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Randomised controlled effectiveness trial of a needs-based psychosocial intervention service for carers of people with schizophrenia

Published online by Cambridge University Press:  03 January 2018

Christine Barrowclough*
Affiliation:
Academic Depariment of Clinical Psychology
Nicholas Tarrier
Affiliation:
Academic Depariment of Clinical Psychology
Shôn Lewis
Affiliation:
University Department of Psychiatry, School of Psychiatry and Behavioural Sciences, University of Manchester
William Sellwood
Affiliation:
Department of Clinical Psychology, Withington Hospital, Manchester
John Mainwaring
Affiliation:
Making Space, Warrington
Joanne Quinn
Affiliation:
Department of Clinical Psychology, Withington Hospital, Manchester
Charlotte Hamlin
Affiliation:
Department of Clinical Psychology, Withington Hospital, Manchester
*
Christine Barrowclough, Academic Department of Clinical Psychology. Mental Health Unit. Tameside General Hospital, Ashton - under-Lyne, Lancashire OL6 9RW

Abstract

Background

Family interventions are effective in reducing relapse in patients with schizophrenia, but there is little work demonstrating the effectiveness of the interventions in routine service settings.

Aims

To test the effectiveness of a needs-based family intervention service for patients recruited as out-patients and their carers, including those of low expressed emotion status.

Method

Carers of out-patient schizophrenia sufferers selected only on illness history factors were randomly allocated to receive either family support alone or in combination with systematic psychosocial interventions based on an assessment of need. Delivery of family interventions attempted to involve the clinical team.

Results

Relapse outcomes were superior for family-treated patients at six-month follow-up, although most of the clinical and symptom patient variables assessed remained stable, as did measures of carer burden.

Conclusions

The study demonstrated the effectiveness of family interventions in routine service settings. Problems with staff, patient and carer engagement and participation were identified.

Type
Papers
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest

The study was funded by the National Health Service Executive North West.

References

Anderson, J. & Adams, C. (1996) Family interventions in schizophrenia: an effective but underused treatment. British Medical Journal, 313, 505.Google Scholar
Barrowclough, C. & Tarrier, N. (1992) Families of Schizophrenic Patients: Cognitive Behavioural Intervention. London: Chapman & Hall.Google Scholar
Barrowclough, C., Marshall, M., Lockwood, A., at al (1998) Assessing relatives' needs for psychosocial interventions in schizophrenia: a relative version of the Cardinal Needs Schedule (RCNS). Psychological Medicine, 28, 531542.Google Scholar
Back, A. T. (1988) Beck Depression Inventory New York: Psychological Corporation.Google Scholar
Birchwood, M., Smith, J., Cochrane, R., et al (1990) The Social Functioning Scale: The development and validation of a scale of social adjustment for use in family intervention programmes with schizophrenic patients. British Journal of Psychiatry, 157, 853859.Google Scholar
Endlcott, J., Spitzer, R. L., Fless, J. L. et al (1976) The global assessment scale. Archives of General Psychiatry 33, 766772.Google Scholar
Falloon, I R. H., Boyd, J. L. & McGill, C. W. (1984) family Core of Schizophrenia. New York: Guilford Press.Google Scholar
Fletcher, R. H., Fletcher, S. W. & Wagner, E. H. W. (1988) Clinical Epidemiology: The Essentials. London: Williams & Wilkins.Google Scholar
Goldberg, D. & Williams, P. A. (1988) A Users' Guide to the General Health Questionnaire. Windsor: NFER–Nelson.Google Scholar
Haddock, G., Tarrier, N., Spaulding, W., et al (1998) Individual cognitive–behaviour therapy in the treatment of hallucinations and delusions: a review. Clinical Psychology Review, 18, 821838.Google Scholar
Hughes, I., Halfwood, R., Abbati-Yeoman, J., et al (1996) Developing a family intervention service for serious mental illness: clinical observations and experiences. Journal of Mental Health, 5, 145159.Google Scholar
Kavanagh, D. J. (1992) Family interventions for schizophrenia. In Schizoptirenia: An Overview and Practical Handbook (ed. Kavanagh, D. J.). London: Chapman & Hall.Google Scholar
Kay, S., Fiszbein, A. & Opler, L. (1987) The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13 261275.Google Scholar
Mari, J. J. & Streiner, D. L. (1994) An overview of family interventions and relapse on schizophrenia: meta analysis of research findings. Psychological Medicine, 24, 565578.Google Scholar
Mari, J. J. & Streiner, D. L. (1996) Family intervention for those with schizophrenia. In Schizophrenia Module of the Cochrane Database of Systematic Reviews (eds Adams, C., Anderson, J. & De Jesus Mari, J.). The Cochrane Collaboration Issue 3. The Cochrane Library. Oxford: Update Software.Google Scholar
McCresdie, R. G., Phillips, K., Harvey, J. A., at al (1991) The Nithsdale schizophrenia surveys. VIII: Do families want family intervention - and does it help? British Journal of Psychiatry, 158, 110113.Google Scholar
Platt, S., Wayman, A., Hirsch, S. R., et el (1980) The social behaviour assessment schedule (SBAS): rationale, contents, scoring and reliability. Social Psychiatry, 15, 4355.Google Scholar
Smith, J. (1992) Family interventions: service implications. In Innovations in the Psychological Treatment of Schizophrenia (eds Birchwood, M. & Tarrier, N.). Chichester: Wiley.Google Scholar
Smith, J. & Birchwood, M. (1990) Relatives and patients as partners in the management of schizophrenia. The development of a service model. British Journal of Psychiatry 156, 654660.Google Scholar
Tarrler, N. (1991) Some aspects of family interventions in schizophrenia. I: Adherence to intervention programmes. British Journal of Psychiatry, 159, 475480.Google Scholar
Tarrler, N., Haddock, G. & Barrowclough, C. (1998) Training and dissemination: research to practice in innovative psychosocial treatments for schizophrenia. In Outcome and Innovation in Psychological Treatment of Schizophrenia (eds Wykes, T., Tarrier, N. & Lewis, S.), pp. 215236. Chichester: Wiley.Google Scholar
World Health Organization (1992) The KZD–10 Classification of Mental and Behavioural Disorders. Geneva: WHO.Google Scholar
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