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SUMMARYBurbach describes the content of a phased approach to delivering family work in psychosis. Clinicians would find it helpful to have guidance on how to address the challenges they face in clinical practice, such as engaging all family members in the process and how to deal with confidentiality conflicts. Implementation challenges are also likely to affect their ability to deliver this intervention. It may also be useful to consider the role that family members can play in co-production and training, and in delivering support to other families through a carer peer support model.DECLARATION OF INTERESTNone.

The purpose of this audit was to explore the experiences of 42 professionals trained over a three‐year period as trainers in behavioural family therapy. Trainers completed a questionnaire designed to explore their motivations, frustrations, sources of support and benefits they experienced through involvement with the Meriden Family Programme. Quasi‐qualitative, thematic analyses were performed on the data. The audit found numerous intrinsic motivations for being a trainer, as well as a wide range of benefits, including belief in the approach, wanting to help families, enjoyment of teaching and professional development. Frustrations encountered were disinterest of staff, lack of support and restrictions on the trainers' role. Trainers were resourceful and used various solutions to overcome these. Recommendations are made on how to manage and maintain enthusiasm and support of trainers, or other family work champions.

Background: Strong evidence exists to support the use of psychoeducational approaches in psychosis. However, engagement of families in such approaches is problematic.Aims: The aim of the qualitative study described was to establish what therapists and families believe to be helpful (or otherwise) in the engagement of families in behavioural family therapy (BFT). In addition, the nature of the relationship between workers and families was explored.Method: Data were collected via interviews with trained therapists and family members engaged in BFT. A grounded theory approach was used in the analysis of interview transcripts.Results: A model of engagement from the therapist perspective was developed. A core category of humanity emerged. The model is described and discussed in relation to the implementation literature regarding psychoeducational family interventions.Conclusions: Qualities possessed by the practitioner are key in engagement of families and the application of psychoeducational approaches. Furth...

The efficacy of family interventions in schizophrenia is now well established. Major reviews of the literature all conclude that family psycho-educational interventions result in reduced relapse rates, hospitalisation rates and costs of care, in improved compliance with medication, and that they are applicable across cultures. However, there is no evidence that family approaches to schizophrenia are being offered on a global scale in mental health services. A number of studies have shown that clinicians can be trained effectively in family intervention skills, but there are major obstacles to the implementation of these interventions in routine clinical practice. The present study describes the results of a survey of 86 therapists who received training in Behavioural Family Therapy (BFT); 70% of therapists reported that they had used the approach in their work, but the mean number of families seen per therapist was only 1.7. Forty per cent of the families were seen by 8% of the therapists trained...

Psychoeducational family approaches are effective in improving the quality of life for both those with mental health problems and their families, but implementation of these approaches within health services has been limited. The Meriden Family Programme has provided training and support for over 3,900 therapists and 242 trainers in Behavioural Family Therapy (BFT) to encourage widespread delivery of effective services for families with a member who has psychosis or other serious mental health problems.This article synthesises healthcare professionals' and carers' views on the implementation of family work and ways of increasing family involvement in services.During the Meriden Programme's 10th anniversary year, three Masterclass groups (n = 27) were conducted with healthcare professionals and carers involved with the programme over the past 10 years.A collaborative approach between management, commissioners, BFT trainers, therapists, carers and service users encourages and ensures the delivery of family work. The most effective types of support, methods of training and organisational factors in supporting family work implementation are illustrated.Best practices in implementing family work are identified to support and better inform those responsible for providing family work within their services.

Os autores fazem uma retrospectiva da utilização de psicoterapia comportamental em famílias de pessoas com doença mental grave, nomeadamente esquizofrenia, focando o modelo de Falloon e colaboradores (Terapia Familiar Comportamental). Trata-se de uma intervenção unifamiliar, psicoeducativa, de inspiração comportamental, que pretende melhorar a capacidade de resolução de problemas no seio da família. Os resultados estão bem documentados em termos clínicos (menores taxas de recaída), psicossociais (melhor funcionamento socio-ocupacional, menor sobrecarga familiar) e económicos. Estas intervenções estão amplamente difundidas na Europa e EUA, e as suas indicações têm sido alargadas a diversos campos da psicopatologia do adulto, bem como da infância e adolescência. Em Portugal, o treino neste tipo de intervenções tem vindo a ser feito desde 1996, ainda que, paradoxalmente, sem tradução significativa na prática clínica de rotina. As dificuldades de implementação são parcialmente comuns a outras intervenções com famílias, constituindo uma área merecedora de investigação específica. Behavioural interventions have been used with families where there are severe mental health difficulties. Behaviour Family Therapy (Falloon and colleagues) is an effective family intervention for schizophrenia with clear-cut aims. Evidence regarding outcome has been established, either in clinical terms (reduced relapse and hospitalisation rates), psycho-social factors (better social and occupational functioning, reduced family burden) or economic terms (reduced cost of service). It’s a family intervention delivered to individual families within a ‘strengths framework’ – the approach is psychoeducational, and there is a focus on the family acquiring specific coping skills. Behavioural psychoeducational interventions are practiced worldwide, and seems helpful in a wide range of mental health conditions. In Portugal, training in this kind of intervention began in 1996, although with scarce impact in regular clinical practice. Implementation difficulties are shared with other forms of family work and this undoubtedly deserves specific high-quality research. info:eu-repo/semantics/publishedVersion

In the field of pychoeducational interventions in schizophrenia, terminology is sometimes misleading and further efforts are needed to specify and operationalise terms such as psychoeducation or family intervention, especially wherever they are adapted, for example, for use in non-English speaking countries. On the other hand, in spite of growing evidence of their clinical effectiveness, family interventions for schizophrenia are still not routinely implemented in real life clinical settings. Furthermore, the current poverty of original literature or replication studies in Portugal in the field of family interventions is astonishing. Several high-quality review papers have been published in the last two decades, summarising or meta-analysing data concerning efficacy, effectiveness and efficiency of these family interventions worldwide, but mostly in Anglo-Saxon literature. These findings were indeed incorporated in several clinical guidelines, namely in the United Kingdom. But there seems to exist, in a considerable number of settings, a lack of will to implement scientific findings established for more than twenty years. In developed countries, this should be addressed as a true paradox.