Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-10T13:08:43.189Z Has data issue: false hasContentIssue false
  • English
  • Français

A Trial of Family Therapy versus a Relatives' Group for Schizophrenia

Two-Year Follow-up

Published online by Cambridge University Press:  02 January 2018

J. Leff ,
R. Berkowitz ,
N. Shavit ,
A. Strachan ,
I. Glass  and
C. Vaughn
J. Leff*
Affiliation:
MRC Social and Community Psychiatry Unit, Institute of Psychiatry, De Crespigny Park, London SE5 8AF
R. Berkowitz
Affiliation:
University of California, Los Angeles
N. Shavit
Affiliation:
University of California, Los Angeles
A. Strachan
Affiliation:
University of California, Los Angeles
*
∗Correspondence
Get access Rights & Permissions [Opens in a new window]

Abstract

The results are reported of a two-year follow-up of a trial of family sessions in the home (including patients) (12 families) versus a relatives' group (excluding patients) (11 families). Subjects were patients with schizophrenia living in high face-to-face contact with high-EE relatives. Patients were maintained on neuroleptic drugs for two years where possible. Relatives' critical comments and hostility were significantly lowered by nine months, but no significant changes occurred subsequently. Relatives' overinvolvement reduced steadily throughout the trial, and reduction in relatives' EE, either alone or in combination with reduced face-to-face contact, appeared to be associated with a lower relapse rate. The relapse rates for patients in the family-therapy and relatives’-group streams were 33% and 36% at two years. When these data were combined with the results of a previous trial, it was found that patients in families assigned to any form of social intervention had a two-year relapse rate of 40%, significantly lower than the 75% relapse rate for patients whose families were offered no help. We therefore recommend that relatives' groups are established in conjunction with some family sessions in the home for patients at high risk of relapse.

Type
Papers
Information
The British Journal of Psychiatry , Volume 157 , Issue 4 , October 1990 , pp. 571 - 577
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.)

References

Anderson, C. M., Reiss, D. J. & Hooarty, G. E. (1986) Schizophrenia in the Family: A Practitioner's Guide to Psychoeducation and Management. New York: Guilford Press.Google Scholar
Berkowitz, R., Kuipers, L., Eberlein-Fries, R., et al (1981) Lowering expressed emotion in relatives of schizophrenics. In New Developments in Interventions with Families of Schizophrenics (ed. M. J. Goldstein). London: Jossey-Bass.Google Scholar
Berkowitz, R., Shavit, N. & Leff, J. (1991) Psychosocial interventions with schizophrenic patients and their families. Family Process (in press).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
Dulz, B. & Hand, I. (1986) Short-term relapse in young schizophrenics: can it be predicted and affected by family (CFI), patient and treatment variables? In Treatment of Schizophrenia (eds M. J. Goldstein, I. Hand & K. Hahlweg). Berlin: Springer-Verlag.Google Scholar
Falloon, I. R. H., Boyd, J. L., McGill, C. W., et al (1982) Family management in the prevention of exacerbations of schizophrenia. New England Journal of Medicine, 306, 1437–1440.Google Scholar
Falloon, I. R. H., Williamson, M., Razani, J., et al (1985) Family versus individual management in the prevention of morbidity of schizophrenia: I. Clinical outcome of a two-year controlled study. Archives of General Psychiatry, 42, 887–896.Google Scholar
Goldstein, M. J., Rodnick, E. H., Evans, J. R., et al (1978) Drug and family therapy in the aftercare treatment of acute schizophrenia. Archives of General Psychiatry, 35, 169–177.Google Scholar
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: I. One-year effects of a controlled study on relapse and expressed emotion. Archives of General Psychiatry, 43, 633–642.CrossRefGoogle Scholar
Hogarty, G. E., Anderson, C. M. & Reiss, D. J. (1987) Family psychoeducation, social skills training and medication in schizophrenia: the long and the short of it. Psychopharmacology Bulletin, 23, 12–13.Google Scholar
Leff, J. P. (1985) Family treatment of schizophrenia. In Recent Advances in Clinical Psychiatry (ed. K. Granville-Grossman), no. 5. London: Churchill Livingstone.Google Scholar
Leff, J. P. (1989) Controversial issues and growing points in research on relatives’ expressed emotion. International Journal of Social Psychiatry, 35, 133–145.Google Scholar
Leff, J. P., Kuipers, L., Berkowitz, R., et al (1982) A controlled trial of intervention in the families of schizophrenic patients. British Journal of Psychiatry, 141, 121–134.CrossRefGoogle ScholarPubMed
Leff, J. P., Kuipers, L., Berkowitz, R., et al (1985) A controlled trial of social intervention in the families of schizophrenic patients: two-year follow-up. British Journal of Psychiatry, 146, 594–600.Google Scholar
Leff, J. P. & Vaughn, C. (1985) Expressed Emotion in Families. New York: Guilford Press.Google Scholar
Leff, J. P., 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.Google Scholar
Strachan, A. M. (1986) Family intervention for the rehabilitation of schizophrenia: toward protection and coping. Schizophrenia Bulletin, 12, 678–698.CrossRefGoogle ScholarPubMed
Tarrier, N., Barrowclouoh, C., Vaughn, C., et al (1988) The community management of schizophrenia: a controlled trial of a behavioural intervention with families to reduce relapse. British Journal of Psychiatry, 153, 532–542.CrossRefGoogle ScholarPubMed
Tarrier, N., Barrowclouoh, C., Vaughn, C., et al (1989) Community management of schizophrenia: a two-year follow-up of a behavioural intervention with families. British Journal of Psychiatry, 154, 625–628.CrossRefGoogle ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.