMed
40.McFarlane, WR, Dixon, L, Lukens, E, Lucksted, A. Family psychoeducation and schizophrenia: a review of the literature. J Marital Fam Ther. 2003;29:223245.CrossRefGoogle ScholarPubMed
41.Mingyuan, Z, Hequin, Z, Chengde, Y, et al.Effectiveness of psychoeducation of relatives of schizophrenic patients: a prospective cohort study in five cities of China. Int J Ment Health. 1993;22:4759.CrossRefGoogle Scholar
42.Xiang, MG, Ran, MS, Li, SG. A controlled evaluation of psychoeducational family intervention in a rural Chinese community. Br J Psychiatry. 1994;165:544548.CrossRefGoogle Scholar
43.Telles, C, Karno, M, Mintz, J, et al.Immigrant families coping with schizophrenia. Behavioral family intervention v. case management with a low-income Spanish-speaking population. Br J Psychiatry. 1995;167:473479.CrossRefGoogle ScholarPubMed
44.Bae, SW, Kung, WW. Family intervention for Asian-Americans with a schizophrenic patient in the family. Am J Orthopsychiatry. 2000;70:532541.CrossRefGoogle ScholarPubMed
45.Montero, I, Gomez Beneyto, M, Ruiz, I, et al.Two strategies for family intervention in schizophrenia: a randomized trial in a Mediterranean environment. Schizophr Bull. 2001;27:661670.CrossRefGoogle Scholar
46.Resnick, SG, Rosenheck, RA, Lehman, AF. An exploratory analysis of correlates of recovery. Psychiatr Serv. 2004;55:540547.CrossRefGoogle ScholarPubMed
47.Schooler, NR, Keith, SJ, Severe, JB, et al.Relapse and rehospitalization during maintenance treatment of schizophrenia. The effects of dose reduction and family treatment. Arch Gen Psychiatry. 1997;54:453463.CrossRefGoogle ScholarPubMed
48.Dixon, L, McFarlane, WR, Lefley, H, et al.Evidence-based practices for services to families of people with psychiatric disabilities. Psychiatr Serv. 2001;52:903910.CrossRefGoogle ScholarPubMed
49.Dixon, L, Adams, C, Lucksted, A. Update on family psychoeducation for schizophrenia. Schizophr Bull. 2000;26:520.CrossRefGoogle ScholarPubMed