Abstract
This paper describes a multidisciplinary (psychiatry, psychology, social work) training program which prepares clinicians to work in a collaborative relationship with families of the chronically mentally ill. Content includes an overview of traditional approaches to family roles in major mental illnesses, research findings on family burden, typology of professional-family interactions, and treatment and outcome issues related to older conceptual models of family-patient relationships. The training model includes a didactic component on relevant research and theory, incorporating social policy and cross-cultural issues and emphasizing the actual experiences of patients and families within a framework of coping and adaptation. Training in patient and family education, problem management, supportive counseling, and resource knowledge is accompanied by practicum experiences involving longitudinal work with chronic patients and families. Special features in psychiatric residency training are highlighted.
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References
Anderson, C.M., Reiss, D.J., & Hogarty, G.E. (1986).Schizophrenia and the family: A practitioner's guide to psychoeducation and management. New York: Guilford.
Bernheim, K.F. & Lehman, A.F. (1985).Working with families of the mentally ill. New York: Norton.
Creer, C. & Wing, J. (1974).Schizophrenia at home. London: Instiute of Psychiatry.
Dearth, N., Labenski, B.J., Mott, M.E., & Pellegrini, L.M. (1986).Families helping families: Living with schizophrenia. New York: Norton.
Dell, P.F. (1980). Researching the family theories of schizophrenia: An exercise in epistemological confusion.Family Process, 19, 321–335.
Estroff, S.E. (1981).Making it crazy: An ethnography of psychiatric clients in an American community. Berkeley: University of California Press.
Fadden, G., Bebbington, P., & Kuipers., L. (1987). The burden of care: The impact of functional psychiatric illness on the patient's family.Britsh Journal of Psychiatry, 150, 285–292.
Falloon, I.R.H., Boyd, J.L., & McGill, C.W.. (1984).Family care of schizophrenia. New York: Guilford.
Falloon, I.R.H. et al. (1985).Family management of schizophrenia: A study of clinical, social, family, and economic benefits. Baltimore: Johns Hopkins University Press.
Goldstein, M.J. (Ed.). (1981).New developments in interventions with families of schizophrenics (New Directions in Mental Health Services, No. 12). San Francisco: Jossey-Bass.
Goldstein, M.J. (1985). Family factors that contribute to the onset of schizophrenia and related disorders: The results of a 15 year prospective longitudinal study.Acta Psychiatrica Scandinavica (Suppl.),319, 7–18.
Goldsten, M.Z. (Ed.). (1986).Family involvement in the treatment of schizophrenia. Washington, DC: American Psychiatric Press.
Group for the Advancement of Psychiatry. (1986).A family affair-helping families cope with mental illness: A guide for the professions (Report No. 119). New York: Brunner/Mazel.
Gubman, G.D., Tessler, R.C.. (1987). & Willis G. Living with the mentally ill: Factors affecting household complaints.Schizophrenia Bulletin, 13(4) 727–736.
Hatfield, A.B. (1978). Psychologicl costs of schizophrenia to the family.Social Work, 23(5), 355–359.
Hatfield, A.B. (1983). What families want of family therapists. In W.R. McFarlane (Ed.),Family therapy of schizophrenia (pp. 41–65). New York: Guilford.
Hatfield, A.B. Issues in psychoeducation for families of the mentally ill.International Journal of Mental Health, in press.
Hatfield, A.B.Coping with mental illness in the family: A family guide. Maryland Department of Health& Mental Hygiene, Mental Hygiene Administration, and the National Aliance for the Mentally Ill, (n.d.).
Hatfield, A.B. & Lefley, H.P. (1987).Families of the mentally ill: Coping and adaptation. New York: Guilford.
Hatfield, A.B., Spaniol, L., & Zipple, A.M. (1987). Expressed emotion: A family perspective.Schizophrenia Bulletin, 13(2), 221–226.
Herz, M.I. (1981). Recognizing and preventing relapse in patients with schizophrenia.Hospital & Community Psychiatry, 35, 344–349.
Herz, M.I., Endicott, J., & Spitzer, R.L. (1976). Brief versus standard hospitlization: The families.American Journal of Psychiatry, 133, 795–801.
Hogarty, G.E., Anderson, C.M., Reiss, D.J., Kornblith, S.J., Greenwald, D.P., Javna, C.D., Madonia, M.J., & Environmental/Personal Indicators in the Course of Schizophrenia Research Group. (1986). Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia: I. One year effect of a controlled study on relapse and expressed emotion.Archives of General Psychiatry, 43, 633–642.
Holden, D.F. & Lewine, R.R.J. (1982). How families evaluate mental health professionals, resources, and effects of illness.Schizophrenia Bulletin, 8(4), 626–633.
Howells, J.G. & Guirguis, W.R. (1985).The family and schizophrenia. Madison, CT: International Universities Press.
Kanter, J.S. (Ed.). (1985).Clinical issues in treating the chronic mentally ill (New Directions for Mental Health Services, No. 27). San Francisco: Jossey-Bass.
