[Family therapy and work with relatives in various psychiatric diseases]

Abstract

The use of family therapy and relatives' groups in various areas of psychiatry, e.g. schizophrenia, affective disorders, eating disorders, dependency disorders, psychogeriatrics, and adolescent and child psychiatry, is discussed. These forms of therapy have continued to increase in popularity, although relatively few controlled studies of their effectiveness had been undertaken until quite recently. For each disorder, the most frequently employed types of therapy are compared with each other on the basis of controlled studies of efficacy. More flexible combinations and integrated approaches are constantly being developed. These rely less on particular methods of treatment than on the patients themselves, their illnesses, and their attitudes towards their mental states and social environments. A few of these treatment strategies are discussed, and their most important features described. Controlled studies have provided increasing evidence of the efficacy of family therapy and relatives' groups in respect of various criteria: relapse rate, psychopathology, symptoms, quality of life (both of the patients and of their relatives), social integration, and subjective well-being, amongst others. The effectiveness of such treatment in many areas requires further investigation, for example in chronic mental illness and psychogeriatric disorders, which represent fields of ever-increasing interest. More basic research and continued assessment of the methods employed in practice will be required to clarify further the underlying principles and the best framework for carrying out family therapy and relatives' group sessions, and thereby develop successful methods of treatment based on firm theoretical principles.