Family systems psychiatry in an acute in‐patient setting: the implementation and sustainability 5 years after its introduction

Abstract

From 2003 to 2008 a multicentre research project, systems therapy methods in acute psychiatry (SYMPA), attempted to establish structured in-patient treatment based on systemic interventions in German nonuniversity psychiatric hospitals. Utilising multi-professional family systems training for team members in six in-patient wards, its main goal was to improve the involvement of familial and non-familial important others. This follow-up study explores the sustainability of family systems psychiatry by evaluating the frequency of the utilisation of four core systemic interventions; elements of a systemic organizational culture in psychiatry; and institutional barriers to this new approach. The degree of implementation was high to moderate, depending on the intervention. More intense communication developed among staff of different professions and the status of nursing staff improved. Organizational barriers to implementation included the ambiguous role of junior doctors in teams, continuously understaffed wards and frequent over-occupancy.

Including families and carers: an evaluation of the family liaison service on inpatient psychiatric wards in Somerset, UK

“…Family members and carers are also involved in delivering the training (Stanbridge and Burbach, 2007b).…”

Thematic review of family therapy journals in 2013

“…There was a special issue of the Journal of Family Therapy on family therapy in medical contexts with articles on medical family therapy (Marlowe, ), the possible contributions that the understanding of reflexivity in systemic thinking can make to medical practice (Ingrassia, ), family therapy and inpatient psychiatry (Haun et al . ; Stanbridge et al . ), and a social relational critique of the biomedical definition and treatment of ADHD (Wilson, ) with a commentary (Thapar et al .…”

Drawing forward family strengths in short therapeutic conversations from a psychiatric nursing perspective

“…Furthermore, results from multiprofessional efficacy studies on psychoeducational interventions and cognitive behavioral interventions for these distressed families, especially for families of schizophrenic, bipolar, and substance‐use disorder patients, have shown improvements in family functioning and better psychosocial outcomes for the patients when family interventions are being used . In spite of scientific evidence and clinical experience that family interventions have shown positive effects for the well‐being and functioning of patients and families, these programs, methods, and interventions have been a great challenge with systems barriers to implement into multidisciplinary everyday adult psychiatry …”

“…1 In Iceland, advanced practice and/or evidence and clinical experience that family interventions have shown positive effects for the well-being and functioning of patients and families, these programs, methods, and interventions have been a great challenge with systems barriers to implement into multidisciplinary everyday adult psychiatry. [14][15][16][17][18][19][20] Family members of psychiatric patients have often experienced emotional suffering long before their relative is admitted for the first time to acute psychiatry and often their caregiving attempts have been rejected by the patient. 21,22 These families are dealing with a complex situation that affects their behavior and expressed emotions that need to be viewed in that context.…”