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Some Aspects of Family Interventions in Schizophrenia. II: Financial Considerations

Published online by Cambridge University Press:  02 January 2018

Nicholas Tarrier ,
Karen Lowson  and
Christine Barrowclough
Nicholas Tarrier*
Affiliation:
Merseyside Health Authority, PCIST, Arrow Park Hospital, Merseyside
Karen Lowson
Affiliation:
Merseyside Health Authority, PCIST, Arrow Park Hospital, Merseyside
Christine Barrowclough
Affiliation:
Department of Psychology, University of New South Wales
*
∗Professor of Clinical Psychology, University Hospital of South Manchester, Withington, Manchester
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Abstract

The direct costs to the mental health services for patients who participated in a trial of a behavioural family intervention to reduce schizophrenic relapse were estimated. Comparisons were made between two patient groups from households of high expressed emotion (HEE): one group received a nine-month family intervention (HEE Intervention) and the other group routine treatment (HEE Control). A third group consisted of patients from low-EE households (LEE Control). The significant decrease in relapse rates in the HEE Intervention group compared with the HEE Control group has previously been reported; the analysis of costs indicates that any increase in costs due to the family intervention is outweighed by a decrease in usage of the established mental health services. The intervention resulted in a decrease of 27% in mean cost per patient.

Type
Papers
Information
The British Journal of Psychiatry , Volume 159 , Issue 4 , October 1991 , pp. 481 - 484
Copyright
Copyright © 1991 The Royal College of Psychiatrists 

