Families of Schizophrenic Patients: Cognitive Behavioral Intervention
| Manual Title |
Families of Schizophrenic Patients: Cognitive Behavioral Intervention |
| Creators |
Christine Barrowclough, Ph.D. and Nicholas Tarrier, Ph.D. |
| Reference |
Barrowclough, C., & Tarrier, N. (1992). Families of schizophrenic patients: Cognitive behavioral intervention. London: Chapman & Hall. |
| Price |
unknown |
| Contact Information: |
Christine Barrowclough, Ph.D. and Nicholas Tarrier, Ph.D.
The Academic Division of Clinical Psychology
School of Psychiatry and Behavioural Sciences
University of Manchester
Education and Research Building
Wythenshawe Hospital
Manchester M23 9LT
United Kingdom
Phone: 0161 275 2585
Fax: 0161 275 2588
Email: Nick.tarrier@man.ac.uk OR Christine Barrowclough
|
Program Overview:
Theoretical Approach:
Behavioral. The focus of the treatment is on changing the family's behavior. The underlying assumption of this approach is that improving the family's coping and problem-solving skills will help them deal with problems that arise, even after treatment is over.
Setting:
The treatment can be provided either in the clinic or at the patient's home (but at least one home visit is recommended).
Core Treatment Components: [text provides descriptions and case examples of each of the following components]
- Assessment & needs assessment of entire family and of each relative individually
- Education about the illness (2 or more sessions; interaction/discussion on schizophrenia -- include patient in parts of sessions)
- Stress management (coping strategies to reduce caregiver's distress; teach self-monitoring of stressors; modifying faulty beliefs, etc)
- Goal setting (key steps in goal setting & planning)
Note: The single-family unit is the focus of intervention (not a group modality)
Frequency / Duration:
Sessions are held with a declining frequency: weekly, biweekly, and then monthly
Program is time limited, typically 9 months -1 year
Research:
Research by Tarrier et al:
- Methods: Randomly assigned patients to either 9 months of their family treatment or routine care
- Results: At 2 year follow-up:
- 33% of family treatment group relapsed vs
- 59% of routine treatment relapsed (Tarrier et al 1989)
AND
The family treatment group had significantly greater improvements at social withdrawal, prosocial activities & overall social adjustment (Barrowclough & Tarrier (1990, 1998))
- Results: The patients who had the 9-month family program continued to have significantly lower relapse rates 5 and 8 years after treatment compared to controls (Tarrier et al 1989, Tarrier, Barrowclough et al 1994)
- Results: The combination of family treatment & amp; standard care gave a cost savings of 27% [Tarrier, N., Lowson, K & Barrowclough, C. (1991). Some aspects of family intervention in schizophrenia II: Financial considerations. British Journal of Psychiatry, 159, 481-488]
- Note: The percentage of families that refused the family intervention ranged from 7-35%. The percentage of families withdrawing from treatment ranged from 7-50%. A follow-up from the Salford study found that 67% of patients whose families either refused or dropped out then relapsed in the subsequent 9 months! (Barrowclough & Tarrier, 1992)
Note: Above description reviewed and approved by Dr. Tarrier, 2-21-03
|
