Family-Based Psycho-education : A Model Outmoded In Psychiatric Services Today?

Abstract: Family-based psycho-education – a model outmoded in psychiatric services today? Aim: To illuminate aspects of the resistance against a family based intervention a qualitative interview study with professionals was accomplished. Background: Family-based psycho-educational models, developed in the beginning of the 1970s, have in several Cochrane reviews shown evidence for a reduced rate of relapse and increased adherence to medication. Studies included in these meta-analyses all encompassed patients receiving in-patient care, and requiring relatives partaking in an extensive educational program. A multi-center randomised control study in Sweden, aimed to investigate the effects of a twelve-month long intervention of a psycho - educational model for people with severe mental illness, SMI, in psychiatric and community settings, showed a powerful resistance from primarily the professionals which had been well trained in the model and secondly the patients which had been offered the intervention. Method: In-depth interviews with 24 professions in psychiatric and community outpatient settings engaged in the RCT study. Results: The findings showed that both patients and professional partners are skeptical about treatment programs of family psycho-pedagogical nature and prefer pure patient perspective and more acute short interventions. A reason for this was according to the professions lack of resources, while their patients experienced a hindrance in bothering their loved ones. Conclusion: The findings might show that the model per se is outmoded, not fitting the new structures of support, with reduced inpatient care, for people with SMI. In worst case, the findings might indicate that family psycho education, notwithstanding evidence based, is unavailable to people with SMI and their relatives which might contribute to a structural stigmatization of this population. More research is needed to understand if our findings are consistent with findings in other international contexts.