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The Royal College of Psychiatrists Improving the lives of people with mental illness

Family Work for Schizophrenia (Second edition)

Julian Leff, Elizabeth Kuipers and Dominic Lam


Price: £15.00

College members' price: £13.50

Published: Feb 2002

Format: paperback

Number of pages: 160

ISBN: 9781901242775

Family Work for Schizophrenia (Second edition)

The relapse rate of schizophrenia can be substantially reduced by working with the families of sufferers on the everyday problems generated by the illness. This book is a detailed practical guide to intervention. The approach to working with families has been used by hundreds of community staff and has proved helpful with a range of clients in addition to those with a diagnosis of schizophrenia. The techniques and strategies included in the guide are clearly described for use by clinical practitioners and are illustrated by case examples.
 
The second edition retains the original sections, including the engaging the family, treading the fine line between working as a therapist and being a guest in the family's home, improving communication, teaching problem-solving and cultural issues. Material has been added on the evidence base for family work for schizophrenia and on the emotional responses of siblings. The guide has been further enriched with the authors' experience of working with families over the ten years since the first edition was published.

Contents

2.  Engaging the family
Strategies · Families who refuse · Maintaining families in treatment · Summary

3.  Being a therapist, not a guest
Social pressures · Forms of address · Greeting and parting · Turning off the television · Tea and biscuits ·   Personal questions · Taking control · Summary

4.  Co-therapy
Modelling · Trust · Forming alliances · Working on separate tasks · Planning sessions · Support during the session · Debriefing · Summary

5.  Offering education
The education programme · The long-term process of education · The main topics · Summary

6.  Family sessions
Aims · Achieving the aims · Briefing and debriefing · Summary

7.  Improving communication
The problems · Establishing the ground rules · Listening skills · Summary

8.  Task setting
Setting a realistic list of goals · Setting an agenda and prioritising · Negotiating solutions and agreeing on homework · Checking up on homework · Summary

9.  Dealing with emotional upset: general issues
The variety of emotional responses · Normalising emotional responses · Positive reframing · Seeing family members separately · The use of relatives' groups and role play · Summary

10.  How families affect professionals
The spread of conflict · Doom and gloom · Guilt and anger · Summary

11. Leaving
Establishing a lifeline · Reviewing the family work · Summary

Part III. Emotional issues, problems of individuals and groups

12.  Anger, conflict, rejection
Defusing anger · Keeping control · Model positive negotiation · Look at the positive aspects · Limit setting · Unpacking a violent incident within the family · Prevention · Summary

13.  Dealing with overinvolvement
General considerations · Relative's guilt · Finding a lever · Exploring anxieties about separation · Replacing the role of carer · Limit setting · Achieving independence · Strategic moves · Summary

14.  Grief
Summary

15.  The vulnerability of adult patients
Sexuality · Social competence · Summary

16.  Stigma
Intervention · Summary

17.  Absent family members
How to get everyone in the family involved · Involving the 'peripheral' family network for support · Coping with non-attendance · Coping with lack of interest in meetings · Summary

18.  Helping marital families
Task sharing · Loss of a confidante · Re-establishing a warm relationship · Sexuality · Separation · Summary

19.  Children in the household
Timing of parents' marriage · Exposure of the child to symptoms · Factors influencing the child's response to a parent with schizophrenia · Specific problems · Summary

20.  Carers who are siblings or children
Siblings · Children · Summary

21.  Employment
Helping patients to gain outside employment or return to education · Preparation of patients · Summary

22.  Cultural issues
Language · Ethnic matching of therapists with clients · Family structure · Maintaining 'face' · Beliefs about the causes and treatment of illness · The advantages · Summary

23.  Special problems complicating family work
Alcohol and substance misuse · Child physical and sexual abuse · Suicide · Physical disabilities · More than one person in the family with schizophrenia · Working with several other agencies · Families who reject therapists · Summary

24.  Running a relatives' group. I
Advantages of relatives' groups · Disadvantages of relatives' groups · General issues · Venue · Timing · Selection · Size · Open or closed groups? · Aims of a relatives' group · Therapists' role · Summary

25.  Running a relatives' group. II
The first group meeting · Subsequent meetings · Themes · Problem solving · Emotional processing · Maintaining attendance · Ending a group · Summary

Part IV. Conclusion

26.  Conclusion
Effect of education · Effect of family sessions

Bibliography
Appendix 1. Education booklet
Appendix 2. Helpful Aspects of Therapy form

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