Family Work
A first episode of psychosis can have a distressing effect on family members, and they are likely to experience their own personal challenges. Many of the issues and concerns facing the young person are also experienced by the family, and families themselves may also require a great deal of information and support.
As noted elsewhere in this site, families are often critically important allies to the clinical team, and can be extremely valuable in the recovery of young people experiencing a first episode of psychosis. Specifically, families can be extremely helpful in monitoring a young person’s mental state, informing the clinical team of concerns, and encouraging attendance and medication adherence.
For these reasons, interventions designed to support family members and care-givers can be extremely valuable in early psychosis work.
Similar to specific psychological therapies, family interventions can be provided on an individual basis or as part of a multi-family group. Family peer support can also be very valuable, where parents with experience of caring for a young person with psychosis can offer support to other parents whose child may be early in the course.
A number of excellent family interventions are described in the literature:
McNab, C. & Linzen D (2009) Family Interventions in Early Psychosis. In Jackson, H.J. & McGorry, P.D. The Recognition and Management of Early Psychosis: A Preventive Approach. 2nd Ed. Cambridge: Cambridge University Press.
Addington, J. & Burnett, P. (2009) Working with Families in the Early Stages of Psychosis. In Gleeson, J.F.M. & McGorry, P.D. (Eds.) Psychological Interventions in Early Psychosis: A Treatment Handbook. West Sussex: John Wiley & Sons Ltd.
Psychosocial interventions for families should focus on issues such as:
- Engaging the family while avoiding blame
- Managing guilt and grief
- Providing education about psychosis and its treatment. This can include discussion on separating behaviours relating to psychosis from those due to the young person’s personality, normal adolescent development, or comorbid disorders such as substance abuse, anxiety or depression
- Providing information about the service and how to access support during the week and after hours
- Exploring and discussing the family’s explanatory model and attributions relating to psychosis
- Identifying helpful coping strategies
- Managing conflict and communicating effectively with each other
- Identifying potential early warning signs and managing relapse
It should be noted that while many families do not want or need structured, long term therapy, many report valuing psychoeducation and support. In addition, the degree to which these are required will vary depending on the phase of recovery of the young person.
Click here for the Psychological Interventions page