Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-22T07:11:06.076Z Has data issue: false hasContentIssue false
  • English
  • Français

Relatives and Patients as Partners in the Management of Schizophrenia

The Development of a Service Model

Published online by Cambridge University Press:  02 January 2018

Jo Smith  and
Max Birchwood
Jo Smith
Affiliation:
Department of Clinical Psychology, All Saints' Hospital, Lodge Road, Winson Green, Birmingham B18 5SD, and University of Birmingham
Max Birchwood*
Affiliation:
Department of Clinical Psychology, All Saints' Hospital, Lodge Road, Winson Green, Birmingham B18 5SD, and University of Birmingham
*
∗Correspondence
Get access Rights & Permissions [Opens in a new window]

Abstract

Considerable advances have been made in the family management of schizophrenia but there remains a major challenge for the psychiatric services to integrate these innovations into clinical practice. A number of important issues need to be considered in developing routine clinical services: the problem of engaging families in a therapeutic programme; the utility of the concept of ‘expressed emotion’; and procedures for clinical practice. The latter include the needs of low-EE families; maintaining quality of intervention in a clinical context; responding to the multiplicity of needs of the patient and family; and integrating family interventions with ongoing rehabilitation practice. A model of service provision is described.

Type
Lecture
Information
The British Journal of Psychiatry , Volume 156 , Issue 5 , May 1990 , pp. 654 - 660
Copyright
Copyright © Royal College of Psychiatrists, 1990 

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.)

Footnotes

Based on a paper presented to the World Congress in Behaviour Therapy, Edinburgh, 1988.

