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Elizabeth Kuipers - One of the best experts on this subject based on the ideXlab platform.
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Family Interventions in early psychosis specificity and effectiveness
Epidemiology and Psychiatric Sciences, 2011Co-Authors: Juliana Onwumere, Paul Bebbington, Elizabeth KuipersAbstract:The first episode of psychosis frequently occurs during adolescence and early adulthood, and is associated with high levels of trauma, affective disturbance and suicide. The social networks of service users often decrease significantly following the first onset, although many will remain in close contact with some Family members particularly during the early phases. However, the negative impact of psychosis on families and their relationship with the identified service user are well documented. Family Intervention is a recommended and evidence-based treatment in later psychosis. In this paper, we review the literature on Family Interventions in early psychosis in the context of new evidence for its efficacy and its routine incorporation in early Intervention services for psychosis.
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early Intervention services cognitive behavioural therapy and Family Intervention in early psychosis systematic review
British Journal of Psychiatry, 2010Co-Authors: Victoria Bird, Preethi Premkumar, Tim Kendall, Craig Whittington, Jonathan Mitchell, Elizabeth KuipersAbstract:Background Early Intervention services for psychosis aim to detect emergent symptoms, reduce the duration of untreated psychosis, and improve access to effective treatments. Aims To evaluate the effectiveness of early Intervention services, cognitive–behavioural therapy (CBT) and Family Intervention in early psychosis. Method Systematic review and meta-analysis of randomised controlled trials of early Intervention services, CBT and Family Intervention for people with early psychosis. Results Early Intervention services reduced hospital admission, relapse rates and symptom severity, and improved access to and engagement with treatment. Used alone, Family Intervention reduced relapse and hospital admission rates, whereas CBT reduced the severity of symptoms with little impact on relapse or hospital admission. Conclusions For people with early psychosis, early Intervention services appear to have clinically important benefits over standard care. Including CBT and Family Intervention within the service may contribute to improved outcomes in this critical period. The longer-term benefits of this approach and its component treatments for people with early and established psychosis need further research.
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cognitive behavioural therapy and Family Intervention for relapse prevention and symptom reduction in psychosis randomised controlled trial
British Journal of Psychiatry, 2008Co-Authors: Philippa Garety, Paul Bebbington, David Fowler, Daniel Freeman, Graham Dunn, Elizabeth KuipersAbstract:Background Family Intervention reduces relapse rates in psychosis. Cognitive–behavioural therapy (CBT) improves positive symptoms but effects on relapse rates are not established. Aims To test the effectiveness of CBT and Family Intervention in reducing relapse, and in improving symptoms and functioning in patients who had recently relapsed with non-affective psychosis. Method A multicentre randomised controlled trial ([ISRCTN83557988][1]) with two pathways: those without carers were allocated to treatment as usual or CBT plus treatment as usual, those with carers to treatment as usual, CBT plus treatment as usual or Family Intervention plus treatment as usual. The CBT and Family Intervention were focused on relapse prevention for 20 sessions over 9 months. Results A total of 301 patients and 83 carers participated. Primary outcome data were available on 96% of the total sample. The CBT and Family Intervention had no effects on rates of remission and relapse or on days in hospital at 12 or 24 months. For secondary outcomes, CBT showed a beneficial effect on depression at 24 months and there were no effects for Family Intervention. In people with carers, CBT significantly improved delusional distress and social functioning. Therapy did not change key psychological processes. Conclusions Generic CBT for psychosis is not indicated for routine relapse prevention in people recovering from a recent relapse of psychosis and should currently be reserved for those with distressing medication-unresponsive positive symptoms. Any CBT targeted at this acute population requires development. The lack of effect of Family Intervention on relapse may be attributable to the low overall relapse rate in those with carers. [1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN83557988
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Cognitive-behavioural therapy and Family Intervention for relapse prevention and symptom reduction in psychosis: randomised controlled trial
BRIT J PSYCHIAT, 2008Co-Authors: Elizabeth KuipersAbstract:BackgroundFamily Intervention reduces relapse rates in psychosis. Cognitive-behavioural therapy (CBT) improves positive symptoms but effects on relapse rates are not established.AimsTo test the effectiveness of CBT and Family Intervention in reducing relapse, and in improving symptoms and functioning in patients who had recently relapsed with non-affective psychosis.MethodA multicentre randomised controlled trial (ISRCTN83557988) with two pathways: those without carers were allocated to treatment as usual or CBT plus treatment as usual, those with carers to treatment as usual, CBT plus treatment as usual or Family Intervention plus treatment as usual. The CBT and Family Intervention were focused on relapse prevention for 20 sessions over 9 months.ResultsA total of 301 patients and 83 carers participated. Primary outcome data were available on 96% of the total sample. The CBT and Family Intervention had no effects on rates of remission and relapse or on days in hospital at 12 or 24 months. For secondary outcomes, CBT showed a beneficial effect on depression at 24 months and there were no effects for Family Intervention. in people with carers, CBT significantly improved delusional distress and social functioning. Therapy did not change key psychological processes.ConclusionsGeneric CBT for psychosis is not indicated for routine relapse prevention in people recovering from a recent relapse of psychosis and should currently be reserved for those with distressing medication-unresponsive positive symptoms. Any CBT targeted at this acute population requires development. The lack of effect of Family Intervention on relapse may be attributable to the low overall relapse rate in those with carers.
