A Trial of Family Therapy v. a Relatives Group for Schizophrenia

1989 ◽  
Vol 154 (1) ◽  
pp. 58-66 ◽  
Author(s):  
Julian Leff ◽  
Ruth Berkowitz ◽  
Naomi Shavit ◽  
Angus Strachan ◽  
Ilana Glass ◽  
...  
Keyword(s):  
Family Therapy ◽  
Relapse Rate ◽  
Expressed Emotion ◽  
Cost Effective ◽  
Or Education ◽  
Face To Face ◽  
Social Interventions ◽  
The Family ◽  
Schizophrenic Patients ◽  
Therapy Sessions

Schizophrenic patients living in high contact with relatives having high expressed emotion (EE) were recruited for a trial of social interventions. The patients were maintained on neuroleptic medication, while their families were randomly assigned to education plus family therapy or education plus a relatives group. Eleven out of 12 families accepted family therapy in the home, whereas only six out of 11 families were compliant with the relatives group. Non-compliance was associated with a poorer outcome for the patients in terms of the relapse rate. The relapse rate over nine months in the family therapy stream was 8%, while that in compliant families in the relatives group stream was 17%. Patients' social functioning showed small, non-significant, gains. The data from the current trial were compared with data from a previous trial. The lowering of the relapse rate in schizophrenia appears to be mediated by reductions in relatives' EE and/or face-to-face contact, and is not explained by better compliance with medication. Reduction in EE and/or contact was associated with a minuscule relapse rate (5%). Very little change occurred in families who were non-compliant with the relatives group. On the basis of these findings, we recommend that the most cost-effective procedure is to establish relatives groups in conjunction with family education and one or more initial family therapy sessions in the home. It is particularly important to offer home visits to families who are unable to or refuse to attend the relatives groups.

A Controlled Trial of Social Intervention in the Families of Schizophrenic Patients: Two Year Follow-up

1985 ◽  
Vol 146 (6) ◽  
pp. 594-600 ◽  
Author(s):  
Julian Leff ◽  
Liz Kuipers ◽  
Ruth Berkowitz ◽  
David Sturgeon
Keyword(s):  
Relapse Rate ◽  
Antipsychotic Medication ◽  
Expressed Emotion ◽  
Controlled Trial ◽  
Social Contact ◽  
Social Intervention ◽  
Face To Face ◽  
The Social ◽  
Schizophrenic Patients

SummaryThe two-year follow-up results are reported of a trial of social intervention in families of schizophrenic patients in high social contact with high-expressed emotion (EE) relatives. For those patients who remained on antipsychotic medication throughout the two years, the social intervention significantly reduced the relapse rate. In those experimental families where relatives' EE and/or face-to-face contact was lowered, the relapse rate was 14%, compared with 78% for control patients on regular medication (P = 0.02).

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

1990 ◽  
Vol 157 (4) ◽  
pp. 571-577 ◽  
Author(s):  
J. Leff ◽  
R. Berkowitz ◽  
N. Shavit ◽  
A. Strachan ◽  
I. Glass ◽  
...  
Keyword(s):  
Family Therapy ◽  
Relapse Rate ◽  
Social Intervention ◽  
Previous Trial ◽  
Neuroleptic Drugs ◽  
Face To Face ◽  
The Family ◽  
Relapse Rates ◽  
Risk Of Relapse

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.

Emotional Attitudes and Direct Communication in the Families of Schizophrenics

1986 ◽  
Vol 149 (3) ◽  
pp. 279-287 ◽  
Author(s):  
Angus M. Strachan ◽  
Michael J. Goldstein ◽  
Julian P. Leff ◽  
Carol Burtt ◽  
Jeri A. Doane
Keyword(s):  
Los Angeles ◽  
Family Life ◽  
Expressed Emotion ◽  
Speech Rate ◽  
Direct Interaction ◽  
Direct Communication ◽  
Face To Face ◽  
Schizophrenic Patients

To examine how the measure of expressed emotion relates to family life, 30 relatives of schizophrenic patients were assessed for EE and then observed in ten-minute discussions with the patients. It was found that high-EE relatives express more negative emotional statements than low-EE relatives when face-to-face with the patient; they also talk more rapidly, and this speech rate is correlated with the patient speech rate. Whereas low-EE relatives expressed few criticisms or intrusive statements, high-EE over-involved relatives were more intrusive, and high-EE critical relatives were more critical as well as more intrusive in direct interaction. These findings emphasise the importance of understanding divergent EE sub-styles and the complementary behaviour of patients. The findings of an earlier Los Angeles study were replicated.

