The application of expressed emotion to clinical work in schizophrenia

The article describes the authors' approach to working with families of schizophrenic clients and attempts to give the reader an understanding of why it is important to take account of expressed emotion (EE) in planning and executing family interventions. To this end we include descriptions of the EE dimensions in the context of schizophrenia in a way that may be meaningful to clinicians (i.e., criticism, emotional overinvolvement, and hostility). Assessment techniques directed at general clinical use are outlined, and we describe methods of harnessing aspects of our understanding of EE to generate and guide family intervention goals. This is followed by a case example used to illustrate the assessments, before we examine the intervention framework and techniques with the help of further clinical material. We employ a case formulation framework to produce an individualized view of each family's problems (Barrowclough and Tarrier, 1992).