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The British Journal of Psychiatry (2000) 177: 434-439
© 2000 The Royal College of Psychiatrists

Effects of behavioural family management on family communication and patient outcomes in schizophrenia

ALAN S. BELLACK, ABPP

VA Capitol Network, Mental Illness Research, Education, and Clinical Center (MIRECC) and University of Maryland School of Medicine, Baltimore, MD

GRETCHEN L. HAAS, PhD

University of Pittsburgh School of Medicine, Pittsburgh, PA

NINA R. SCHOOLER, PhD

Long Island Jewish Medical Center, NY

JANINE D. FLORY, PhD

University of Pittsburgh, PA, USA

Correspondence: Alan S. Bellack, University of Maryland School of Medicine, 737 West Lombard St, Suite 551, Baltimore, MD 21201, USA; e-mail: abellack{at}umaryland.edu

Declaration of interest This research was supported in part by grants from the National Institute of Mental Health (MH41577 and MH39998) to A.S.B., and by the Department of Veterans Affairs Capitol Network, MIRECC.

Background Family interventions for schizophrenia have proved to be highly effective in preventing relapse, but it is not clear how they work or how they should be structured.

Aims To examine the effects of a behavioural family intervention and a family support programme on communication, problem solving and outcome in order to determine the impact of structured communication training.

Method Patients and family members participating in the Treatment Strategies in Schizophrenia study were videotaped engaging in 10-minute problem-solving conversations at baseline and after the conclusion of the family intervention. Tapes were subsequently evaluated for changes in communication patterns.

Results The intensive behavioural intervention did not produce differential improvement in communication, and change in communication was unrelated to patient outcomes.

Conclusions The data suggest that intensive behavioural family interventions may not be cost efficient, and that change in family communication patterns may only be important for a subset of families.




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