Delivering Cognitive‐Behavioural Family Interventions for Schizophrenia

Abstract

Background

In 1993, Kavanagh and colleagues outlined outcomes from a training programme designed to equip mental health practitioners to deliver evidence‐based cognitive‐behavioural family interventions within routine care. The authors highlighted how the training had not been able to deliver notable increases in the numbers of families being seen by the trained clinicians. There were significant issues in the translation and provision of family interventions within clinical settings, specifically difficulties with the integration of family interventions and caseload demands, and insufficient time within job plans and service settings to undertake the work. The authors posed the question: what can the matter be? Interestingly, the same question was being asked over a decade later.

Objective

The current article provides a narrative review of the issues on implementation of family interventions in psychosis.

Results

Current evidence suggests that while there exist pockets of good practice and provision for family interventions, it was a mistake to assume that care coordinators would be able to include these family interventions as part of their role, effectively to add duties without significant modification to their current roles and duties. It also seems to have been an underestimate of the skills required for delivering family work in psychosis and the ongoing requirements for high‐quality supervision.

Conclusion

We argue for carer specialists to be involved in mental health teams, particularly early intervention teams, and for a triage system to offer families a range of evidence‐based support, as well as family interventions for more complex problems and presentations.

Key words:

• caregivers
• family interventions
• implementation
• psychosis
• schizophrenia

Acknowledgement

The authors acknowledge Stephanie Learmonth for editorial support.

Notes

1. Although no specific criterion was offered, evidence in support of 10-hr per week or greater caring contact being indicative of a greater level of strain for carers has been reported in general caring population studies (e.g., Smith et al., 2014).