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Counselling the Relatives of the Long-Term Adult Mentally Ill

II. A Low-Cost Supportive Model

Published online by Cambridge University Press:  02 January 2018

Liz Kuipers ,
Brigid MacCarthy ,
Jane Hurry ,
Rod Harper  and
Alain LeSage
Liz Kuipers*
Affiliation:
Psychology Department, Institute of Psychiatry and District Services Centre, Maudsley Hospital
Brigid MacCarthy
Affiliation:
Academic Unit, St Bernard's Wing, Ealing Hospital and Charing Cross and Westminster Medical School
Jane Hurry
Affiliation:
District Services Centre, Maudsley Hospital
Rod Harper
Affiliation:
St Charles' Hospital
Alain LeSage
Affiliation:
Centre de Recherche, Hôpital Luis-H Lafontaine, Montreal, Canada
*
∗Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF
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Abstract

A psychosocial intervention is described geared to the needs of carers of the long-term mentally ill, which is feasible for a busy clinical team to implement: relatives were not selected for the group by patient diagnosis or motivation and little extra staff input was required. An interactive education session at home was followed by a monthly relatives group which aimed to reduce components of expressed emotion (EE) and to alleviate burden. The group facilitators adopted a directive but non-judgemental style, and constructive coping efforts were encouraged. The intervention was effective at reducing EE and improving family relationships. The study offers a realistic model of how to offer support to people providing long-term care for the severely mentally ill.

Type
Papers
Information
The British Journal of Psychiatry , Volume 154 , Issue 6 , June 1989 , pp. 775 - 782
Copyright
Copyright © Royal College of Psychiatrists, 1989 

