Family work in first‐onset psychosis: a literature review

Abstract

Family intervention may be helpful for people with psychosis. We reviewed the literature for family intervention for people with a first-onset psychosis. There is limited and conflicting evidence of the efficacy of family intervention for this population. Definitive randomized controlled trials are required to establish the efficacy. At this time, evidence suggests that in High Expressed Emotion (EE) families, family intervention is a possible effective intervention. We suggest caution in families with Low EE as one study suggests that in Low EE families, family intervention can increase the levels of EE.

The Relationships Among Perceived Criticism, Family Contact, and Consumer Clinical and Psychosocial Functioning for African-American Consumers with Schizophrenia

“…This is in marked contrast to what is suggested in the EE literature concerning related consumer outcomes (Askey et al 2007;Bebbington and Kuipers 1994;Cutting et al 2006;Hooley 1985Hooley , 1998King 2000;King and Dixon 1996;Van Humbeeck et al 2002;Weisman et al 1993). This empirical relationship was the largest of any found in these analyses and suggests that contact with the family is strongly associated with better consumer functioning.…”

Family Perceptions of Benefits and Barriers to First Episode Psychosis Carer Group Participation

“…FEP carers tend to be unfamiliar with symptoms and behaviors associated with psychosis, unfamiliar with medications and side-effects, unfamiliar with mental health services and systems, with limited knowledge of the process of recovery or common treatments, and inexperienced in developing coping mechanisms (Lowenstein, et al, 2010;Sin, Moone, & Newell, 2007). Since onset of FEP is typically early 20s, individuals remain living with their families for an extended period, resulting in the parental role being extended for carers (Askey et al, 2007;Lowenstein et al, 2010). Family work with FEP carers has been found to have the potential to reduce depression, stress, and distress in carers (Addington, Coldham, Jones, Ko, & Addington, 2003;Jeppesen, Peterson, Thorup, Abel, Øehlenschlaeger, Christensen, Krarup, Hemmingsen, Jørgensen, & Nordentoft, 2005), including the confusion created by the negative symptoms and challenging behaviors of the person they care for.…”

Family interventions in early psychosis: specificity and effectiveness

“…As there are still relatively few well-controlled randomized trials of family intervention in early psychosis, there is a clear need for additional studies (Askey et al 2007(Askey et al , 2009Alvarez-Jimenez et al 2009). Further work is also required to identify the key mediators of change, and to determine the most effective format and timing of interventions.…”