Family Work for Schizophrenia (Second edition) Julian Leff, Elizabeth Kuipers and Dominic Lam
Price: £15.00
Published: Feb 2002
Format: paperback The relapse rate of schizophrenia can be substantially reduced by working with the families of sufferers on the everyday problems generated by the illness. This book is a detailed practical guide to intervention. The approach to working with families has been used by hundreds of community staff and has proved helpful with a range of clients in addition to those with a diagnosis of schizophrenia. The techniques and strategies included in the guide are clearly described for use by clinical practitioners and are illustrated by case examples.
The second edition retains the original sections, including the engaging the family, treading the fine line between working as a therapist and being a guest in the family's home, improving communication, teaching problem-solving and cultural issues. Material has been added on the evidence base for family work for schizophrenia and on the emotional responses of siblings. The guide has been further enriched with the authors' experience of working with families over the ten years since the first edition was published.
Contents: Acknowledgements
Part I. Introduction
1. Introduction to our approach What are the emotions measured by EE? · Low-EE relatives and the importance of warmth · Low-EE relatives are not simply neutral · Targeting interventions · The treatment model · Differences between our approach to work with families and that of others · General interpersonal effectiveness · Support group for therapists · Summary Part II. Practical issues in family work
2. Engaging the family Strategies · Families who refuse · Maintaining families in treatment · Summary 3. Being a therapist, not a guest Social pressures · Forms of address · Greeting and parting · Turning off the television · Tea and biscuits · Personal questions · Taking control · Summary 4. Co-therapy Modelling · Trust · Forming alliances · Working on separate tasks · Planning sessions · Support during the session · Debriefing · Summary 5. Offering education The education programme · The long-term process of education · The main topics · Summary 6. Family sessions Aims · Achieving the aims · Briefing and debriefing · Summary 7. Improving communication The problems · Establishing the ground rules · Listening skills · Summary 8. Task setting Setting a realistic list of goals · Setting an agenda and prioritising · Negotiating solutions and agreeing on homework · Checking up on homework · Summary 9. Dealing with emotional upset: general issues The variety of emotional responses · Normalising emotional responses · Positive reframing · Seeing family members separately · The use of relatives' groups and role play · Summary 10. How families affect professionals The spread of conflict · Doom and gloom · Guilt and anger · Summary 11. Leaving Establishing a lifeline · Reviewing the family work · Summary Part III. Emotional issues, problems of individuals and groups
12. Anger, conflict, rejection Defusing anger · Keeping control · Model positive negotiation · Look at the positive aspects · Limit setting · Unpacking a violent incident within the family · Prevention · Summary 13. Dealing with overinvolvement General considerations · Relative's guilt · Finding a lever · Exploring anxieties about separation · Replacing the role of carer · Limit setting · Achieving independence · Strategic moves · Summary 14. Grief Summary 15. The vulnerability of adult patients Sexuality · Social competence · Summary 16. Stigma Intervention · Summary 17. Absent family members How to get everyone in the family involved · Involving the 'peripheral' family network for support · Coping with non-attendance · Coping with lack of interest in meetings · Summary 18. Helping marital families Task sharing · Loss of a confidante · Re-establishing a warm relationship · Sexuality · Separation · Summary 19. Children in the household Timing of parents' marriage · Exposure of the child to symptoms · Factors influencing the child's response to a parent with schizophrenia · Specific problems · Summary 20. Carers who are siblings or children Siblings · Children · Summary 21. Employment Helping patients to gain outside employment or return to education · Preparation of patients · Summary 22. Cultural issues Language · Ethnic matching of therapists with clients · Family structure · Maintaining 'face' · Beliefs about the causes and treatment of illness · The advantages · Summary 23. Special problems complicating family work Alcohol and substance misuse · Child physical and sexual abuse · Suicide · Physical disabilities · More than one person in the family with schizophrenia · Working with several other agencies · Families who reject therapists · Summary 24. Running a relatives' group. I Advantages of relatives' groups · Disadvantages of relatives' groups · General issues · Venue · Timing · Selection · Size · Open or closed groups? · Aims of a relatives' group · Therapists' role · Summary 25. Running a relatives' group. II The first group meeting · Subsequent meetings · Themes · Problem solving · Emotional processing · Maintaining attendance · Ending a group · Summary Part IV. Conclusion
26. Conclusion Effect of education · Effect of family sessions Bibliography Appendix 1. Education booklet Appendix 2. Helpful Aspects of Therapy form
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