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Family Interventions in schizophrenia evidence for efficacy and proposed mechanisms of change
Journal of Family Therapy, 2006Co-Authors: Elizabeth KuipersAbstract:Family Intervention for psychosis developed from empirical work on the role of emotion in families of those caring for someone with schizophrenia. The level of expressed emotion (EE) has been shown to be a robust predictor of subsequent outcome for service users returning to live in Family settings. There is also evidence that staff have similar attitudes. This has led to the development of specific Family Interventions for schizophrenia. NICE Guidelines for Schizophrenia (2003) confirm that Family Intervention is effective at reducing service user relapse rates and recommends it for those in contact with carers. Exactly how Family Intervention improves outcome is less clear. A recent model of psychosis proposes a primarily emotional rather than cognitive route for Family factors, and some evidence is presented which supports this. Implications for Family Interventions are discussed.
Nicholas Tarrier - One of the best experts on this subject based on the ideXlab platform.
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needs based cognitive behavioural Family Intervention for carers of patients suffering from schizophrenia 12 month follow up
Acta Psychiatrica Scandinavica, 2001Co-Authors: William Sellwood, Christine Barrowclough, Nicholas Tarrier, Joanne Quinn, John Mainwaring, Shon LewisAbstract:Objective: To examine longer-term effectiveness of a needs-based Family Intervention for carers and out-patients suffering from schizophrenia. Method: Seventy-nine unselected patient–carer pairs were recruited from a geographical area and allocated randomly to one of two conditions. One group received needs-based cognitive-behavioural Family Intervention in combination with general Family support plus the standard care. The control group received the general Family support and standard care only. Results: Analysis was carried out on an intention-to-treat basis. There was a significant advantage for Family Intervention, in terms of relapse (37% relapsed compared to 72%, NNT=3) and on other clinical measures. Treatment group and medication compliance were significant and independent predictors of relapse. There was a significant reduction in carer needs in the Intervention group. Conclusion: Family Intervention directed at carers' needs within a standard mental health service can produce benefits for patients beyond the term of Intervention.
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randomized controlled trial of motivational interviewing cognitive behavior therapy and Family Intervention for patients with comorbid schizophrenia and substance use disorders
American Journal of Psychiatry, 2001Co-Authors: Christine Barrowclough, Gillian Haddock, Nicholas Tarrier, Shon Lewis, Jan Moring, Robert Obrien, Nichola Schofield, John McgovernAbstract:OBJECTIVE: Comorbidity of substance abuse disorders with schizophrenia is associated with a greater risk for serious illness complications and poorer outcome. Methodologically sound studies investigating treatment approaches for patients with these disorders are rare, although recommendations for integrated and comprehensive treatment programs abound. This study investigates the relative benefit of adding an integrated psychological and psychosocial treatment program to routine psychiatric care for patients with schizophrenia and substance use disorders. METHOD: The authors conducted a randomized, single-blind controlled comparison of routine care with a program of routine care integrated with motivational interviewing, cognitive behavior therapy, and Family or caregiver Intervention. RESULTS: The integrated treatment program resulted in significantly greater improvement in patients' general functioning than routine care alone at the end of treatment and 12 months after the beginning of the study. Other benefits of the program included a reduction in positive symptoms and in symptom exacerbations and an increase in the percent of days of abstinence from drugs or alcohol over the 12-month period from baseline to follow-up. CONCLUSIONS: These findings demonstrate the effectiveness of a program of routine care integrated with motivational interviewing, cognitive behavior therapy, and Family Intervention over routine psychiatric care alone for patients with comorbid schizophrenia and alcohol or drug abuse or dependence.