References

Birchwood, M. J. (1983) Family coping behaviour and course of schizophrenia; a two year follow-up study. Unpublished PhD thesis, University of Birmingham.Google Scholar
Birchwood, M. J. (1986) The control of auditory hallucinations through occlusion of monaural auditory input. British Journal of Psychiatry, 149, 104–107.CrossRefGoogle ScholarPubMed
Birchwood, M. J. & Smith, J. (1987a) Expressed emotion and first episodes of schizophrenia. British Journal of Psychiatry, 152, 859–860.Google Scholar
Birchwood, M. J. & Smith, J. (1987b) Schizophrenia and the family. In Coping with Disorder in the Family (ed. Orford, J.). Beckenham: Croom Helm.Google Scholar
Birchwood, M., Hallett, S. & Preston, M. (1988) Schizophrenia: An Integrated Approach to Research and Treatment. London: Longman.Google Scholar
Birchwood, M., Smith, J., MacMillan, J. F., et al (1989) Predicting relapse in schizophrenia: the development of an ‘early signs’ warning system using patients and families as observers. Psychological Medicine, 19, 649–656.CrossRefGoogle Scholar
Birchwood, M. & Preston, M. (1990) Schizophrenia. In Clinical Problems: A Cognitive-Behavioural Approach (eds Dryden, W., Howells, K. & Rentoul, R.). London: Methuen.Google Scholar
Brown, G. W., Birley, J. L. T. & Wing, J. K. (1972) Influence of family life on the course of schizophrenic disorders: a replication. British Journal of Psychiatry, 121, 241–258.Google Scholar
Creer, C. & Wing, J. K. (1973) Schizophrenia in the Home. Surbiton, Surrey: National Schizophrenia Fellowship.Google Scholar
Dulz, B. & Hand, I. (1986) Short term relapse in young schizophrenics: can it be predicted and affected by family, patient and treatment? An experimental study. In Treatment of Schizophrenia: Family Assessment and Intervention (eds Goldstein, M., Hand, I. & Halweg, K.). Berlin: Springer.Google Scholar
Falloon, I. R. H. (1988) Expressed emotion: current status, Psychological Medicine, 18, 269–274.Google Scholar
Falloon, I. R. H., Boyd, J. L., McGill, C. W., et al (1985) Family management in the prevention of morbidity of schizophrenia: clinical outcome of a two year longitudinal study. Archives of General Psychiatry, 42, 887–896.CrossRefGoogle ScholarPubMed
Falloon, I. R. H. & Penderson, J. (1985) Family management in the prevention of morbidity of schizophrenia: the adjustment of the family unit. British Journal of Psychiatry, 144, 70–77.Google Scholar
Gibbons, J. S., Horn, S. H., Powell, J. M., et al (1984) Schizophrenic patients and their families: a survey in a psychiatric service based in a DGH unit. British Journal of Psychiatry, 144, 70–77.Google Scholar
Goldstein, M. J. & Kopeikin, H. S. (1981) Short and long term effects of combining drug and family therapy. In New Developments in Interventions with Families of Schizophrenics (ed Goldstein, M. J.). San Francisco: Jossey-Bass.Google Scholar
Hatfield, A. B. (1979) The family as a partner in the treatment of mental illness. Hospital and Community Psychiatry, 30, 338–346.Google ScholarPubMed
Hatfield, A. B. (1987) The expressed emotion theory: why families object. Hospital and Community Psychiatry, 30, 338–341.Google Scholar
Hatfield, A. B., Spaniol, L. & Zipple, A. M. (1987) Expressed emotion: a family perspective. Schizophrenia Bulletin, 13, 221–226.CrossRefGoogle ScholarPubMed
Hogarty, G. E., Anderson, C. M., Reiss, D. J., et al (1986) Family psychoeducation, social skills training and maintenance chemotherapy in the aftercare treatment of schizophrenia. Archives of General Psychiatry, 43, 633–642.CrossRefGoogle ScholarPubMed
Johnstone, E. C., Owens, D. G. C., Gold, A., et al (1984) Schizophrenic patients discharged from hospital: a follow-up study. British Journal of Psychiatry, 145, 586–590.CrossRefGoogle ScholarPubMed
Kantor, J., Lamb, R. & Loeper, C. (1987) Expressed emotion in families: a critical review. Hospital and Community Psychiatry, 38, 374–380.Google Scholar
Kottgen, C., Sonnichsen, I., Mollenhauer, K., et al (1984) Group therapy with families of schizophrenic patients: results of the Hamburg Camberwell family interview study III. Journal of Family Psychiatry, 5, 84–94.Google Scholar
Kuipers, L. & Bebbington, P. (1985) Relatives as a resource in the management of functional illness. British Journal of Psychiatry, 141, 121–134.Google Scholar
Kuipers, L. & Bebbington, P. (1988) Expressed emotion research in schizophrenia: theoretical and clinical implications: Psychological Medicine, 18, 893–909.Google Scholar
Leff, J., Kuipers, L., Berkowitz, R., et al (1982) A controlled trial of social intervention in the families of schizophrenic patients. British Journal of Psychiatry, 141, 121–134.Google Scholar
Leff, J. & Vaughn, C. (1985) Expressed Emotion in Families. London: The Guildford Press.Google Scholar
Leff, J., Berkowitz, R., Shavit, N., et al (1989) A trial of family therapy v. a relatives group for schizophrenia. British Journal of Psychiatry, 154, 58–66.CrossRefGoogle Scholar
Smith, J. & Birchwood, M. (1985) Understanding Schizophrenia, vols I–IV. West Birmingham Health Authority: Health Promotion Unit. Google Scholar
Smith, J. & Birchwood, M. (1987) Specific and non-specific effects of an educational intervention with families living with a schizophrenic relative. British Journal of Psychiatry, 150, 645–652.CrossRefGoogle ScholarPubMed
Tarrier, N., Barrowclough, C., Vaughn, C., et al (1988) A controlled trial of behavioural intervention with families to reduce relapse. British Journal of Psychiatry, 153, 532–542.Google Scholar
Vaughn, C. E. (1986) Patterns of emotional response in the families of schizophrenic patients. In Treatment of Schizophrenia: Family Assessment and Intervention (eds Goldstein, M. J., Hand, I. & Halweg, K.). Berlin: Springer-Verlag.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.