Family Interventions for Schizophrenia: A Review of Long-term Benefits of International Studies

Clinical, social, family and economic benefits are achieved by adding psychosocial family interventions, based on the vulnerability/stress model of mental disorders, to pharmacotherapy and case management for schizophrenic disorders. Twenty-two controlled studies with treatment extending for at least 6 months (including 14 randomized, controlled comparisons with good quality methodology) have documented the benefits of structured types of family approaches. A re-analysis of the effectiveness of these approaches, with outcome variables that included all major psychotic and affective episodes, deaths, hospital admissions, and serious non-compliance or withdrawal from drug or psychosocial interventions as indices of poor outcome, showed significantly better results for the addition of family-based stress management to medication and case management alone. Although fewer studies examined social and family benefits, the trends supported the family-based approaches. Further delays in implementing these methods in clinical practice can no longer be justified.