Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-18T08:50:49.521Z Has data issue: false hasContentIssue false

Behavioural Family Interventions in the Management of Schizophrenia: A Review

Published online by Cambridge University Press:  06 October 2014

Mark Dadds*
Affiliation:
University of Queensland
Roger Dooley
Affiliation:
The Prince Charles Hospital, Queensland
Ken Pakenham
Affiliation:
Division of Psychiatric Services, Queensland
*
Department of Psychology, University of Queensland, St. Lucia, Qld. 4067
Get access

Abstract

A change has taken place in the role ascribed families in the treatment of schizophrenia. Rather than being implicated etiologically, families are seen more as the natural support system in preventing relapse of schizophrenic illness after discharge from hospital. The factors predicting relapse are reviewed including expressed emotion, communication deviance and medication compliance. From these, a set of objectives for treatment have been derived and the behavioural family intervention programme of Falloon and Liberman is described. Outcome research on the efficacy of this and the psychoeducational family approaches show short term benefits in relapse prevention and symptom amelioration but that more long term follow up data are needed. Further research also needs to address the relationship between outcome, specific treatment modality, medication use and the behavioural disturbance of the patient.

Type
Articles
Copyright
Copyright © The Author(s) 1985

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

Anderson, C.M. (1983). A psychoeducation-al program for families of patients with schizophrenia. In McFarlane, W.R. (Ed.), Family therapy in schizophrenia. New York: Guilford Press.Google Scholar
Anderson, C.M., Hogarty, G., & Reiss, D.J. (1981). The psychoeducational family treatment of schizophrenia. In Goldstein, M.J., (Ed.), New developments in interventions with families of schizophrenics. San Francisco: Jossey-Bass.Google Scholar
Bateson, G., Jackson, D.D., Haley, J., & Weakland, J. (1956). Toward a theory of schizophrenia. Behavioural Science, 4, 241264.Google Scholar
Brown, G.W., Birley, J.T., & Wing, J.K. (1972). Influence of family life on the course of schizophrenic disorders: A replication. British Journal of Psychiatry, 121, 241258.CrossRefGoogle ScholarPubMed
Brown, G.W., & Rutter, M. (1966). The measurement of family activities and relationships: A methodological study. Human Relations, 19, 241263.Google Scholar
Creer, C. (1978). Social work with patients and their families. In Wing, J. (Ed.), Schizophrenia: Toward a new synthesis. New York: Grune and Stratton.Google Scholar
Creer, C., & Wing, J. (1974). Schizophrenia at home. London: Institute of Psychiatry.Google Scholar
Doll, W. (1976). Family coping with the mentally ill: An unanticipated problem of deinstitutionalization. Hospital and Community Psychiatry, 27, 183185.Google Scholar
Dooley, R.T. & Dadds, M.R. (1985). Issues in the reciprocal influence of schizophrenia and the family. Proceedings of the 8th National Conference of the Australian Behaviour Modification Association, Melbourne.Google Scholar
Doane, J.A., West, K.L., Goldstein, M.J., Rodnick, E.H., & Jones, J.E. (1983). Parental communication deviance and affective style: Predictors of subsequent spectrum disorders in vulnerable adolescents. Archives of General Psychiatry, 38, 679685.Google Scholar
D'Zurilla, T.J., & Goldfried, M.R. (1971). Problem solving and behavior modification. Journal of Abnormal Psychology, 78, 107126.CrossRefGoogle ScholarPubMed
Evans, J.R., Rodnick, E.H., Goldstein, M.J., & Judd, L.L. (1972). Premorbid adjustment, phenothiazine treatment and remissions in acute schizophrenics. Archives of General Psychiatry, 27, 486490.CrossRefGoogle ScholarPubMed
Falloon, I.R.H. (1981). Communication and problem solving skills training with relapsing schizophrenics and their families. In Lansky, M.R. (Ed.), Family therapy and majorpsy-chopathology. New York: Grune and Stratton.Google Scholar
Falloon, I.H., Boyd, J.L., & McGill, C.W. (1982). Behavioral family therapy for schizophrenia. In Curran, J.P. & Monti, P.M. (Eds), Social skills training: A practical handbook for assessment and treatment. New York: Guilford Press.Google Scholar
Falloon, I.H., Boyd, J.L., McGill, C.W., Razani, J., Moss, H.B., & Gilderman, A.M. (1982). Family management in the prevention of exacerbations of schizophrenia: A controlled study. New England Journal of Medicine, 306, 14371440.Google Scholar
Falloon, I.H., & Liberman, R.P. (1983). Behavioral family interventions in the management of chronic schizophrenia. In McFarlane, W.R. (Ed.), Family therapy in schizophrenia. New York: Guilford Press.Google Scholar
Falloon, I.H., Liberman, R.P., Lillie, F.J., & Vaughn, C. (1981). Family therapy with relapsing schizophrenics and their families: A pilot study. Family Process, 20, 211221.Google Scholar
Goldstein, M.J., & Doane, J.A. (1982). Family factors in the onset, course, and treatment of schizophrenic spectrum disorders: An update on current research. The Journal of Nervous and Mental Disease, 170, 692700.CrossRefGoogle ScholarPubMed
