Family functioning, burden, and reward in the caregiving for chronic mental illness.

The burdens that caregivers for the chronically mentally ill experience are reviewed. Rewards that caregivers might experience have been understudied and the sparse literature is herein reviewed. The concept of expressed emotion, the importance of psychoeducation, and the role of family treatment are also reviewed, as they relate to the experience of the caregivers. Family conflict and family intimacy have been found to reflect the degree of burden or reward experienced and it is suggested that the family system, as the context within which the patient exists, be seen as the mediating environment for caregiving burden and reward. Family assessment, including a measure of the comfort with the role of caregiver and the extent of family support, is recommended in the assessment of caregivers. The family s ability to adapt over time is discussed as a measure of the family's ability to solve the problem of caregiving. Future directions for research are also presented.