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randomized controlled trial of motivational interviewing cognitive behavior therapy and Family Intervention for patients with comorbid schizophrenia and substance use disorders
American Journal of Psychiatry, 2001Co-Authors: Christine Barrowclough, Gillian Haddock, Nicholas Tarrier, Shon Lewis, Jan Moring, Robert Obrien, Nichola Schofield, John McgovernAbstract:OBJECTIVE: Comorbidity of substance abuse disorders with schizophrenia is associated with a greater risk for serious illness complications and poorer outcome. Methodologically sound studies investigating treatment approaches for patients with these disorders are rare, although recommendations for integrated and comprehensive treatment programs abound. This study investigates the relative benefit of adding an integrated psychological and psychosocial treatment program to routine psychiatric care for patients with schizophrenia and substance use disorders. METHOD: The authors conducted a randomized, single-blind controlled comparison of routine care with a program of routine care integrated with motivational interviewing, cognitive behavior therapy, and Family or caregiver Intervention. RESULTS: The integrated treatment program resulted in significantly greater improvement in patients’ general functioning than routine care alone at the end of treatment and 12 months after the beginning of the study. Other b...
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effectiveness of cognitive behavioural Family Intervention in reducing the burden of care in carers of patients with alzheimer s disease
British Journal of Psychiatry, 2000Co-Authors: Alison Marriott, Nicholas Tarrier, Catherine Donaldson, Alistair BurnsAbstract:Background The majority of patients with Alzheimer's disease live outside institutions and there is considerable serious psychological morbidity among their carers. Aims To evaluate whether Family Intervention reduces the subjective burden of care in carers of patients with Alzheimer's disease and produces clinical benefits in the patients. Method A prospective single-blind randomised controlled trial with three-month follow-up in which the experimental group received Family Intervention and was compared with two control groups. Results There were significant reductions in distress and depression in the Intervention group compared with control groups at post-treatment and follow-up. There were significant reductions in behavioural disturbance at post-treatment and an increase in activities at three months in patients in the Intervention group. Based on an improvement on the General Health Questionnaire resulting in a carer converting from a case to a non-case, the number to treat was three immediately post-treatment and two at follow-up. Conclusions Family Intervention can have significant benefits in carers of patients with Alzheimer's disease and has a positive impact on patient behaviour.
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randomised controlled effectiveness trial of a needs based psychosocial Intervention service for carers of people with schizophrenia
British Journal of Psychiatry, 1999Co-Authors: Christine Barrowclough, Nicholas Tarrier, Shon Lewis, William Sellwood, Joanne Quinn, John Mainwaring, Charlotte HamlinAbstract:BACKGROUND Family Interventions are effective in reducing relapse in patients with schizophrenia, but there is little work demonstrating the effectiveness of the Interventions in routine service settings. AIMS To test the effectiveness of a needs-based Family Intervention service for patients recruited as out-patients and their carers, including those of low expressed emotion status. METHOD Carers of out-patient schizophrenia sufferers selected only on illness history factors were randomly allocated to receive either Family support alone or in combination with systematic psychosocial Interventions based on an assessment of need. Delivery of Family Interventions attempted to involve the clinical team. RESULTS Relapse outcomes were superior for Family-treated patients at six-month follow-up, although most of the clinical and symptom patient variables assessed remained stable, as did measures of carer burden. CONCLUSIONS The study demonstrated the effectiveness of Family Interventions in routine service settings. Problems with staff, patient and carer engagement and participation were identified.
Matthew R Sanders - One of the best experts on this subject based on the ideXlab platform.
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childhood feeding difficulties a randomized controlled trial of a group based parenting Intervention
Journal of Developmental and Behavioral Pediatrics, 2013Co-Authors: Michelle Adamson, Alina Morawska, Matthew R SandersAbstract:Background: Difficulty with feeding is common during early childhood. Behavioral techniques have shown considerable utility for difficult feeding, although large-scale studies of behavioral parenting Interventions with typically developing young children, and in group formats, are limited. Objective: The current study aimed to evaluate the efficacy of a group-based, behavioral Family Intervention for typically developing healthy children with problem eating via a fully randomized 2-group design. Methods: Ninety-six families of children aged 1.5 to 6 years with feeding difficulties participated in a trial of Hassle Free Mealtimes Triple P (A. Morawska and M.R. Sanders, unpublished data, 2008) in regional and metropolitan Queensland (Australia). Results: Results support the utility of a group-based behavioral parenting program for childhood feeding issues, with significant improvements to the mealtime and general behavior of target children, the mealtime and general practices of parents, parental confidence and cognitions, compared with a waitlist control. Six-month follow-up data and clinical and reliable change indices support the Intervention's utility. Parents were also highly satisfied with the program. Conclusion: The current study provides evidence of the efficacy of a group-based behavioral Family Intervention for mealtime difficulties, including observational and more extended outcome measures. Future directions and clinical implications of this research are discussed.
