AN INVESTIGATION INTO FAMILY INTERVENTION WITHIN FORENSIC SERVICES

Abstract

Schizophrenia is a severe and chronic disorder in many cases. The illness can impact on the whole family. Family interventions are a psychosocial treatment for schizophrenia. A robust evidence base has developed supporting the use of family interventions, as reduced relapse and other clinical benefits can be produced. The majority of service users in forensic services suffer from schizophrenia. Yet little is known about the need, acceptability or feasibility of family intervention in forensic services. The over-arching goal of this programme of research was to review the literature for family intervention and conduct a comprehensive needs assessment, with a final aim to resolve the barriers of implementation of family intervention within forensic services. Meta-analysis indicated that the efficacy of family interventions resulted in positive outcomes in reduced relapse and psychotic symptoms, and improved knowledge and relationships. Family interventions were found to be applicable to the psychological needs of forensic service users. Problems were identified with staff training and supervision on forensic wards, with few wards providing family intervention as part of treatment for schizophrenia. Relatives of forensic service users expressed a need for family intervention. Staff highlighted that the barriers to family intervention were associated with insufficient time, poor support, lack of training, deficient information sharing, and geographic limitations between family homes and the forensic units. Staff offered solutions to implementing family intervention that related to revised policy and improved supervision. Relatives and staff held positive attitudes toward family intervention with open-minded attitudes towards the use of a web camera to facilitate family intervention in forensic services (e-FFI). The fourteen week web based family intervention (e-FFI) feasibility study generated reduced levels of stress, stigma and expressed emotion with improvements in the family's knowledge of schizophrenia, personal health and an acceptance of forensic services. E-FFI was administered with ease achieving positive feedback from the family and the forensic service.

Date of Award	1 Aug 2012
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Nicholas Tarrier (Supervisor) & Patricia Gooding (Supervisor)