Synopsis
Use family and systemic approaches to improve communication, coping and relapse planning while distinguishing evidence-based treatment programmes from routine carer contact.
- Family intervention supports coping and communication; it should not suggest that relatives caused psychosis or are responsible for preventing every relapse.
- Offer family intervention in psychosis or schizophrenia when relatives live with or remain in close contact with the person.
- NICE specifies at least ten planned sessions over three months to one year for family intervention in psychosis or schizophrenia.
- Include the person when practical and negotiate whether a single-family or multifamily format best suits those involved.
- A specific supportive, educational or treatment purpose should include negotiated problem solving or crisis-management work.
- Bipolar disorder guidance also recommends family intervention for people living with or in close contact with their family.
- Consent to share patient information and the family's own need for support are related but distinct issues.
Key red flags
A partner controlling answers, access to care or consequences of disclosure should prompt a private safety assessment and consideration of domestic abuse.
Investigation priorities
Identify whom the person regards as family and who is involved in everyday care.
Management branches
The person lives with or has close contact with family who may participate in care.
- Discuss the purpose and evidence with the person and relatives, agreeing safe participation and what information can be shared.
- For psychosis or schizophrenia plan at least ten sessions across three months to one year, incorporating the person's participation when practical and the preferred family format.
- Build education, communication, negotiated problem solving and crisis planning into the programme, reviewing outcomes and the needs of each participant over time.