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maintenance of treatment gains a comparison of enhanced standard and self directed triple p positive parenting program
Journal of Abnormal Child Psychology, 2007Co-Authors: Matthew R Sanders, William Bor, Alina MorawskaAbstract:This report describes the 3 year outcomes of three different variants of the Triple P-Positive Parenting Program, a behavioural Family Intervention. Families were randomly assigned to one of three Intervention conditions or to a waitlist condition. At 1 year follow-up there were similar improvements on observational and self-report measures of preschooler disruptive behaviour for Enhanced, Standard and Self Directed variants of Triple P. At 3 year follow-up (completed by 139 families), each condition showed a similar level of maintenance of Intervention effects. Approximately 2/3 of preschoolers who were clinically elevated on measures of disruptive behaviour at pre-Intervention moved from the clinical to the non-clinical range. Across conditions, there was a comparable preventive effect for each Intervention for these high risk children. The implications of the findings for the development of brief, cost effective parenting Interventions within a public health framework are discussed.
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help when it s needed first a controlled evaluation of brief preventive behavioral Family Intervention in a primary care setting
Behavior Therapy, 2006Co-Authors: Karen M T Turner, Matthew R SandersAbstract:This study evaluated the effects of a brief 3- to 4-session behavioral Family Intervention program for parents of preschool-aged children in a primary care setting, compared to parents in a wait-list control condition. Parents receiving the Primary Care Triple P-Positive Parenting Program Intervention reported significantly lower levels of targeted child behavior problems, dysfunctional parenting, and reduced parental anxiety and stress in comparison to wait-listed parents at postassessment. These short-term effects were largely maintained at 6-month follow-up assessment of the Intervention group. Implications of these findings for the prevention of behavioral and emotional problems in children are discussed.
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behavioral Family Intervention for children with developmental disabilities and behavioral problems
Journal of Clinical Child and Adolescent Psychology, 2006Co-Authors: Clare Roberts, Trevor G Mazzucchelli, Lisa J Studman, Matthew R SandersAbstract:The outcomes of a randomized clinical trial of a new behavioral Family Intervention, Stepping Stones Triple P, for preschoolers with developmental and behavior problems are presented. Forty-eight children with developmental disabilities participated, 27 randomly allocated to an Intervention group and 20 to a wait-list control group. Parents completed measures of parenting style and stress, and independent observers assessed parent-child interactions. The Intervention was associated with fewer child behavior problems reported by mothers and independent observers, improved maternal and paternal parenting style, and decreased maternal stress. All effects were maintained at 6-month follow-up.
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prevention of child behavior problems through universal implementation of a group behavioral Family Intervention
Prevention Science, 2005Co-Authors: Stephen R Zubrick, Kristine A Ward, Sven R Silburn, David Lawrence, Anwen Williams, Eve Blair, Deborah Robertson, Matthew R SandersAbstract:The aim of this mental health promotion initiative was to evaluate the effectiveness of a universally delivered group behavioral Family Intervention (BFI) in preventing behavior problems in children. This study investigates the transferability of an efficacious clinical program to a universal prevention Intervention delivered through child and community health services targeting parents of preschoolers within a metropolitan health region. A quasiexperimental two-group (BFI, n = 804 vs. Comparison group, n = 806) longitudinal design followed preschool aged children and their parents over a 2-year period. BFI was associated with significant reductions in parent- reported levels of dysfunctional parenting and parentreported levels of child behavior problems. Effect sizes on child behavior problems ranged from large (.83) to moderate (.47). Positive and significant effects were also observed in parent mental health, marital adjustment, and levels of child rearing conflict. Findings are discussed with respect to their implication for significant population reductions in child behavior problems as well as the pragmatic challenges for prevention science in encouraging both the evaluation and uptake of preventive initiatives in real world settings.
Shon Lewis - One of the best experts on this subject based on the ideXlab platform.
