Skip to main content
    • Aa
    • Aa

Efficacy and effectiveness of individual family intervention on social and clinical functioning and family burden in severe schizophrenia: a 2-year randomized controlled study

  • M. Girón (a1), A. Fernández-Yañez (a2), S. Mañá-Alvarenga (a3), A. Molina-Habas (a4), A. Nolasco (a5) and M. Gómez-Beneyto (a6) (a7)...

Empirical evidence of the efficacy and effectiveness of psychosocial family intervention and of the specificity of its effects on the course of schizophrenia is limited. The aim was to study the efficacy and effectiveness of psychosocial family intervention with regard to clinical and social functioning and family burden after controlling for compliance and several prognostic factors.


A 2-year randomized controlled trial with blind assessments. Fifty patients with DSM-IV schizophrenia and persistent positive symptoms and/or previous clinical relapse were allocated to psychosocial family intervention, individual counselling and standard treatment versus individual counselling and standard treatment.


Family intervention was associated with fewer clinical relapses, hospitalizations and major incidents, and an improvement in positive and negative symptoms, social role performance, social relations, employment and family burden. The reduction in hospitalizations in the family intervention group was significantly greater than that observed in the group of patients who refused to participate but this was not the case for the control group. The effects of family intervention were independent of compliance and prognostic factors.


Family intervention is effective in severe schizophrenia independently of compliance and prognostic factors.

Corresponding author
*Address for correspondence: Dr M. Girón, Departamento de Medicina Clinica, Universitat Miguel Hernández, Campus de Sant Joan, Carretera Alacant-València (N-332) Km 87, 03550Sant Joan d'Alacant, Spain. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

C Barrowclough , G Haddock , N Tarrier , SW Lewis , J Moring , R O'Brien , N Schofield , J McGovern (2001). 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 158, 17061713.

C Barrowclough , N Tarrier , S Lewis , W Sellwood , J Mainwaring , J Quinn , C Hamlin (1999). Randomised controlled effectiveness trial of a needs-based psychosocial intervention service for carers of people with schizophrenia. British Journal of Psychiatry 174, 505511.

M Bertelsen , P Jeppesen , L Petersen , A Thorup , J Øhlenschlaeger , P le Quach , Christensen , G Krarup , P Jørgensen , M Nordentoft (2008). Five-year follow-up of a randomized multicenter trial of intensive early intervention vs standard treatment for patients with a first episode of psychotic illness: the OPUS trial. Archives of General Psychiatry 65, 762771.

GM Bradley , GM Couchman , A Perlesz , AT Nguyen , B Singh , C Riess (2006). Multiple-family group treatment for English- and Vietnamese-speaking families living with schizophrenia. Psychiatric Services 57, 521530.

RL Butzlaff , JM Hooley (1998). Expressed emotion and psychiatric relapse: a meta-analysis. Archives of General Psychiatry 55, 547552.

JM Canive , J Sanz-Fuentenebro , C Vazquez , C Qualls , F Fuentenebro , VB Tuason (1995). Family environment predictors of outcome in schizophrenic patients in Spain: a nine-month follow-up study. Acta Psychiatrica Scandinavica 92, 371377.

WT Chien , SW Chan , DR Thompson (2006). Effects of a mutual support group for families of Chinese people with schizophrenia: 18-month follow-up. British Journal of Psychiatry 189, 4149.

WT Chien , KF Wong (2007). A family psychoeducation group program for Chinese people with schizophrenia in Hong Kong. Psychiatric Services 58, 10031006.

IRH Falloon , JL Boyd , CW McGill , M Williamson , J Razani , HB Moss , AM Gilderman , GM Simpson (1985). Family management in the prevention of morbidity of schizophrenia: clinical outcome of a two-year longitudinal study. Archives of General Psychiatry 42, 887896.

PA Garety , DG Fowler , D Freeman , P Bebbington , G Dunn , E Kuipers (2008). Cognitive-behavioural therapy and family intervention for relapse prevention and symptom reduction in psychosis: randomised controlled trial. British Journal of Psychiatry 192, 412423.

M Girón , M Gómez-Beneyto (1998). Relationship between empathic family attitude and relapse in schizophrenia: a two year follow-up study. Schizophrenia Bulletin 24, 619627.

