Key Elements of a Family Intervention for Schizophrenia: A Qualitative Analysis of an RCT

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Abstract

Schizophrenia is a complex biopsychosocial condition in which expressed emotion in family members is a robust predictor of relapse. Not surprisingly, family interventions are remarkably effective and thus recommended in current treatment guidelines. Their key elements seem to be common therapeutic factors, followed by education and coping skills training. However, few studies have explored these key elements and the process of the intervention itself. We conducted a qualitative and quantitative analysis of the records from a pioneering family intervention trial addressing expressed emotion, published by Leff and colleagues four decades ago. Records were analyzed into categories and data explored using descriptive statistics. This was complemented by a narrative evaluation using an inductive approach based on emotional markers and markers of change. The most used strategies in the intervention were addressing needs, followed by coping skills enhancement, advice, and emotional support. Dealing with overinvolvement and reframing were the next most frequent. Single-family home sessions seemed to augment the therapeutic work conducted in family groups. Overall the intervention seemed to promote cognitive and emotional change in the participants, and therapists were sensitive to the emotional trajectory of each subject. On the basis of our findings, we developed a longitudinal framework for better understanding the process of this treatment approach.

Original languageEnglish
Pages (from-to)100-112
Number of pages12
JournalFamily Process
Volume57
Issue number1
Early online date29 Nov 2016
DOIs
Publication statusPublished - Mar 2018

Keywords

  • Family Interventions
  • Psychoeducation
  • Psychosis
  • Schizophrenia
  • Process
  • Qualitative Research

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