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needs based cognitive behavioural Family Intervention for carers of patients suffering from schizophrenia 12 month follow up
Acta Psychiatrica Scandinavica, 2001Co-Authors: William Sellwood, Christine Barrowclough, Nicholas Tarrier, Joanne Quinn, John Mainwaring, Shon LewisAbstract:Objective: To examine longer-term effectiveness of a needs-based Family Intervention for carers and out-patients suffering from schizophrenia. Method: Seventy-nine unselected patient–carer pairs were recruited from a geographical area and allocated randomly to one of two conditions. One group received needs-based cognitive-behavioural Family Intervention in combination with general Family support plus the standard care. The control group received the general Family support and standard care only. Results: Analysis was carried out on an intention-to-treat basis. There was a significant advantage for Family Intervention, in terms of relapse (37% relapsed compared to 72%, NNT=3) and on other clinical measures. Treatment group and medication compliance were significant and independent predictors of relapse. There was a significant reduction in carer needs in the Intervention group. Conclusion: Family Intervention directed at carers' needs within a standard mental health service can produce benefits for patients beyond the term of Intervention.
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randomized controlled trial of motivational interviewing cognitive behavior therapy and Family Intervention for patients with comorbid schizophrenia and substance use disorders
American Journal of Psychiatry, 2001Co-Authors: Christine Barrowclough, Gillian Haddock, Nicholas Tarrier, Shon Lewis, Jan Moring, Robert Obrien, Nichola Schofield, John McgovernAbstract:OBJECTIVE: Comorbidity of substance abuse disorders with schizophrenia is associated with a greater risk for serious illness complications and poorer outcome. Methodologically sound studies investigating treatment approaches for patients with these disorders are rare, although recommendations for integrated and comprehensive treatment programs abound. This study investigates the relative benefit of adding an integrated psychological and psychosocial treatment program to routine psychiatric care for patients with schizophrenia and substance use disorders. METHOD: The authors conducted a randomized, single-blind controlled comparison of routine care with a program of routine care integrated with motivational interviewing, cognitive behavior therapy, and Family or caregiver Intervention. RESULTS: The integrated treatment program resulted in significantly greater improvement in patients' general functioning than routine care alone at the end of treatment and 12 months after the beginning of the study. Other benefits of the program included a reduction in positive symptoms and in symptom exacerbations and an increase in the percent of days of abstinence from drugs or alcohol over the 12-month period from baseline to follow-up. CONCLUSIONS: These findings demonstrate the effectiveness of a program of routine care integrated with motivational interviewing, cognitive behavior therapy, and Family Intervention over routine psychiatric care alone for patients with comorbid schizophrenia and alcohol or drug abuse or dependence.
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randomized controlled trial of motivational interviewing cognitive behavior therapy and Family Intervention for patients with comorbid schizophrenia and substance use disorders
American Journal of Psychiatry, 2001Co-Authors: Christine Barrowclough, Gillian Haddock, Nicholas Tarrier, Shon Lewis, Jan Moring, Robert Obrien, Nichola Schofield, John McgovernAbstract:OBJECTIVE: Comorbidity of substance abuse disorders with schizophrenia is associated with a greater risk for serious illness complications and poorer outcome. Methodologically sound studies investigating treatment approaches for patients with these disorders are rare, although recommendations for integrated and comprehensive treatment programs abound. This study investigates the relative benefit of adding an integrated psychological and psychosocial treatment program to routine psychiatric care for patients with schizophrenia and substance use disorders. METHOD: The authors conducted a randomized, single-blind controlled comparison of routine care with a program of routine care integrated with motivational interviewing, cognitive behavior therapy, and Family or caregiver Intervention. RESULTS: The integrated treatment program resulted in significantly greater improvement in patients’ general functioning than routine care alone at the end of treatment and 12 months after the beginning of the study. Other b...
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randomised controlled effectiveness trial of a needs based psychosocial Intervention service for carers of people with schizophrenia
British Journal of Psychiatry, 1999Co-Authors: Christine Barrowclough, Nicholas Tarrier, Shon Lewis, William Sellwood, Joanne Quinn, John Mainwaring, Charlotte HamlinAbstract:BACKGROUND Family Interventions are effective in reducing relapse in patients with schizophrenia, but there is little work demonstrating the effectiveness of the Interventions in routine service settings. AIMS To test the effectiveness of a needs-based Family Intervention service for patients recruited as out-patients and their carers, including those of low expressed emotion status. METHOD Carers of out-patient schizophrenia sufferers selected only on illness history factors were randomly allocated to receive either Family support alone or in combination with systematic psychosocial Interventions based on an assessment of need. Delivery of Family Interventions attempted to involve the clinical team. RESULTS Relapse outcomes were superior for Family-treated patients at six-month follow-up, although most of the clinical and symptom patient variables assessed remained stable, as did measures of carer burden. CONCLUSIONS The study demonstrated the effectiveness of Family Interventions in routine service settings. Problems with staff, patient and carer engagement and participation were identified.