Goldstein, M.J., & Kopeikin, H.S. (1981). Short- and long-term effects of combining drug and family therapy. In Goldstein, M.J. (Ed), New developments in interventions with families of schizophrenics. San Francisco: Jossey-Bass.Google Scholar
Goldstein, M.J., Rodnick, E.H., Evans, J.R., May, P.A., & Steinberg, M. (1978). Drug and family therapy in the aftercare of acute schizophrenics. Archives of General Psychiatry, 35, 11691177.CrossRefGoogle ScholarPubMed
Hatfield, A. (1978). Psychological costs of schizophrenia to the family. Social Work, 23, 355359.Google ScholarPubMed
Hatfield, A. (1979). Help seeking behavior in families of schizophrenics. American Journal of Community Psychology, 7, 563569.Google Scholar
Hatfield, A.B. (1983). What families want from family therapists. In McFarlane, W.R. (Ed.), Family therapy in schizophrenia. New York: Guildford Press.Google Scholar
Herman, B.F., & Jones, J.E. (1976). Lack of acknowledgment in the family Rorschachs of families with a child at risk for schizophrenia. Family Process, 15, 289302.Google Scholar
Holden, D., & Lewine, R. (1979). Families of schizophrenic individuals: An evaluation of mental health professionals, resources, and the effects of schizophrenia. Chicago: Illinois State Psychiatric Institute.Google Scholar
Jones, J.E. (1977). Patterns of transactional style deviance in the T. A. T.'s of parents of schizophrenics. Family Process, 16, 327337.CrossRefGoogle Scholar
King, C.E., & Goldstein, M.J. (1979). Therapist ratings of achievement of objectives in psychotherapy with acute schizophrenia. Schizophrenia Bulletin, 5, 118129.Google Scholar
Leff, J.P. (1976). Schizophrenia and sensitivity to the family environment. Schizophrenia Bulletin, 2, 566574.CrossRefGoogle Scholar
Leff, J., Kuipers, L., Berkowitz, R., Eberlein-Vries, R., & Sturgeon, D. (1982). A controlled trial of social intervention in the families of schizophrenic patients. British Journal of Psychiatry, 141, 121134.Google Scholar
Leff, J., & Wing, J.K. (1971). Trial of maintenance therapy in schizophrenia. British Medical Journal, iii, 599604.Google Scholar
Liem, J.H. (1974). Effects of verbal communications of parents and children: A comparison of normal and schizophrenic families. Journal of Consulting and Clinical Psychology, 42, 438450.Google Scholar
Liem, J.H. (1980). Family studies of schizophrenia: An update and commentary. Schizophrenia Bulletin, 6, 429455.Google Scholar
Marshall, V., & Goldstein, M.J. (1981). Crisis-oriented family therapy with acute schizophrenics, Unpublished Master's Thesis, University of California at Los Angeles.Google Scholar
Palazzoli, M.S., Bascolo, L., Cecchin, G., & Prata, G. (1978). Paradox and counter paradox: A new model in the therapy of the family in schizophrenic transaction. New York: Jason Aronson.Google Scholar
Scheflen, A. (1981). Levels of schizophrenia. New York: Brunner/Mazel.Google Scholar
Sokolovsky, J. (1978). Personal networks of ex-mental patients in a Manhattan SRO Hotel. Human Organization, 37, 515.Google Scholar
Strang, J.S., Falloon, I.H., Moss, H.B., Razani, J., & Boyd, J.L. (1981). The effects of family therapy on treatment compliance in schizophrenia. Psychopharmacology Bulletin, 17, 8788.Google Scholar
Sturgeon, D., Kuipers, L., Berkowitz, R., Turpin, G., & Leff, J.P. (1981). Psychophysiological responses of schizophrenic patients to high and low expressed emotion relatives. British Journal of Psychiatry, 138, 4045.CrossRefGoogle ScholarPubMed
Tarrier, N., Vaughn, C.E., Lader, M.H., & Leff, J.P. (1979). The reactions to people and events in schizophrenics. Archives of General Psychiatry, 36, 311315.Google Scholar
Van Putten, T. (1974). Why do schizophrenic patients refuse to take their drugs? Archives of General Psychiatry, 31, 6772.CrossRefGoogle ScholarPubMed
Vaughn, C.E., & Leff, J.P. (1976). The influence of family and social factors on the course of psychiatric illness. A comparison of schizophrenic and depressed patients. British Journal of Psychiatry, 129, 125137.Google Scholar
Vaughn, C.E., Snyder, K.S., Freeman, W., Jones, S., Falloon, I.R.H., & Liberman, R.P. (1982). Family factors in schizophrenic relapse: A replication. Schizophrenia Bulletin, 8, 425426.Google Scholar
Walsh, F.W. (1979). Breaching of family generation boundaries by schizophrenics, disturbed non-schizophrenics and normals. International Journal of Family Therapy, 1, 254275.CrossRefGoogle Scholar
Wing, J.K. (1978). Social influences on the course of schizophrenia. In Wynne, L.C., Cromwell, R.L., & Matthysse, S. (Eds.), The nature of schizophrenia: New approaches to research and treatment. New York: Wiley.Google Scholar
Wild, C.M., Shapiro, L.N., & Abelin, T. (1977). Communication patterns and role structure in families of male schizophrenics. Archives of General Psychiatry, 34, 5870.Google Scholar
Wynne, L.C., Singer, M.T., Bartko, J.J., & Toohey, M.L. (1977). Schizophrenics and their families: Research on parental communication. In Tanner, J.M. (Ed.), Developments in psychiatric research. London: Hodder and Stoughton.Google Scholar
Zubin, J., Magaziner, J., & Steinhauer, S.R. (1983). The metamorphosis of schizophrenia: From chronicity to vulnerability. Psychological Medicine, 13, 551571.Google Scholar