Skip to main content Accessibility help

Cognitive-Behavioural Family Interventions for Major Mental Disorders

  • Ian R.H. Falloon (a1) and John H. Coverdale (a1)


Cognitive-behavioural family interventions for major mental disorder have undergone significant refinement over recent years. This paper reviews the current techniques for assessing mental disorder in the family. The initial task of the therapist is to undertake a comprehensive family assessment, including an assessment of their stress management. Specific information must be obtained about each family member's view of the presenting problems, interaction within the family system, and function in settings outside the family, as well as the family's effectiveness in problem solving and quality of life. Key goals of cognitive-behavioural family therapy are personal goal setting, education, and communication training that enhance the efficiency of family problem solving. The efficiency of cognitive-behavioural therapies in treating major mental disorders is also reviewed in relation to the family's ability to achieve specific goals in therapy and to modify the outcome of major mental illness. Particular attention is given to the strengths and weaknesses of the research, and to possible future research directions. Cognitive-behavioural family interventions are found to be effective in reducing clinical, social, and family morbidity.


Corresponding author

Department of Psychiatry and Behavioural Science, University of Auckland, Private Bag 92109, Auckland, New Zealand


Hide All
Barrowclough, C., & Tarrier, N. (1990). Social functioning in schizophrenic patients: I. The effects of expressed emotion and family intervention. Social Psychiatry and Psychiatric Epidemiology, 25, 125129.
Brooker, C., Falloon, I., Butterworth, A., Goldberg, D., Graham-Hole, V., & Hillier, V. (1994). The outcome of training community psychiatric nurses to deliver psychosocial intervention. British Journal of Psychiatry, 165, 222230.
Brooker, C., Tarrier, N., Barrowclough, C., Butterworth, C., & Goldberg, D., (1993). Training community psychiatric nurses to undertake psychosocial intervention: Report of a pilot study. British Journal of Psychiatry, 160, 836844.
Brown, G.W., & Harris, T.O. (1978). Social origins of depression: A study of psychiatric disorder in women. London: Tavistock.
Doane, J.A., Goldstein, M.J., Falloon, I.R.H., & Mintz, J. (1985). Parental affective style and the treatment of schizophrenia: Predicting course of illness and social functioning. Archives of General Psychiatry, 42, 3442.
Doane, J.A., Goldstein, M.J., Miklowitz, D.J., & Falloon, I.R.H. (1986). The impact of individual and family treatment on the affective climate of families of schizophrenics. British Journal of Psychiatry, 148, 279287.
D'Zurilla, T.J., & Goldfried, M.R. (1971). Problem solving and behavior modification. Journal of Abnormal Psychology, 78, 107126.
Falloon, I.R.H. (1985). Family management of schizophrenia. Baltimore: Johns Hopkins University Press.
Falloon, I.R.H. (1992). Early intervention for first episodes of schizophrenia: A preliminary exploration. Psychiatry, 55, 112.
Falloon, I.R.H., & Fadden, G. (1993). Integrated mental health care. Cambridge: Cambridge University Press.
Falloon, I.R.H., Marshall, G.N., Boyd, J.L., Razani, J., & Wood-Siverio, C. (1983). Relapse in schizophrenia: A review of the concept and its definitions. Psychological Medicine, 13, 469477.
Falloon, I.R.H., & Morosini, P.L. (1993). Long-term outcome of optimal clinical management of schizophrenia: An international collaborative study. Research proposal to the European Commission.
Falloon, I.R.H., & Pederson, J. (1985). Family management in the prevention of morbidity of schizophrenia: The adjustment of the family unit. British Journal of Psychiatry, 147, 156163.
Falloon, I.R.H., Shanahan, W., & Laporta, M. (1992). Prevention of major depressive episodes: Early intervention with family-based stress management. Journal of Mental Health, 1, 5360.
Falloon, I.R.H., Watt, D.C., & Shepherd, M. (1978). A comparative controlled trial of pimozide and fluphenazine decanoate in the continuation therapy of schizophrenia. Psychological Medicine, 8, 5970.
Hahlweg, K., Revensdorf, D., & Schindler, L. (1984). Effects of behavioral marital therapy on couples' communication and problem solving skills. Journal of Consulting and Clinical Psychology, 52, 553566.
Hahlweg, K., Wiedemann, G., Muller, U., Feinstein, E., Hank, G., & Dose, M. (1993). Effectiveness of behavioural family management in combination with standard dose or target medication to prevent relapse in schizophrenia. Unpublished manuscript.
Held, T., (1994). Schizophrenic behandlung in der Familie. Unpublished dissertation, Rheinischen Landersklinik, Bonn.
