Exploring the process of family interventions for psychosis in relation to attachment, attributions and problem‐maintaining cycles: an IPA study

Abstract

This study sought to understand how the experience of family interventions (FI) for psychosis helped family members to develop their thinking about their attachment experiences and the attributions made about a relative, and how these discussions helped to inform their understanding about problem-maintaining cycles, that is, the interactional way in which difficulties could be maintained. Ten individuals who had attended an FI service participated in a semi-structured interview. The transcript analysis used interpretative phenomenological analysis. The analysis yielded four themes: a supportive therapeutic relationship and safe therapeutic space; understanding patterns of relating and identifying when family interactions become unhelpful; making sense of psychosis and developing a sense of agency. The FI was experienced as helpful in bringing about changes in the way family members construed each other and psychosis, and this influenced patterns of relating.Practitioner points • A safe therapeutic space for both client and family can help them discuss sensitive issues, restore emotional connections and reach better understandings of psychosis. • Exploring family relational experiences, attachment and attributions can be helpful in gaining understanding of how problems in psychosis are maintained. • Family intervention can help families identify helpful versus unhelpful interactions and make positive changes. a Clinical Psychologist, Somerset Partnership NHS Foundation Trust, Foundation House,

Towards the recovery of a sense of self: An interpretative phenomenological analysis of patients’ experience of body-oriented psychotherapy for schizophrenia

“…Our analysis also concurs with findings of previous literature based on first-person accounts of schizophrenia investigating psychotherapy process and outcome (e.g. Dennick et al 2013;Grealish et al, 2013;Messari & Hallam, 2003, Rapsey, Burbach, & Reibstein, 2015. This provides further support for the efficacy of BPT and enhances the development of its theory and practice.…”

Editorial: Family Interventions in Psychosis Change Outcomes in Early Intervention Settings – How Much Does the Evidence Support This?

“…To date, our understanding of the exact mechanism through which family interventions yield positive effects for patient and carer groups remains limited. Qualitative data indicate that patient and family groups highlight the importance of psychoeducation, developing a shared understanding of the illness, enhancing skills in problem solving and communication (Nilsen et al, 2016 ) and having a safe place to discuss issues and learn about their patterns of relating to one another (Rapsey et al, 2015 ). In addition, reported changes in carer empathy and engagement styles are confirmed mediators of improved outcomes in family based interventions in psychosis (Girón et al, 2015 ).…”