The Family Therapy Chronogram: An Aid to Supervision

1986 ◽  
Vol 67 (3) ◽  
pp. 174-179 ◽  
Author(s):  
Ben-Zion Cohen ◽  
Orly Shlomy
Keyword(s):  
Family Therapy ◽  
The Family ◽  
Therapy Sessions

Complex family therapy sessions have given rise to a need for structured and innovative supervisory techniques. One, the family therapy interaction chronogram, provides a framework for workers to organize and analyze the interactional data of therapy sessions under the direction of a supervisor.

Family therapy preventing the bipolar patient against recurrent episode : A case series

2011 ◽  
Vol 26 (S2) ◽  
pp. 1313-1313
Author(s):  
H.C. Hsu ◽  
P.Y. Lin ◽  
Y. Takashi
Keyword(s):  
Family Therapy ◽  
Case Series ◽  
Bipolar Patient ◽  
Recurrent Episode ◽  
Affective Symptoms ◽  
Increased Risk ◽  
The Family ◽  
Therapy Model ◽  
Poor Outcomes ◽  
Therapy Sessions

Bipolar disorder is a chronic, recurrent disorder, and its dysfunction has been correlated with poor outcomes and increased risk of recurrence. The main purpose of the family therapy model at issue is to prevent the bipolar patient against recurrent episode.The focuses of the therapy sessions are on the apples drawn by the patient(DDAA), the patient, and the patient-parent relationship. Keywords are gathered from every participant during the therapy session. Besides, the subjects to have verbalized meaningful ideas or successful experiences are immediately, intensely praised by applause during the session. DAILY DRAW AN APPLE(DDAA) homework is that the patient has drawn an apple on a calendar everyday and shares with parents about the apple as well as the patient's feelings of the day. The participants of the family therapy are the patient, parents, and the therapists. The frequency of the model is once monthly. Each session consists of the 10 minutes pre-session, the 60 minutes family therapeutic session, and the 30 minutes post-session. It needs to be emphasized that the frequency of re-hospitalization definitely decreased after receiving therapy.Finally, positive transference was demonstrated in the high attendance rate, in their excitement in receiving the applause, and in their collaboration in presenting the keywords. With the aid of the family therapy, they have been almost free from affective symptoms, and the hostile dependent tie with their parents having been steadily improved. To prevent the bipolar patient against recurrent episode has been achieved in the five cases family therapy presented here.

scholarly journals Correlation of family expressed emotion and frequency of relapse schizophrenia patients

2020 ◽  
Vol 1 (2) ◽  
pp. 35-37
Author(s):  
I Gusti Agung Ayu Putri Yuni Aryanti ◽  
Luh Nyoman Alit Aryani ◽  
Cokorda Bagus Jaya Lesmana
Keyword(s):  
Mental Disorder ◽  
Expressed Emotion ◽  
Causative Factor ◽  
Spearman Correlation ◽  
Severe Mental Disorder ◽  
Cross Sectional ◽  
Significance Level ◽  
The Family ◽  
Schizophrenic Patients ◽  
Spearman Correlation Test

Background: Schizophrenia is a severe mental disorder in the psychiatric field, is chronic, and is characterized by recurring relapse. The causative factor that plays an important role is the expressed emotion (EE) of the family. The aim of this study was to determine the expressed emotion scores of families who treated schizophrenic patients at Sanglah Hospital. Methods: The study used a cross-sectional analytical method. Measurement of the EE of families using the Family Questionnaire (FQ). Data were analyzed descriptively and used the Spearman correlation test with a significance level of p <0.05. Results: The research participants were 61 families of schizophrenia patients treated at Sanglah Hospital, female (57.4%), and average age 45 years old. The results showed a correlation between the family’s expressed emotion score and the frequency of recurrence of schizophrenic patients in Sanglah Hospital, which was statistically significant (R=0.611, p <0.001). That value shows that the correlation between the family expressed emotion score and the frequency of relapse patients with schizophrenia at Sanglah Hospital has a strong categorical correlation. Conclusion: There is a significant correlation between the scores of family expressed emotion and the frequency of relapse in schizophrenia patients, where the expressed emotion of families is high, the frequency of relapse in schizophrenia patients will increase.

Focal Family Therapy Outcome Study I: Patient and Family Functioning*

1989 ◽  
Vol 34 (7) ◽  
pp. 641-647 ◽  
Author(s):  
Judith E. Levene ◽  
Francis Newman ◽  
J.J. Jefferies
Keyword(s):  
Family Therapy ◽  
Family Functioning ◽  
Poor Responders ◽  
Post Discharge ◽  
Time Out ◽  
The Family ◽  
Community Tenure ◽  
Schizophrenic Patients ◽  
Supportive Management

This pilot study compared the efficacy of two models of family therapy plus medication in the treatment of ten schizophrenic patients previously considered poor responders to neuroleptics alone. Focal Family Therapy (FFT), a limited psychodynamic model, was compared with Supportive Management Counselling (SMC), an educative, problem-solving approach. Family treatment was begun during admission to hospital and continued for up to six months post-discharge. Patient and family measures were administered on assessment, termination, and at three, six and 12 month follow-up interviews. Our data suggest that patients in both groups improved significantly following treatment on measures of social functioning and community tenure. The average increase in amount of time out of hospital was a full year, compared to previous rates. Patients receiving FFT demonstrated significantly greater improvement in symptoms, compared to patients in the SMC group. On average, families scored in the normal range on the family functioning measure at assessment and upon termination of treatment.