Kanter, J., Lamb, H.R., & Loeper, C. (1987). Expressed emotion in families: A critical review.Hospital & Community Psychiatry, 38(4), 374–380.
Kreisman, D.E. & Joy, V.D. (1974). Family response to the mental illness of a relative: A review of the literature.Schizophrenia Bulletin, 1, 34–54.
Lefley, H.P. (1985). Etiological and prevention views of clinicians with mentally ill relatives.American Journal of Orthopsychiatry, 55(3), 363–370
Lefley, H.P. (1985). Families, of the mentally ill in cross-cultural perspective.Psychosocial Rehabilitation Journal, 8, 57–75.
Lefley, H.P. (1987). Aging parents as caregivers of mentally ill adult children: An emerging social problem.Hospital & Community Psychiatry, 38(10), 1063–1070 (a).
Lefley, H.P. (1987b). The family's response to mental illness in a relative. In A. Hatfield (Ed.),Families of the mentally ill: Meeting the challenges (pp. 3–21) (New Directions in Mental Health Services No. 34). San Francisco: Jossey-Bass.
Lefley, H.P. (1987). Impact of mental illness in families of mental health professionalsJournal of Nervous & Mental Disease, 175, 613–619 (c).
Liem, J.H. (1980). Family studies of schizophrenia: An update and commentary.Schizophrenia Bulletin, 6, 429–455.
McElroy, E.B. (1986). The beat of a different drummer. In A.B. Hatifeld & H.P. Lefley (Eds.),Families of the mentally ill: Coping and adaptation (pp. 225–243). New York: Guilford.
McFarlane, W.R. (Ed.). (1983).Family therapy in schizophrenia. New York: Guilford.
McFarlane, W.R. & Beels, C. (1983). Family research in schizophrenia: A review and integration for clinicians. In W.R. McFarlane (Ed.),Family therapy of schizophrenia (pp. 311–323). New York: Guilford.
McGlashan, T.H. (1984). The Chestnut Lodge follow-up study: II. Long-term outcome of schizophrenia and the affective disorders.Archives of General Psychiatry, 41, 586–601.
Minkoff, K. (1978). A map of chronic mental patients. In J.A. Talbott (Ed.),The chronic mental patient. Wshington, DC: APA Press.
Noh, S. & Turner, R.J. (1987). Living with psychiatric patients: Implications for the mental health of family members.Social Science & Medicine, 25(3), 263–271.
Parker, G. (1982). Re-searching the schizophrenogenic mother.Journal of Nervous & Mental Disease, 170(8), 452–462.
Potasznick, H. & Nelson, G. (1984). Stress and social support The burden experienced by the family of a mentally ill person.American Journal of Community Psychiatry, 12, 589–607.
Reiss, D. (1976). The family and schizophrenia.American Journal of Psychiatry, 133, 181–185.
Rohrbaugh, M. (1983). Family therapy and schizophrenia research: Swimming against the mainstream.Family Therapy Networker, 62, 29–31.
Selvini, M.P. (1986). Towards a general model of psychotic family games.Journal of Marital and Family Therapy, 12, 339–349.
Simon, R. (1987). Good-bye paradox, Hello invariant prescription: An interview with Mara Selvini-Palazzoli.The Family Therapy Networker, 11(5), 16–25.
Stone, M.H. (1978). Etiological factors in schizophrenia: A reevaluation in the light of contemporary research.Psychiatric Quarterly, 50(2), 83–119.
Swan, R.W. & Lavitt, M.R.Patterns of adjustment to violence in families of the mentally ill (Vol. 1, No. 1). Monograph. Tulane University School of Social Work, Elizabeth Wisner Research Center.
Talbott, J.A. (1983). The chronic mental patient: What have we learned?American Journal of Social Psychiatry, 3, 37–42.
Terkelsen, K.G. (1983). Schizophrenia and the family: II. Adverse effects of family therapy.Family Process, 22, 191–200.
Terkelsen, K.G. & Cole, S.A. (1985).Methodological flaws in the schizophrenogenic hypothesis and their implications for mental health services in an era of community care. Unpublished paper. Mount Vernon, NY: Family Institute of Westchester.
Torrey, E.F. (1983).Surviving schizophrenia: A family manual. New York: Harper & Row.
Tsuang, M.T. (1982).Schizophrenia: The facts. Oxford: Oxford University Press.
Vaughn, C., Snyder, K.S., Jones, S., Freeman, W., & Falloon, I.R.H. (1984). Family factors in schizophrenic relapse.Archives of General Psychiatry, 41, 1169–1177.
Walsh, M. (1985).Schizophrenia: Straight talk for families and friends. New York: Morrow.
Wechsler, J.A. (1983).In a darkness. New York: Irvington.
World Health Organization. (1979).Schizophrenia: An international follow-up study. Chichester, England: John Wiley & Sons.
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The project described in this paper was funded by NIMH Clinical Training/Human Resource Development Grant No. 1T24-MH18779.
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Lefley, H.P. Training professionals to work with families of chronic patients. Community Ment Health J 24, 338–357 (1988). https://doi.org/10.1007/BF00752476
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DOI: https://doi.org/10.1007/BF00752476