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References

Barrowclough, C., Tarrier, N., Watts, S., et al (1987) Assessing the functional value of relatives' knowledge about schizophrenia: a preliminary report. British Journal of Psychiatry, 151, 1–8.Google Scholar
Bebbington, P. E. (1982) The course and prognosis of affective psychosis. In Cambridge Handbook of Psychiatry, Vol. 3 (ed. Wing, J. K.). Cambridge: Cambridge University Press.Google Scholar
Berkowitz, R., Eberlein-Fries, R., Kuipers, L. & Leff, J. (1984) Educating relatives about schizophrenia. Schizophrenia Bulletin, 10, 418–429.Google Scholar
Birchwood, M. & Smith, J. (1987) Schizophrenia. In Coping with Disorder in the Family (ed. Orford, J.). London: Croom Helm.Google Scholar
Birley, J. & Hudson, B. (1983) The family, the social network and rehabilitation. In Theory and Practice of Psychiatric Rehabilitation (eds Watts, F. N. & Bennett, D. H.). Chichester: John Wiley & Sons.Google Scholar
Bleuler, M. (1978) The long-term course of schizophrenic psychosis. In The Nature of Schizophrenia (eds Wynne, L., Cromwell, R. L. & Matthysse, S.). New York: Wiley.Google Scholar
Brewin, C., Wing, J., Manger, S. P., et al (1987) Principles and practice of measuring needs in the long term mentally ill: the MRC Needs for Care Assessment. Psychological Medicine, 17, 971–981.Google Scholar
Brugha, T. S., Wing, J. K., Brewin, C. R., et al (1988) The problems of people in long-term psychiatric day care: an introduction to the Camberwell High Contact Survey. Psychological Medicine, 18, 443–456.Google Scholar
Compton, S. & Brugha, T. S. (1988) Problems in monitoring needs for care of long term psychiatric patients: evaluating a service for casual attenders. Social Psychiatry and Psychiatric Epidemiology, 23, 121–125.Google Scholar
Creer, C., Sturt, E. & Wykes, T. (1982) The role of relatives. In Long Term Community Care: Experience in a London Borough (ed. Wing, J. K.). Psychological Medicine Monograph Supplement 2. Google Scholar
Fadden, G., Bebbington, P. & Kuipers, L. (1987) The burden of care: the impact of functional psychiatric illness on the patient's family. British Journal of Psychiatry, 150, 285–292.Google Scholar
Falloon, I. (1983) Relapse in schizophrenia: a review of the concept and its definitions. Psychological Medicine, 13, 469–477.Google Scholar
Falloon, I. (1988) Expressed emotion: current status. Psychological Medicine, 18, 269–274.Google Scholar
Falloon, I., Boyd, J. L., McGill, C. W., et al (1985) Family management in the prevention of morbidity of schizophrenia: clinical outcome of a two-year longitudinal study. Archives of General Psychiatry, 42, 887–896.Google Scholar
Ferris, P. A. & Marshall, C. A. (1987) A model project for families of the chronically mentally ill. Social Work, 32, 110–114.Google Scholar
Freeman, H. & Simmons, O. (1963) The Mental Patient Comes Home. New York: John Wiley & Sons.Google Scholar
Gibbons, J. S., Horn, S. H., Powell, J. M. & Gibbons, J. L. (1984) Schizophrenic patients and their families: a survey in a psychiatric service based on a DGH unit. British Journal of Psychiatry, 144, 70–77.Google Scholar
Hatfield, A. B. (1983) What families want of family therapists. In Family Therapy in Schizophrenia (ed. McFarlane, W. R.). New York: Guilford Press.Google Scholar
Hogarty, G. E. (1985) Expressed emotion and schizophrenic relapse: implications from the Pittsburgh study. In Controversies in Schizophrenia (ed. Alpert, M.). New York: Guilford Press.Google Scholar
Hogarty, G. E., Anderson, C. M., Reiss, D. J., et al (1986) Family psychoeducation, social skills training and maintenance chemotherapy in the aftercare treatment of schizophrenia. Archives of General Psychiatry, 43, 633–642.Google Scholar
Hudson, B. (1975) A behaviour modification programme with chronic schizophrenics in the community. Behaviour Research and Therapy, 13, 230–241.Google Scholar
Kuipers, L., Sturgeon, D., Berkowitz, R. & Leff, J. P. (1983) Characteristics of expressed emotion: its relationship to speech and looking in schizophrenic patients and their relatives. British Journal of Clinical Psychology, 22, 257–264.Google Scholar
Kuipers, L. & Bebbington, P. B. (1985) Relatives as a resource in the management of functional illness. British Journal of Psychiatry, 147, 465–470.Google Scholar
Kuipers, L. & Bebbington, P. B. (1988) Expressed emotion research in schizophrenia: theoretical and clinical implications. Psychological Medicine 18, 893–909.Google Scholar
Leff, J. P., Kuipers, L., Berkowitz, R., et al (1982) A controlled trial of social intervention in the families of schizophrenic patients. British Journal of Psychiatry, 144, 121–134.Google Scholar
Leff, J. P., Kuipers, L. & Berkowitz, R. (1985) A controlled trial of social intervention in the families of schizophrenic patients: two year follow-up. British Journal of Psychiatry, 146, 594–600.Google Scholar
Leff, J. P., Liberman, R. P. (1986) Coping and competence as protective factors in the vulnerability-stress model of schizophrenia. In Treatment of Schizophrenia: Family Assessment and Intervention (eds Goldstein, M. J., Hand, I. & Halweg, K.). Berlin: Springer-Verlag.Google Scholar
Leff, J. P. & Vaughn, C. (1985) Expressed Emotion in Families. London: Guilford Press.Google Scholar
MacCarthy, B. (1988) The role of relatives. In Community Care in Practice. Chichester: John Wiley & Sons.Google Scholar
MacCarthy, B., Hemsley, D. J., Shrank-Fernandez, C., et al (1986) Unpredictability as a correlate of expressed emotion in the relatives of schizophrenics. British Journal of Psychiatry, 148, 727–731.Google Scholar
MacCarthy, B. & Brown, R. G. (1989) Psychosocial factors in Parkinson's Disease. British Journal of Clinical Psychology, 28, 41–52.Google Scholar
MacMillan, J. F., Crow, T. J., Johnson, A. L. & Johnstone, E. C. (1986) The Northwick Park Study of First Episodes of Schizophrenia: iii. Short-term outcome in trial entrants and trial eligible patients. British Journal of Psychiatry, 148, 128–133.Google Scholar
Smith, J. V. & Birchwood, M. J. (1987) Specific and non-specific effects of educational interventions with families of schizophrenic patients. British Journal of Psychiatry, 150, 645–652.Google Scholar
Tarrier, N., Barrowclough, C., Vaughn, C., et al (1988) The community management of schizophrenia: a controlled trial of behavioural intervention with families to reduce relapse. British Journal of Psychiatry, 153, 532–542.Google Scholar
Vaughn, C. E. & Leff, J. P. (1976a) The influence of family and social factors on the course of psychiatric illness. British Journal of Psychiatry, 129, 125–137.Google Scholar
Vaughn, C. E. & Leff, J. P. (1976b) The measurement of expressed emotion in families of psychiatric patients. British Journal of Social & Clinical Psychology, 15, 157–165.CrossRefGoogle ScholarPubMed
Watts, F. N. & Bennett, D. H. (1983) Management of the staff team. In Theory and Practice of Psychiatric Rehabilitation (eds Watts, F. N. & Bennett, D. H.). Chichester: John Wiley & Sons.Google Scholar
Wing, J. K. (1982) Forward. In Long-term Community Care: Experience in a London Borough (ed. Wing, J. K.). Psychological Medicine Monograph Supplement 2. Google Scholar
Wing, J. K., Babor, T., Brugha, T., et al (1989) SCAN: schedules for clinical assessment in neuropsychiatry. Archives of General Psychiatry (in press).Google Scholar
Wood, J. V., Taylor, S. E. & Lichtman, R. R. (1985) Social comparison in adjustment to breast cancer. Journal of Personality and Social Psychology, 49, 1169–1183.Google Scholar
Yalom, I. D. (1975) The Theory and Practice of Group Psychotherapy. New York: Basic Books.Google Scholar
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