Family work for schizophrenia: practical application.

OBJECTIVE To review the evidence for the efficacy, efficiency and effectiveness of family work for schizophrenia. METHOD The review is based on the relevant literature but is not intended to be exhaustive, except in the area of practical application. RESULTS The effectiveness of family work has been established by a series of randomized controlled trials. Relatives groups are efficient in terms of staff time, and multiple family groups may be more efficacious than sessions with single families. However, a substantial proportion of relatives refuse to attend a group and need sessions in the home. Family work skills can be acquired by clinicians working in ordinary settings, although few studies have addressed this question. Problems have been encountered regularly by trained community workers trying to practise their newly acquired skills. CONCLUSION Difficulties in implementation may be remedied by adopting a systemic approach and including the managers of the service in the initial training sessions.