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References

Aizen, I. & Fishbein, M. (1980) Understanding Attitudes and Predicting Behavior. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
Backer, T. E. & Richardson, D. (1989) Building bridges: Psychologists and the families of the mentally ill. American Psychologist, 44, 546–550.CrossRefGoogle ScholarPubMed
Barrowclough, C., Tarrier, N., Watts, S., et al (1987) Assessing the functional value of relatives' reported knowledge about schizophrenia. British Journal of Psychiatry, 151, 1–8.CrossRefGoogle ScholarPubMed
Barrowclough, C. & Tarrier, N. (1990) Social functioning in schizophrenic patients. 1: The effect of expressed emotion and family intervention. Social Psychiatry and Psychiatric Epidemiology, 25, 125–129.CrossRefGoogle Scholar
Barrowclough, C. & Tarrier, N. (1991) Interventions with families. In Psychological Approaches to Schizophrenia: Innovations in Assessment, Treatment and Services (eds Birchwood, M. & Tarrier, N.). Chichester: Wiley (in press).Google Scholar
Becker, M. H. & Maiman, L. A. (1975) Sociobehavioral determinants of compliance with health and medical care recommendations. Medical Care, 13, 10–24.CrossRefGoogle ScholarPubMed
Bernheim, K. F. (1989) Psychologists and the families of the severely mentally ill. The role of family consultant. American Psychologist, 44, 561–564.CrossRefGoogle Scholar
Cardin, V. A., McGill, C. W. & Falloon, I. R. H. (1986) An economic analysis: Costs, benefits and effectiveness. In Family Management of Schizophrenia (ed. Falloon, I. R. H.). Baltimore: Johns Hopkins University Press.Google Scholar
Cass, Y. & Lapsley, H. (1983) The costing study. In Psychiatric Hospital Versus Community Treatment: A Controlled Study. Sydney, New South Wales: Department of Health.Google Scholar
Cheek, F. E., Laucius, J., Mahnoke, M., et al (1971) A behaviour modification training programme for parents of convalescent schizophrenics. In Advances in Behavior Therapy, Vol. 3 (ed. Rubin, R.). New York: Academic.Google Scholar
Emmelkamp, P. M. G. & Foa, E. B. (1983) Failures as a challenge. In Failures in Behavior Therapy (eds Foa, E. B. & Emmelkamp, P. M. B.). New York: Wiley.Google Scholar
Fadden, G. Kuipers, L. & Bebbington, P. (1987) The burden of care: The impact of functional psychiatric illness on the patients' family. British Journal of Psychiatry, 150, 285–292.CrossRefGoogle Scholar
Falloon, I. R. H. (1988) Expressed emotion: current status. Psychological Medicine, 18, 269–274.CrossRefGoogle ScholarPubMed
Falloon, I. R. H., Boyd, J. L. & McGill, C. W. (1984) Family Care of Schizophrenia. New York: Guilford Press.Google Scholar
Feuerstein, M., Labbe, E. E. & Kuczmierczyk, A. R. (1986) Health Psychology: A Psychobiological Perspective. New York: Plenum.CrossRefGoogle Scholar
Foa, E. B. & Emmelkamp, P. M. B. (eds) (1983) Failures in Behavior Therapy. New York: Wiley.Google Scholar
Gaines, T. & Stedman, N. (1981) Factors associated with dropping out of child and family treatment. American Journal of Family Therapy, 9, 45–51.CrossRefGoogle Scholar
Garfield, S. L. (1980) Psychotherapy: An Eclectic Approach. New York: Wiley.Google Scholar
Hafner, H. & van der Heiden, W. (1989) The evaluation of mental health care systems. British Journal of Psychiatry, 155, 12–17.CrossRefGoogle ScholarPubMed
Hatfield, A. B., Spaniol, L. & Zipple, A. M. (1987) Expressed emotion: a family perspective. Schizophrenia Bulletin, 13, 221–226.CrossRefGoogle ScholarPubMed
Hawton, K., Salkovskis, P. M., Kirk, J., et al (1989) Cognitive Behaviour Therapy for Psychiatric Problems. Oxford: Oxford University Press.Google Scholar
Hogarty, G., Anderson, C. M., Reiss, D. J., et al (1986) Family psychoeducation, social skills training and maintenance chemotherapy in the aftercare treatment of schizophrenia. 1: One-year effects of a controlled study on relapse and expressed emotion. Archives of General Psychiatry, 43, 633–642.CrossRefGoogle Scholar
Hoult, J. (1986) Community care of the acutely mentally ill. British Journal of Psychiatry, 149, 137–144.CrossRefGoogle ScholarPubMed
Hudson, B. (1975) A behaviour modification project with chronic schizophrenic patients in the community. Behaviour Research and Therapy, 13, 339–341.CrossRefGoogle Scholar
Kingston, P. (1984) ‘But they aren't motivated …' Issues concerned with encouraging motivation for change in families. Journal of Family Therapy, 6, 381–403.CrossRefGoogle Scholar
Kuipers, L. & Bebbington, P. (1988) Expressed emotion research in schizophrenia. Psychological Medicine, 18, 893–909.CrossRefGoogle ScholarPubMed
Leff, J. & Vaughn, C. (1985) Expressed Emotion in Families: Its Significance for Mental Illness. New York: Guilford.Google Scholar
Leff, J., Berkowitz, R., Shavit, A., et al (1989) A trial of family therapy v. a relatives group for schizophrenia. British Journal of Psychiatry, 154, 58–66.CrossRefGoogle Scholar
Lefley, H. P. (1989) Family burden and family stigma in major mental illness. American Psychologist, 44, 556–560.CrossRefGoogle ScholarPubMed
Marks, I. (1978) Behavioural psychotherapy of adult neurosis. In Handbook of Psychotherapy and Behavior Change (eds Garfield, S. L. & Bergin, A. E.). New York: Wiley.Google Scholar
MacCarthy, B., Benson, J. & Brewin, C. (1986) Task motivation and problem appraisal in long term psychiatric patients. Psychological Medicine, 16, 431–438.CrossRefGoogle ScholarPubMed
MacCarthy, B., Kuipers, L., Harper, R., et al (1989) Counselling the relatives of the long-term adult mentally ill. I: Evaluation of the impact on relatives and patients. British Journal of Psychiatry, 154, 768–774.CrossRefGoogle ScholarPubMed
McCune, N. (1988) Behavioural family intervention in schizophrenia: A case study. Behavioural Psychotherapy, 16, 329–334.CrossRefGoogle Scholar
McIntyre, K., Farrell, M. & David, A. (1989) In-patient psychiatric care: The patient's view. British Journal of Medical Psychology, 62, 249–255.CrossRefGoogle ScholarPubMed
Meichenbaum, D. & Turk, D. (1987) Facilitating Treatment Adherence. New York: Plenum.CrossRefGoogle Scholar
Nelson, R. O. & Hayes, S. C. (1986) Conceptual Foundations of Behavioural Assessment. New York: Guilford Press.Google Scholar
Nelson, A. A., Gold, B., Hutchinson, R. A., et al (1975) Drug default among schizophrenic patients. American Journal of Hospital Pharmacy, 42, 1237–1242.Google Scholar
Rodin, J. & Salovey, P. (1989) Health psychology. Annual Review of Psychology, 40, 533–579.CrossRefGoogle ScholarPubMed
Salford Health Authority (1988) Annual Accounts—Korner Cost Accounts. Salford: Salford H.A.Google Scholar
Shapiro, R. J. & Budman, S. (1973) Defection, termination, continuation in family and individual therapy. Family Process, 12, 55–67.CrossRefGoogle Scholar
Smith, J. & Birchwood, M. (1987) Education for families with schizophrenic relatives. British Journal of Psychiatry, 150, 645–652.CrossRefGoogle Scholar
Smith, J. & Birchwood, M. (1990) Relatives and patients as partners in the management of schizophrenia: The development of a service model. British Journal of Psychiatry, 156, 654–660.CrossRefGoogle ScholarPubMed
Szmukler, G. I., Eisler, I., Russell, G. F. M., et al (1985) Anorexia nervosa, parental expressed emotion and dropping out of treatment. British Journal of Psychiatry, 147, 265–271.CrossRefGoogle ScholarPubMed
Tarrier, N. & Barrowclough, C. (1986) Providing information to relatives about schizophrenia: Some comments. British Journal of Psychiatry, 149, 458–463.CrossRefGoogle ScholarPubMed
Tarrier, N., Barrowclough, C., Vaughn, C., et al (1988) The community management of schizophrenia: A controlled trial of behavioural intervention with families to reduce relapse. British Journal of Psychiatry, 153, 532–542.CrossRefGoogle ScholarPubMed
Tarrier, N., Barrowclough, C., Vaughn, C., et al (1989) The community management of schizophrenia: A controlled trial of a behavioural intervention with families: Two year follow-up. British Journal of Psychiatry, 154, 625–628.CrossRefGoogle ScholarPubMed
Tarrier, N. & Barrowclough, C. (1990) Family interventions. Behavior Modification, 14, 408–440.CrossRefGoogle ScholarPubMed
Weinstein, N. D. (1988) The precaution adoption process. Health, Psychology, 7, 355–386.CrossRefGoogle ScholarPubMed
Wooff, K., Goldberg, D. P. & Fryers, T. (1988) The practice of community psychiatric nursing and mental health social work in Salford. British Journal of Psychiatry, 152, 783–792.CrossRefGoogle ScholarPubMed
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