Family work for schizophrenia: a practical guide

Contents......Page 7
Acknowledgements......Page 10
Part I. Introduction......Page 11
Introduction to our approach......Page 13
Low-EE relatives and the importance of warmth......Page 14
Targeting interventions......Page 15
The treatment model......Page 16
Differences between our approach to work with families and that of others......Page 17
General interpersonal effectiveness......Page 19
Summary......Page 20
Part II. Practical issues in family work......Page 21
Engaging the family......Page 23
Strategies......Page 24
Families who refuse......Page 25
Summary......Page 26
Social pressures......Page 28
Greeting and parting......Page 29
Tea and biscuits......Page 30
Summary......Page 31
Trust......Page 32
Planning sessions......Page 33
Summary......Page 34
The education programme......Page 36
The long-term process of education......Page 37
The main topics......Page 38
Summary......Page 39
Aims......Page 40
Achieving the aims......Page 41
Summary......Page 42
Establishing the ground rules......Page 43
Summary......Page 45
Setting an agenda and prioritising......Page 46
Negotiating solutions and agreeing on homework......Page 47
Checking up on homework......Page 51
Summary......Page 52
The variety of emotional responses......Page 54
Normalising emotional responses......Page 55
Positive reframing......Page 56
The use of relatives’ groups and role play......Page 57
Summary......Page 58
The spread of conflict......Page 59
Doom and gloom......Page 60
Summary......Page 61
Establishing a lifeline......Page 62
Summary......Page 63
Part III. Emotional issues, problems of individuals and groups......Page 65
Defusing anger......Page 67
Keeping control......Page 68
Model positive negotiation......Page 69
Look at the positive aspects......Page 70
Prevention......Page 71
Summary......Page 72
General considerations......Page 73
Relative’s guilt......Page 74
Exploring anxieties about separation......Page 75
Replacing the role of carer......Page 77
Limit setting......Page 78
Achieving independence......Page 79
Strategic moves......Page 80
Summary......Page 81
Grief......Page 82
Summary......Page 83
The vulnerability of adult patients......Page 84
Sexuality......Page 85
Social competence......Page 86
Summary......Page 87
Stigma......Page 88
Intervention......Page 89
Summary......Page 91
How to get everyone in the family involved......Page 92
Coping with non-attendance......Page 93
Summary......Page 95
Task sharing......Page 97
Loss of a confidante......Page 98
Sexuality......Page 99
Separation......Page 100
Summary......Page 101
Timing of parents’ marriage......Page 102
Exposure of the child to symptoms......Page 103
Factors influencing the child’s response to a parent with schizophrenia......Page 104
Specific problems......Page 105
Summary......Page 106
Siblings......Page 107
Summary......Page 109
Helping patients to gain outside employment or return to education......Page 111
Preparation of patients......Page 112
Summary......Page 113
Language......Page 115
Family structure......Page 116
Maintaining ‘face’......Page 117
Summary......Page 118
Alcohol and substance misuse......Page 119
Child physical and sexual abuse......Page 121
Suicide......Page 122
More than one person in the family with schizophrenia......Page 124
Working with several other agencies......Page 125
Families who reject therapists......Page 126
Summary......Page 127
Disadvantages of relatives’ groups......Page 128
General issues......Page 129
Venue......Page 130
Selection......Page 131
Aims of a relatives’ group......Page 132
Summary......Page 133
The first group meeting......Page 134
Subsequent meetings......Page 135
Themes......Page 136
Problem solving......Page 137
Emotional processing......Page 138
Summary......Page 139
Part IV. Conclusion......Page 141
Conclusion......Page 143
Effect of family sessions......Page 144
Bibliography......Page 146
Appendix 1. Education booklet......Page 148
Appendix 2. Helpful Aspects of Therapy form......Page 158
Index......Page 159