Family psychoeducation for people living with schizophrenia and their families

Abstract

SUMMARYMost people with schizophrenia have frequent contact with their families. Therefore, the family should be involved in their relative's treatment and care wherever possible, so that they can contribute to that person's recovery and the family's own needs for information, support and treatment can be addressed. Family psychoeducation refers to a group of structured psychotherapeutic interventions that involve the person with schizophrenia and their family as partners in care. Trained practitioners adopt a collaborative approach to information sharing and provide training in coping, communication and problem-solving skills. This article describes the common principles and techniques of family psychoeducation (FPE), along with the substantial evidence for its benefits for families, especially reduced relapse rates for the person with schizophrenia. Despite recommendations in clinical practice guidelines, FPE is not widely available throughout the world. The current challenge is to address this through systemic approaches to practice change and tiered approaches to family service delivery. LEARNING OBJECTIVES• Appreciate the needs of families and recognise how these may be addressed by family psychoeducation • Understand the evidence for family psychoeducation • Delineate the key elements of family psychoeducation and consider how it may be applied in practiceNone.The treatment of schizophrenia has involved psychotherapeutic work with families since the 1950s. Different models have developed, informed by psychoanalysis, systems theory, behavioural and cognitive-behavioural psychology, educational approaches and the family advocacy movement (Farhall 2012; Killackey 2015).Family psychoeducation (FPE) describes a number of closely overlapping interventions provided to people with schizophrenia and their families. These structured psychotherapeutic interventions were originally developed with the primary aim of decreasing the number of relapses of illness. A strong evidence base has been generated for these various forms of FPE in supporting people with schizophrenia to achieve this outcome. It has also become apparent that FPE offers other benefits to all family members, such as improved relationships within and outside the family. Terminology

Effects of brief family psychoeducation for caregivers of people with schizophrenia in Japan provided by visiting nurses: protocol for a cluster randomised controlled trial

“…12 Other reasons include funding and staff shortages, as well as providing necessary training. 13 In Japan, even if healthcare professionals perform FPE for a family, they cannot obtain reimbursement for medical expenses. In addition, while the Meriden Family Programme appears to be effective, training is time consuming and expensive.…”

Manajemen Beban dengan Pendekatan Terapi Keluarga Triangles dalam Mengatasi Beban Subjektif Keluarga Merawat Klien Diabetes Melitus

“…Penelitian lain juga menunjukkan hasil yang sama dimana kecemasan dan persepsi beban keluarga menurun setelah diberikan psikoedukasi keluarga (Rosmaharani, Wihastuti, & Supriati, 2015). Penelitian pada klien skizofrenia menunjukkan bahwa psikoedukasi keluarga mampu meningkatkan pengetahuan keluarga, mengurangi gejala, mengurangi beban keluarga, meningkatkan kualitas hidup klien dan keluarga, serta mengurangi tingkat kekambuhan (Harvey, 2018;Hasan, Callaghan, & Lymn, 2015;Liza, Loebis, & Camellia, 2019).…”

The Cal-DSH diversion guidelines

“…Although initial FPE and support studies in the 1980s and 1990s indicated the primary goal of this treatment was to decrease high expressed emotion, 126 recent adaptations move toward a CBT-based model of providing family members with coping, communication, and problem-solving skills. 127 Additionally, recent literature review suggests pairing supportive interventions from both professionals and family members with lived experience (eg, NAMI) may provide the most overall benefit.…”