Providing information to relatives about expressed emotion and schizophrenia : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University
Studies have shown that long term psychoeducational programmes aimed at lowering the Expressed Emotion (EE) in family environments can improve communications between the family members and the client, reduce EE, and lower expectations. The present study aimed to enhance family members knowledge about schizophrenia and expressed emotion, as well as awareness of their current coping strategies by conducting a brief educational intervention designed to overcome methodological shortcomings of similar studies. It was hypothesised that providing information to families (excluding clients) about schizophrenia, expressed emotion and ways in which each member can help, would alter the views and attributions that relatives make about the causality of the client's behaviour compared to a randomly assigned wait-list control condition. These changes would then be reflected in reduced criticism, hostility, and emotional overinvolvement and increases in the amount of accurate information concerning schizophrenia. People with schizophrenia were recruited into a controlled trial of a brief educational intervention with family members. Relatives and clients were randomly allocated to one of two groups. a treatment group or a wait-list control group. They received a brief educational intervention designed to give clients and relatives individualised information about schizophrenia, expressed emotion, and how to manage individually in the home and in their relationships. Analyses of the results showed that relatives knowledge increased significantly after the education, and was maintained at the three month follow-up. The control condition reflected no changes in knowledge. Other results showed that relatives' and clients' EE ratings significantty decreased from pre- to post-test. All gains were maintained at the three month follow-up. At nine months after education only 1/19 clients had relapsed. The analyses suggested that although knowledge increased as a result of education, the decreases in EE were not due to education alone. The discussion considers these findings in some detail.