April 16, 2007

Book on Family Psychoeducation

Family psychoeducation has been getting increasing publicity for its effectiveness in helping patients and their families cope with schizophrenia. This type of family intervention involves a combination of education and improved communication, problem solving, and processing of emotions for both family members and affected individuals.

Family psychoeducation is a process in which the whole family is taught about the patient’s psychiatric illness, and an attempt is made to lower the level of "expressed emotion" in the household. It is believed that people with schizophrenia living in families with a high level of expressed emotion (EE) are at greater risk of relapse than those living in low EE households.

Negative reactions from within a family is referred to as the family's "high expressed emotions". A family with "low expressed emotions" is described as one wherein the family members are supportive of the ill family member -- showing sympathy, compassion and concern -- without becoming overly protective.

Family psychoeducation is not considered "family therapy", which is a therapy used to correct disturbed family dynamics. Instead, family psychoeducation is used to engage the family as a supportive resource for aiding the patient's continuing recovery.

Although family psychoeducation is expensive, studies have shown that it is actually cost-effective in the long run since it reduces risk of relapse.

Dr. Harriet P. Lefley, Ph.D., professor in the Department of Psychiatry, University of Miami School of Medicine reviewed a new book titled, "Advanced Family Work for Schizophrenia: An Evidence-Based Approach" by Julian Leff. The book contains 19 case studies detailing how clinicians deal with special problems that arise in family psychoeducation for schizophrenia.

Dr. Lefley writes:

Each case is presented with history, presenting problems, formulation, supervisor's suggestions, follow-up, and commentary. Major issues involve control and independence, family roles, emotional overinvolvement of caregivers, and appropriate behavioral expectations. Different cultural assumptions and diverse feelings about medications are acknowledged. Illness behaviors and strategies for coping with voices and other hallucinations are discussed. Referrals are made for cognitive therapy to deal with delusions, a child guidance team, or dual therapists for a husband and wife.

The book is aimed at clinicians, but may give the lay-person better insight into how this important work is actually accomplished.

Read the full book review: Book Review: Advanced Family Work for Schizophrenia: An Evidence-Based Approach

Related Reading:
Medication is Not Enough: Job and Family Counseling Needed as Well

Family and Cognitive Interventions for Schizophrenia

Family Psychoeducation for Schizophrenia Lowers Relapse Rate, is Cost Effective

Family Education Programs


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