Multiple‐family groups and psychoeducation in the treatment of schizophrenia

McFarlane, William R.

doi:10.1002/yd.23319946204

Cited by 118 publications

(156 citation statements)

References 28 publications

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“…Note, however, that the studies involved psychotherapy or consultation for the families of schizophrenic patients as well, mobilizing the more accessible social resources to support the identified patient better. A more recent report by McFarlane et al (43) has demonstrated that multiple-family groups may result in even lower relapse rates than single-family therapy for patients with schizophrenia. This modality required exactly half the staff time per patient in comparison with a format involving single-family therapy.…”

Section: Discussionmentioning

confidence: 99%

The economic impact of psychotherapy: a review

Gabbard

Lazar²,

Hornberger³

et al. 1997

AJP

134

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studies designed to investigate the effect of psychotherapy on subsequent medical care utilization. Of these studies, 26 were naturalistic time-series studies that compared medical care utilization before and after psychotherapy. Thirty-two studies were experimental in design, in that patients were assigned to treatment conditions randomly (or through a thoughtful matching system). The authors found that 85% of the studies reported a decrease in utilization of medical care following psychotherapy. Of the 22 methodologically rigorous studies that used random assignment, psychotherapeutic interventions reduced medical inpatient stays by approximately 1.5 days below the control groups' average of 8.5 days.The Mumford et al. review is now substantially outdated. It was published at a time when reimbursement for medical services was considerably different from what it is today and when fewer psychopharmacology options were available. In addition, psychotherapy was defined so broadly in the review that interventions such as educating patients before surgery were considered under the rubric of psychotherapy. Perhaps the most dated aspect of the study is that it concentrated rather narrowly on cost offset (i.e., reductions of medical care costs due to the addition of psychotherapy) rather than on the broader issue of cost-effectiveness. In the last decade or so, the emphasis in the mental health field has shifted away from cost offset to a more complex understanding of the economic impact of psychosocial inter-

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Section: Discussionmentioning

confidence: 99%

The economic impact of psychotherapy: a review

Gabbard

Lazar²,

Hornberger³

et al. 1997

AJP

134

View full text Add to dashboard Cite

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“…All family intervention programmes offer psycho-education and psychosocial support to family members, and some include the patient, although the theoretical orientation of these interventions varies considerably. Studies using these interventions have produced inconsistent or inconclusive evidence of effects in patients, other than in delaying relapse and improving drug compliance (McFarlane et al, 1995;Pharoah et al, 2001). Surprisingly, few clinical trials of family intervention have assessed family-related outcomes (Barbato and D'Avanzo, 2000), and those that have reported inconsistent findings with regard to any significant improvement in family functioning.…”

Section: Introductionmentioning

confidence: 99%

The effectiveness and active ingredients of mutual support groups for family caregivers of people with psychotic disorders: A literature review

Chien

Norman

2009

International Journal of Nursing Studies

102

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Objectives: To explore the literature through a systematic search to assess the effectiveness of mutual support groups for family caregivers of people with schizophrenia and other psychotic disorders.Methods: This review of the research literature was based on the procedures suggested by the National Health Service Centre for Reviews and Dissemination (2001) Report Number 4 in the UK. A combined free-text and thesaurus approach was used to search relevant research studies within electronic databases, including Medline, Embase, CINAHL, OVID full-text, PsycINFO, the Cochrane Library, the British Nursing Index, the NHS National Research register, and System for Info on Grey literature for the period 1980-2007. Reference lists of all retrieved literature were also searched to identify studies that may have been missed. Twenty-five research studies were selected for inclusion in the analysis on the basis that they were either family-led or professional-facilitated support group programmes for family caregivers of people with schizophrenia or other psychotic disorders.Results: The review identified that most studies on this group programme used qualitative, exploratory cross-sectional surveys and quasi-experimental study designs (n= 19); six were experimental studies or randomised controlled trials. There were only a few small-scale, singlecentre controlled trials with the findings supporting the significant positive effects of mutual support groups on families' and patients' psychosocial well-being. A number of nonexperimental studies conducted in Western countries reported benefits of group participation up to one year, such as increased knowledge about the illness, reduced burden and distress, and enhanced coping ability and social support. However, many of these studies lacked rigorous control and did not use standardised and valid instruments as outcome measures or schedule follow-up to examine the long-term effects of support groups on families and/or patients. This is the Pre-Published Version.2 Conclusions: With increasing recognition of benefits from mutual support, this review highlights the dearth of evidence for the effects and active ingredients of mutual support groups.Mutual support may have significant impacts on long-term psychosocial and nursing interventions for both patients with severe mental illness and their families in community mental health care. Further research is recommended to investigate the therapeutic components and effects of mutual support groups for family caregivers of people with schizophrenia and psychotic disorders across cultures.

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“…• Análise estatística 39 , Merinder et al 40 , Shimodera et al 41 e Herz et al 42 (ensaios que não poderiam ser classificados quanto ao método e técnica dentro dos subgrupos considerados pelo presente estudo, considerando os referenciais acima mencionados, ou com propostas não explicitadas); cinco, porque não constituíam, efetivamente, ensaios clínicos (nesse grupo encontram-se artigos que não possuíam resumo e não foram descartados pelos títulos, ou cuja metodologia não era clara quanto ao desenho de estudo e cujos autores eram também autores de ensaios e por esse motivo foram inicialmente selecionados); dois, por corresponderem a ensaios comparativos 43,44 ; e dois ensaios, por terem sido realizados exclusivamente em serviço hospitalar 45,46 .…”

Section: Diagnostic and Statistical Manual Of Mental Disorders Fourtunclassified

Meta-análise de ensaios clínicos de intervenção familiar na condição esquizofrenia

2008

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A esquizofrenia é um dos mais graves transtornos mentais e atinge aproximadamente 1% da população mundial. Caracteriza-se por uma desorganização de diversos processos mentais e por alteração do comportamento, evoluindo com recaídas (recorrência de sintomas), na maioria dos casos, que podem resultar em que a vida afetiva, social e produtiva do paciente fique severamente comprometida. Pode representar ainda um impacto importante na vida dos familiares, o que vem sendo conceituado como "sobrecarga familiar", bem como custos relevantes para toda a sociedade. No Brasil, a esquizofrenia corresponde ao 5º lugar na manutenção de auxílio-doença no país 1 .Para o presente trabalho, os procedimentos de atenção à condição esquizofrenia, inclusive a intervenção familiar, foram identificados, inicialmente, a partir do livro-texto de Kaplan & Sadock 2 , e de documentos governamentais do Canadá 3 e dos Estados Unidos 4 . Esse último documento aponta que das intervenções psicossociais testadas para o tratamento da esquizofrenia, a partir da década de 70, apenas para a chamada "intervenção familiar", haveria um volume de ensaios clínicos bem desenhados com resultados consistentes.A análise das propostas de intervenção familiar dos ensaios foi previamente efetuada 5 com ] was equivalent to that of the behavioral therapy subgroup and the "pragmatic" subgroup

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Multiple‐family groups and psychoeducation in the treatment of schizophrenia

Cited by 118 publications

References 28 publications

The economic impact of psychotherapy: a review

The economic impact of psychotherapy: a review

The effectiveness and active ingredients of mutual support groups for family caregivers of people with psychotic disorders: A literature review

Meta-análise de ensaios clínicos de intervenção familiar na condição esquizofrenia

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