Summary
The result of a psychosocial intervention which aimed to reduce schizophrenic relapse through relatives' counselling is presented. Thirty-six schizophrenic patients living in high Expressed Emotion (EE) parental house-holds were randomly allocated to an intervention or control group. The parents of patients allocated to the intervention were offered ten weekly sessions of counselling. The patient was not included in these session. Patients in both groups received standard after-care of medication and support. Relapses in the intervention group, although fewer, were not significantly different from the control group. Given the impressive evidence in favour of family interventions in reducing relapse rates in schizophrenic patients possible reasons for this result are discussed. Aspects of the intervention described here, exclusion of the patient, no control over the patients' medication or involvement with their management, short duration of intervention and lack of individual assessment, could explain this finding. This negative result is important in indicating what factors should be included in an effective psychosocial intervention.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Abramowitz IA, Coursey RD (1989) Impact of an educational support group on family participants who take care of their schizophrenic relatives. J Consult Clin Psychol 57: 232–236
Barrowclough C, Tarrier N (1984) Psychosocial interventions with families and their effects on the course of schizophrenia: a review. Psychol Med 14: 629–642
Barrowclough C, Tarrier N (1990) Social functioning in schizophrenic patients. I. The effects of expressed emotion and family intervention. Soc Psychiatry Psychiatr Epidemiol 25: 125–129
Barrowclough C, Tarrier N, Watts S et al. (1987) Assessing the functional value of relatives' reported knowledge about schizophrenia. Br J Psychiatry 151: 1–8
Falloon IRH, Watt DC, Shepherd M (1978) The social outcome of patients in a trial of longerm continuation therapy. Psychol Med 8: 265–274
Falloon IRH, Boyd JL, McGill CW et al. (1982) Family management in the prevention of morbidity of schizophrenia. N Engl J Med 306: 1437–1440
Falloon IRH, Boyd JL, McGill CW (1984) Family Care of Schizophrenia. Guilford, New York
Falloon IRH, Boyd JL, McGill CW et al. (1985) Family management in the prevention of morbidity of schizophrenia. Clinical outcome of a two year longitudinal study. Arch Gen Psychiatry 42: 887–896
Goldstein MJ, Miklowitz DJ, Strachan AM et al. (1989) Patterns of expressed emotion and patient coping styles that characterise the families of recent onset schizophrenics. Br J Psychiatry 155 [Suppl 5]: 107–111
Hahlweg K, Goldstein MJ, Nuechterlein KH et al. (1989) Expressed Emotion and patient-relative interaction in families of recent onset schizophrenics. J Consult Clin Psychol 57: 11–18
Hogarty GE, Schooler NR, Ulrich RF et al. (1979) Fluphenazine and social therapy in the aftercare of schizophrenic patients: relapse analyses of a two-year controlled trial. Arch Gen Psychiatry 36: 1283–1294
Hogarty GE, Anderson CM, Reiss DJ et al. (1986) Family psychoeducation, social skills training and maintenance chemotherapy in the aftercare treatment of schizophrenia. I. One year effects of a controlled study on relapse and expressed emotion. Arch Gen Psychiatry 43: 633–642
Hogarty GE, Anderson CM, Reiss DJ (1987) Family psychoeducation, social skills training and medication in schizophrenia: the long and the short of it. Psychopharmacol Bull 23: 12–13
Kottgen C, Sonnichsen I, Mollenhauer K et al. (1984) Group therapy with families of schizophrenic patients: results of the Hamburg Camberwell family interview study III. Int J Fam Psychiatry 5: 83–94
Leff JP, Kuipers L, Berkowitz R et al. (1982) A controlled trial of social intervention in the families of schizophrenic patients. Br J Psychiatry 141: 121–134
Leff JP, Kuipers L, Berkowitz R et al. (1985) A controlled trial of social intervention in the families of schizophrenic patients: two year follow-up. Br J Psychiatry 146: 594–600
Leff JP, Berkowitz R, Shavit N et al. (1990) A trial of family therapy vs a relatives' group for schizophrenia. Br J Psychiatry 154: 58–66
Leff JP, Berkowitz R, Shavit N et al. (1990) A trial of family therapy versus a relatives, group for schizophrenia: two-year follow-up. Br J Psychiatry 157: 571–577
MacCarthy B, Kuipers L, Hurry J et al. (1989) Counselling the relatives of the long-term adult mentally ill. I. Evaluation of the impact on relatives and patients. Br J Psychiatry 154: 768–775
Schooler NR, Levine J, Severe JB et al. (1980) Prevention of relapse in schizophrenia: an evaluation of fluphenazine decanoate. Arch Gen Psychiatry 37: 16–24
Smith J, Birchwood M (1987) Education for families with schizophrenic relatives. J Consult Clin Psychol 150: 645–652
Smith J, Birchwood M (1989) Relatives and patients as partners in the management of schizophrenia: the development of a service model. Br J Psychiatry 156: 654–660
Tarrier N (1989) Effect of treating the family to reduce relapse in schizophrenia: a review. J R Soc of Med 82: 1941–1942
Tarrier N, Barrowclough C (1986) Providing information to the relatives about schizophrenia: some comments. Br J Psychiatry 149: 458–463
Tarrier N, Barrowclough C, Vaughn C et al. (1988) The community management of schizophrenia: a controlled trial of a behavioural intervention with families to reduce relapse. Br J Psychiatry 153: 532–542
Tarrier N, Barrowclough C, Vaughn C, Bamrah JS, Porceddu K, Watts S, Freeman HL (1989) The community management of schizophrenia: a controlled trial of a behavioural intervention with families: two year follow-up. Br J Psychiatry 154: 625–628
Vaughan K, Doyle M, McConaghy N et al. (1991) High expressed emotion in relatives predicts schizophrenic relapse: an Australian replication. (submitted for publication).
Vaughn C (1986) Comments on Dulz and Hand. In: Goldstein MJ, Hand I, Hahlweg K (eds) Treatment of schizophrenia: family assessment and intervention. Springer, Berlin Heidelberg New York
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Vaughan, K., Doyle, M., McConaghy, N. et al. The Sydney intervention trial: a controlled trial of relatives' counselling to reduce schizophrenic relapse. Soc Psychiatry Psychiatr Epidemiol 27, 16–21 (1992). https://doi.org/10.1007/BF00788951
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00788951