Involucrando a la familia en la atención de los adolescentes en riesgo de psicosis / Involving the family in the care of adolescents at risk of psychosis / Implicant la familia en l'atenció dels adolescents en risc de psicosi

Existe un consenso general acerca de los elementos centrales de las intervenciones que pueden ser útiles para los jóvenes que se consideran en riesgo de desarrollar psicosis. La mayoría de los centros de todo el mundo ofrecen la psicoeducación familiar y apoyo como parte de esos elementos. Estudios preliminares muestran que los enfoques de la familia son factibles, útiles y aceptables para los jóvenes y sus familias. Los tratamientos que se han desarrollado suelen ser adaptaciones de lo que ha sido eficaz en los pacientes con psicosis ya sea temprana o trastornos psicóticos graves y duraderos, y por lo tanto provienen de base de la psicopatología en lugar de de la medicina general. En muchos estudios, es difícil determinar qué intervenciones contribuyeron a qué resultados, ya que los enfoques generalmente tienen múltiples elementos. El trabajo familiar parece retrasar la aparición de la psicosis en un período de dos años. Lo que se ofrece debe ser sensible al desarrollo, potenciar las habilidades de afrontamiento, el manejo del estrés y de la comunicación y ayudar a la familia para aumentar la resiliencia

There is general consensus about the core elements of interventions that may be helpful for young people considered to be at risk of developing psychosis. Most centres worldwide offer family education and support as one of those elements. Studies in their early stages have shown that familybased approaches are feasible, helpful and acceptable to young people and their families. The treatments that have been developed tend to be adaptations of what has been effective for patients with either early psychosis or severe and enduring psychotic disorders, and therefore come from a background of pathology rather than general health. In many studies, it is difficult to ascertain which of the interventions contributed to which outcomes, as approaches generally have featured a number of different elements. Family work appears to delay the onset of psychosis over a two year period. Whatever attention is offered must be developmentally sensitive, build coping, stress-management and communication skills and help the family to build resilience

Implicant la família en l’atenció dels adolescents en risc de psicosi. Existeix un consens sobre els elements centrals de les intervencions que poden ser útils per als joves considerats amb risc de desenvolupar psicosi. La majoria dels centres de tot el món ofereixen la psicoeducació familiar i suport com a part d’aquests elements. Estudis preliminars mostren que els enfocs de la família són factibles, útils i acceptables per als joves i les seves famílies. Els tractaments que s’han desenvolupat acostumen a ser adaptacions del que ha estat eficaç en els pacients amb psicosi, ja sigui primerenca o trastorns psicòtics greus i de llarga durada, i per tant provenen de la base de la psicopatologia enlloc de la medicina general. En molts estudis, és difícil determinar quines intervencions van contribuir a segons quins resultats, ja que els enfocs tenen generalment múltiples elements. El treball familiar sembla retardar l’aparició de la psicosi en un període de dos anys. El que s’ofereix ha de ser sensible al desenvolupament, potenciar les habilitats d’afrontament, el maneig de l’estrès i de la comunicació i ajudar a la família per augmentar la resiliència

The Meriden Family Programme: lessons learned over 10 years.

BACKGROUND: Psychoeducational family approaches are effective in improving the quality of life for both those with mental health problems and their families, but implementation of these approaches within health services has been limited. The Meriden Family Programme has provided training and support for over 3,900 therapists and 242 trainers in Behavioural Family Therapy (BFT) to encourage widespread delivery of effective services for families with a member who has psychosis or other serious mental health problems. AIMS: This article synthesises healthcare professionals' and carers' views on the implementation of family work and ways of increasing family involvement in services. METHODS: During the Meriden Programme's 10th anniversary year, three Masterclass groups (n = 27) were conducted with healthcare professionals and carers involved with the programme over the past 10 years. RESULTS: A collaborative approach between management, commissioners, BFT trainers, therapists, carers and service users encourages and ensures the delivery of family work. The most effective types of support, methods of training and organisational factors in supporting family work implementation are illustrated. CONCLUSIONS: Best practices in implementing family work are identified to support and better inform those responsible for providing family work within their services.

[Family interventions in schizophrenia. From theory to the real world in Portugal today]. / Intervenções familiares na esquizofrenia. Dos aspectos teóricos à situação em Portugal.

In the field of pychoeducational interventions in schizophrenia, terminology is sometimes misleading and further efforts are needed to specify and operationalise terms such as psychoeducation or family intervention, especially wherever they are adapted, for example, for use in non-English speaking countries. On the other hand, in spite of growing evidence of their clinical effectiveness, family interventions for schizophrenia are still not routinely implemented in real life clinical settings. Furthermore, the current poverty of original literature or replication studies in Portugal in the field of family interventions is astonishing. Several high-quality review papers have been published in the last two decades, summarising or meta-analysing data concerning efficacy, effectiveness and efficiency of these family interventions worldwide, but mostly in Anglo-Saxon literature. These findings were indeed incorporated in several clinical guidelines, namely in the United Kingdom. But there seems to exist, in a considerable number of settings, a lack of will to implement scientific findings established for more than twenty years. In developed countries, this should be addressed as a true paradox.

Effectiveness of a psychoeducational intervention for families of patients with schizophrenia: preliminary results of a study funded by the European Commission.

In spite of their proven efficacy, psychoeducational interventions for families of patients with schizophrenia are not being commonly applied in clinical practice. In this report, we present the preliminary results of a one-year follow-up study on the implementation and effectiveness of a psychoeducational family intervention in six European countries. Forty-eight professionals were involved in the study and provided the intervention for one year to 55 families of patients with schizophrenia. During the implementation period, the professionals reported significant organisational difficulties in the provision of the intervention, but acknowledged an improvement of their relationships with users and their families. At follow-up assessment, statistically significant improvements were found in patients' symptoms and social functioning as well as in relatives' burden, coping strategies and social resources.