M Girón , M Gómez-Beneyto (2004). Relationship between family attitudes and social functioning in schizophrenia: a nine month follow-up perspective study. Journal of Nervous and Mental Disease 192, 414420.

G Haddock , C Barrowclough , N Tarrier , J Moring , R O'Brien , N Schofield , J Quinn , S Palmer , L Davies , I Lowens , J McGovern , S Lewis (2003). Cognitive-behavioural therapy and motivational intervention for schizophrenia and substance misuse: 18-month outcomes of a randomised controlled trial. British Journal of Psychiatry 183, 418426.

NA Hazel , MG McDonell , RA Short (2004). Impact of multiple-family groups for outpatients with schizophrenia on caregivers' distress and resources. Psychiatric Services 55, 3541.

DW Heinrichs , TE Hanlon , WT Carpenter (1984). The Quality of Life Scale: an instrument for rating the schizophrenia deficit syndrome. Schizophrenia Bulletin 10, 388398.

MJ Hilsenroth , SJ Ackerman , MD Blagys , BD Baumann , MR Baity , SR Smith , JL Price , CL Smith , TL Heindselman , MK Mount , DJ Holdwick Jr. (2000). Reliability and validity of DSM IV Axis V. American Journal of Psychiatry 157, 18581863.

GE Hogarty , CM Anderson , DJ Reiss , SJ Kornblith , DP Greenwald , RF Ulrich , M Carter (1991). Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia. II. Two-year effects of a controlled study on relapse and adjustment. Archives of General Psychiatry 48, 340347.

M Krawiecka , D Goldberg , M Vaughan (1977). A standardized psychiatric assessment scale for rating chronic psychotic patients. Acta Psychiatrica Scandinavica 55, 299308.

L Magliano , A Fiorillo , C Malangone , C De Rosa , M Maj (2006). Patient functioning and family burden in a controlled, real-world trial of family psychoeducation for schizophrenia. Psychiatric Services 57, 17841791.

MG McDonell , RA Short , CM Berry , DG Dyck (2003). Burden in schizophrenia caregivers: impact of family psychoeducation and awareness of patient suicidality. Family Process 42, 91–103.

I Montero , M Gómez-Beneyto , I Ruiz , E Puche , A Adam (1992). The influence of family expressed emotion on the course of schizophrenia in a sample of Spanish patients: a two-year follow-up study. British Journal of Psychiatry 161, 217222.

M Pfammater , U Martin-Junghan , H Dieter-Brenner (2006). Efficacy of psychological therapy in schizophrenia: conclusions from meta-analyses. Schizophrenia Bulletin 32, 6480.

S Platt , A Weyman , S Hirsch , S Hewett (1980). The Social Behaviour Assessment Schedule (SBAS): rationale, contents, scoring and reliability of a new interview schedule. Social Psychiatry 15, 4355.

HL Provencher , KT Mueser (1997). Positive and negative symptom behaviors and caregiver burden in the relatives of persons with schizophrenia. Schizophrenia Research 26, 7180.

C Roick , D Heider , M Toumi , MC Angermeyer (2006). The impact of caregivers' characteristics, patients' conditions and regional differences on family burden in schizophrenia: a longitudinal analysis. Acta Psychiatrica Scandinavica 114, 363374.

SJ Siegel , F Irani , CM Brensinger , CG Kohler , WB Bilker , JD Ragland , SJ Kanes , RC Gur , RE Gur (2006). Prognostic variables at intake and long-term level of function in schizophrenia. American Journal of Psychiatry 163, 433441.

JS Strauss , WT Carpenter Jr. (1974). The prediction of outcome in schizophrenia. II. Relationships between predictor and outcome variables: a report from the WHO international pilot study of schizophrenia. Archives of General Psychiatry 31, 3742.

N Tarrier , C Barrowclough , K Porceddu , E Fitzpatrick (1994). The Salford Family Intervention Project: relapse rates of schizophrenia at five and eight years. British Journal of Psychiatry 165, 829832.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 25
Total number of PDF views: 123 *
Loading metrics...

Abstract views

Total abstract views: 518 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 27th May 2017. This data will be updated every 24 hours.