Psychophysiological Responses of Schizophrenic Patients to High and Low Expressed Emotion Relatives: A Follow-up Study

1984 ◽  
Vol 145 (1) ◽  
pp. 62-69 ◽  
Author(s):  
David Sturgeon ◽  
Graham Turpin ◽  
Liz Kuipers ◽  
Ruth Berkowitz ◽  
Julian Leff
Keyword(s):  
Skin Conductance Response ◽  
Expressed Emotion ◽  
Social Intervention ◽  
Psychophysiological Responses ◽  
Social Interventions ◽  
Follow Up Study ◽  
Schizophrenic Patients ◽  
Experimental Group ◽  
Relapse Rates

SummaryMeasurements of skin conductance response frequencies (SCRf) were obtained from 30 acutely ill schizophrenic patients during a standardised videotaped interview, conducted with the patient's key relative present. Significant differences in SCRf's were demonstrated between patients whose relatives had high and low Expressed Emotion (EE) respectively. Patients at high risk of relapse were allocated either to a control or an experimental group, the latter being offered a number of social interventions in order to reduce the relative's EE and/or contact with the patient. Follow-up measurements were obtained on 19 patients nine months after discharge. Although social intervention was highly successful in reducing relapse rates, its effects did not appear to be directly mediated via SCRf, which was found to be independently related to relapse.

The Salford Family Intervention Project: Relapse Rates of Schizophrenia at Five and Eight Years

1994 ◽  
Vol 165 (6) ◽  
pp. 829-832 ◽  
Author(s):  
Nicholas Tarrier ◽  
Christine Barrowclough ◽  
Kathleen Porceddu ◽  
Elizabeth Fitzpatrick
Keyword(s):  
Predictive Power ◽  
Expressed Emotion ◽  
Intervention Group ◽  
Family Intervention ◽  
Control Group ◽  
Long Term Effects ◽  
The Family ◽  
Schizophrenic Patients ◽  
Relapse Rates

BackgroundThis study assessed the long-term effects of family intervention on schizophrenic relapse.MethodForty schizophrenic patients who had participated in a family intervention trial and who had not experienced relapse at two years after discharge from the index admission were traced through case notes and hospital records. The percentage of patients experiencing a relapse was estimated for patients in the family intervention group, the high-EE control group, and the low-EE control group, at five years and eight years after discharge.ResultsThere were significantly fewer relapses in the family intervention group than in the high-EE control group at both five years and eight years. The number of relapses in the low-EE control group was lower than in the high-EE control group, but this just failed to reach significance.ConclusionsThe benefit of family intervention and the predictive power of EE are sustained over eight years. Expressed emotion (EE) has remained a remarkably robust predictor of relapse in schizophrenia. Kavanagh (1992) cited 20 out of 23 prospective studies that showed patients who returned to live with high-EE relatives had higher relapse rates over 9–12 months after discharge than did patients returning to live with low-EE relatives. Seventeen of these studies reported this difference to be significant.British Journal of Psychiatry (1994),165, 829–832

scholarly journals The Role of the Family in Preventing Relapse of Schizophrenia Patient

2021 ◽  
Vol 9 (T4) ◽  
pp. 44-49
Author(s):  
Mamnuah Mamnuah
Keyword(s):  
Relapse Rate ◽  
Schizophrenia Patient ◽  
Sampling Technique ◽  
Qualitative Design ◽  
Purposive Sampling ◽  
The Family ◽  
Schizophrenic Patients ◽  
Field Notes ◽  
The Government

BACKGROUND: The relapse rate of schizophrenia patients is still high. The family has an important role in helping schizophrenia patients to avoid recurrence. AIM: This study aimed to describe the role of the family in preventing relapse schizophrenia patients. METHODS: The research used a qualitative design with a phenomenology approach. The sample consisted of 12 families who had schizophrenic patients. The samples were obtained by purposive sampling technique. The data were collected by interview and using field notes, then analyzed by Colaizzi technique. RESULTS: The results showed that the role of the family in preventing the recurrence of schizophrenia patients was of four themes, namely, acceptance, assistance, hope, and communication from the family. CONCLUSION: There are four roles of the family to prevent a patient’s recurrence. The government needs to pay attention to the families of schizophrenia patients.

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