Paul Bebbington - One of the best experts on this subject based on the ideXlab platform.
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Family Interventions in early psychosis specificity and effectiveness
Epidemiology and Psychiatric Sciences, 2011Co-Authors: Juliana Onwumere, Paul Bebbington, Elizabeth KuipersAbstract:The first episode of psychosis frequently occurs during adolescence and early adulthood, and is associated with high levels of trauma, affective disturbance and suicide. The social networks of service users often decrease significantly following the first onset, although many will remain in close contact with some Family members particularly during the early phases. However, the negative impact of psychosis on families and their relationship with the identified service user are well documented. Family Intervention is a recommended and evidence-based treatment in later psychosis. In this paper, we review the literature on Family Interventions in early psychosis in the context of new evidence for its efficacy and its routine incorporation in early Intervention services for psychosis.
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cognitive behavioural therapy and Family Intervention for relapse prevention and symptom reduction in psychosis randomised controlled trial
British Journal of Psychiatry, 2008Co-Authors: Philippa Garety, Paul Bebbington, David Fowler, Daniel Freeman, Graham Dunn, Elizabeth KuipersAbstract:Background Family Intervention reduces relapse rates in psychosis. Cognitive–behavioural therapy (CBT) improves positive symptoms but effects on relapse rates are not established. Aims To test the effectiveness of CBT and Family Intervention in reducing relapse, and in improving symptoms and functioning in patients who had recently relapsed with non-affective psychosis. Method A multicentre randomised controlled trial ([ISRCTN83557988][1]) with two pathways: those without carers were allocated to treatment as usual or CBT plus treatment as usual, those with carers to treatment as usual, CBT plus treatment as usual or Family Intervention plus treatment as usual. The CBT and Family Intervention were focused on relapse prevention for 20 sessions over 9 months. Results A total of 301 patients and 83 carers participated. Primary outcome data were available on 96% of the total sample. The CBT and Family Intervention had no effects on rates of remission and relapse or on days in hospital at 12 or 24 months. For secondary outcomes, CBT showed a beneficial effect on depression at 24 months and there were no effects for Family Intervention. In people with carers, CBT significantly improved delusional distress and social functioning. Therapy did not change key psychological processes. Conclusions Generic CBT for psychosis is not indicated for routine relapse prevention in people recovering from a recent relapse of psychosis and should currently be reserved for those with distressing medication-unresponsive positive symptoms. Any CBT targeted at this acute population requires development. The lack of effect of Family Intervention on relapse may be attributable to the low overall relapse rate in those with carers. [1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN83557988
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psychological treatments in schizophrenia i meta analysis of Family Intervention and cognitive behaviour therapy
Psychological Medicine, 2002Co-Authors: Stephen Pilling, Elizabeth Kuipers, Paul Bebbington, Philippa Garety, John R Geddes, G Orbach, Celia J A MorganAbstract:Background. While there is a growing body of evidence on the efficacy of psychological Interventions for schizophrenia, this meta-analysis improves upon previous systematic and meta-analytical reviews by including a wider range of randomized controlled trials and providing comparisons against both standard care and other active Interventions. Method. Literature searches identified randomized controlled trials of four types of psychological Interventions: Family Intervention, cognitive behavioural therapy (CBT), social skills training and cognitive remediation. These were then subjected to meta-analysis on a variety of outcome measures. This paper presents results relating to the first two. Results. Family therapy, in particular single Family therapy, had clear preventative effects on the outcomes of psychotic relapse and readmission, in addition to benefits in medication compliance. CBT produced higher rates of 'important improvement' in mental state and demonstrated positive effects on continuous measures of mental state at follow-up. CBT also seems to be associated with low drop-out rates. Conclusions. Family Intervention should be offered to people with schizophrenia who are in contact with carers. CBT may be useful for those with treatment resistant symptoms. Both treatments, in particular CBT, should be further investigated in large trials across a variety of patients, in various settings. The factors mediating treatment success in these Interventions should be researched.