Hogarty, G.E., Anderson, C.M., Reiss, D.J., Kornblith, S.J., Greenwald, D.P., Javna, C.D., & Madonia, M.J. (1986). Family psycho-education, social skills training and maintenance chemotherapy in the aftercare treatment of schizophrenia. Archives of General Psychiatry, 43, 633642.
Hogarty, G.E., Anderson, C.M., Reiss, D.J., Kornblith, S.J., Greenwald, D.P., Ulrich, R.F., Carter, M., & the EPICS Schizophrenia Research Group. (1991). 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. Archives of General Psychiatry, 48, 340347.
Hogarty, G.E., Schooler, N.R., & Ulrich, R.F. (1979). Fluphenazine and social therapy in the aftercare of schizophrenic patients: Relapse analysis of a two-year controlled trial. Archives of General Psychiatry, 36, 12831294.
Jacobson, N.S., Dobson, K., Fruzzetti, A.E., Schmaling, K.B., & Salusky, S. (1991). Marital therapy as a treatment for depression. Journal of Consulting and Clinical Psychology, 59, 547557.
Kavanagh, D.J. (1992). Family interventions in schizophrenia. In Kavanagh, D.J. (Ed.), Schizophrenia: An overview and practical handbook (pp. 407423). London: Chapman & Hall.
Leff, J., Berkowitz, R., Shavit, R, Strachan, A.S., Glass, I., & Vaughn, C. (1989). A trial of family therapy v. a relatives group for schizophrenia. British Journal of Psychiatry, 154, 5866.
Leff, J., Kuipers, L., Berkowitz, R., Eberlein-Fries, R., & Sturgeon, D. (1982). A controlled trial of social intervention in the families of schizophrenic patients. British Journal of Psychiatry, 141, 121134.
Leff, J.P., & Vaughn, C.E. (1985). Expressed emotion in families. New York: Guilford.
Leff, J.P., & Wing, J.K. (1971). Trial of maintenance therapy in schizophrenia. British Medical Journal, 3, 599604.
Liberman, R.P. (1970). Behavioral approaches to family and couple therapy. American Journal of Orthopsychiatry, 40, 106118.
MacCarthy, B., Kuipers, L., Hurry, J., Harper, R., & LeSage, A. (1989). Counselling relatives of the long-term adult mentally ill: I. Evaluation of the impact on relatives and patients. British Journal of Psychiatry, 154, 768775.
McCreadie, R.G., Phillips, K., Harvey, J.A., Waldron, G., Stewart, M., & Baird, D. (1991). The Nithsdale schizophrenia surveys: VIII. Do relatives want family intervention — and does it help? British Journal of Psychiatry, 158, 110113.
McFarlane, W.R. (1990). Multiple family groups and the treatment of schizophrenia. In Herz, M.I., Keith, S.J., Docherty, J.P. (Eds.), Handbook of schizophrenia: Vol. 4. Psychosocial treatment of schizophrenia (pp. 167189). Amsterdam, Elsevier.
McGill, C.W., Falloon, I.R.H., Boyd, J.L., & Wood-Siverio, C. (1983). Family education interventions in the treatment of schizophrenia. Hospital and Community Psychiatry, 34, 934938.
Miklowitz, D.J., & Goldstein, M.J. (1990). Behavioral family treatment for patients with bipolar affective disorder. Behavior Modification, 14, 457489.
Miklowitz, D.J., Goldstein, M.J., Nuechterlein, K.H., Snyder, K.S., & Mintz, J. (1988). Family factors and the course of bipolar affective disorder. Archives of General Psychiatry, 45, 225231.
Patterson, G.R. (1976). Living with children. Champaign, IL: Research Press.
Paul, G.L. (1967). Strategy of outcome research in psychotherapy. Journal of Consulting and Clinical Psychology, 31, 109118.
Randolph, E.T., Eth, S., Glynn, S.M., Paz, G.G., Leong, G.B., Shaner, A.L., Strachan, A., Van Wort, W., Escobar, J.I., & Liberman, R.P. (1994). Behavioural family management in schizophrenia: Outcome of a clinic-based intervention. British Journal of Psychiatry, 164, 501506.
Schooler, N.R. (06, 1993). The NIMH Treatment Strategies for Schizophrenia study. Paper presented at the World Congress of Psychiatry, Buenos Aires, Brazil.
Stein, L.I., & Test, M.A. (1980). Alternative to mental hospital treatment: I. Conceptual model, treatment program, clinical evaluation. Archives of General Psychiatry, 37, 392397.
Stuart, R.B. (1969). Operant-interpersonal treatment for marital discord. Journal of Clinical and Consulting Psychology, 33, 675682.
Tarrier, N. (1991). Some aspects of family interventions in schizophrenia: I. Adherence to intervention programmes. British Journal of Psychiatry, 154, 625628.
Tarrier, N., Barrowclough, C., Vaughn, C., Bamrah, J., Porceddu, K., Watts, S., & Freeman, H. (1988). The community management of schizophrenia: A controlled trial of behavioural intervention with families to reduce relapse. British Journal of Psychiatry, 153, 532.
Vaughan, K., Doyle, M., McConaghy, N., Fox, A., & Tarrier, N. (1992). The Sydney intervention trial: A controlled trial of relatives' counselling to reduce schizophrenic relapse. Social Psychiatry and Psychiatric Epidemiology, 27, 1621.
Whitfield, W., Taylor, C., Virgo, N. (1988). Family care of schizophrenia. Journal of the Royal Society of Health, 1, 14.


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed