Multiple‐Family Group Treatment of Outpatients With Schizophrenia: Impact on Service Utilization

Abstract

The impact of multiple-family group treatment (MFGT) on outpatient and inpatient mental health service utilization of 97 persons with schizophrenia was investigated. Participants were randomly assigned to standard care (n = 44) or standard care plus MFGT (n = 53). Service use for a year prior to randomization, the 2-year study period, and a 1-year follow-up were examined. Relative to standard care participants, the MFGT group had reduced community hospitalization during year 1 of the intervention and reduced state hospitalization at follow-up. During the intervention period, MFGT participants demonstrated a significant increase in outpatient utilization as a direct consequence of the intervention. However, when service use was summed across 3 years post-randomization, no group differences were observed. Results suggest that implementation of MFGT in a community mental health setting reduces inpatient service at specific time periods, without significantly increasing outpatient service utilization. These findings add to other outcomes from this study that demonstrate decreased psychiatric symptoms and caregiver distress.

Clinician Integrity in Multiple Family Groups: Psychometric Properties and Relationship with Schizophrenia Client and Caregiver Outcomes

“…Relative to SFP approaches, MFGT compares favorably in reducing psychiatric relapse and increasing functional outcomes (McFarlane, Link, Dushay, Marchal, & Crilly, 1995;McFarlane, Lukens, et al, 1995). When compared to a standard care group, MFGT has shown reductions in negative symptoms, inpatient service utilization, and caregiver distress in an outpatient community mental health setting (Dyck et al, 2000;Dyck, Hendryx, Short, Voss, & McFarlane, 2002;Hazel et al, 2004;McDonell, Short, Hazel, Berry & Dyck, 2006). As a result of this empirical support of family psycho-education in general, and MFGT the format specifically, MFGT is currently being disseminated throughout the United States through the Substance Abuse and Mental Health Administration's (SAMHSA; 2003) Toolkit for Empirically Supported Treatments.…”

Recent Developments in Family Psychoeducation as an Evidence‐Based Practice

“…The core study compared 2 years of McFarlane model multifamily FPE (MFG‐FPE) against standard care, finding effects for relapse and negative symptoms (Dyck, Hendryx, Short, Voss, & McFarlane, 2002; Dyck et al., 2000). The recent publications report that the MFG‐FPE condition participants showed no reductions in family burden (McDonell, Short, Berry, & Dyck, 2003), significant decrease in consumer hospitalizations with no net increase in outpatient services use over the 3 years after baseline (Dyck et al., 2002; McDonell et al., 2006), and significantly reduced family‐member distress but no increase in family‐member active coping nor perceived social support (Hazel et al., 2004).…”

Family Process 1962–1969

“…Finally, in the 1980s, the families BEELS / 7 themselves, especially the parents organized as the Friends and Allies of the Mentally Ill, some of whom were psychologists and social workers, began to find professional voices in their own ranks (Hatfield, Spaniol, & Zipple, 1987;Lefley, 1998) to express what a harmful experience the whole double bind era had been for them. The family therapy profession began to make amends by systematically promoting treatments (McDonell, Short, Hazel, Berry, & Dyck, 2006) that made use of the strengths and dedication of families so unfortunate as to be confronted with the later-life care of an offspring with schizophrenia. Carol Anderson's distinguished career included becoming editor of Family Process in 1998.…”