Family management in “schizophrenia”: Its assumptions and contradictions

Abstract

The principles of the Family Management interventions in schizophrenia, together with some of their advantages and limitations, are reviewed. The evidence for the widely accepted necessity of medication as an adjunct in all cases is closely examined and found to be unconvincing, and it is suggested that on the contrary perhaps a majority of those diagnosed with schizophrenia could be treated drug-free. A further issue is that of blame, and it is argued that although Family Management researchers are very anxious not to blame families for their relatives' psychiatric problems, a close reading of the research does point to a causal role of family relationship styles not only in relapse but also in initial breakdown. There follows a critical discussion of some of the underlying assumptions of the Family Management work.