Family Therapy for Schizophrenia in the South African Context: Challenges and Pathways to Implementation

Abstract

Schizophrenia is a chronic psychiatric disorder that affects 1% of the world's population. Family interventions whereby the patients and their relatives can attend psychiatric therapy sessions are effective at preventing relapse of symptoms. In a country such as South Africa where there has been a shift from institutionalisation to community care, family therapy treatment models are an important option to explore. Although there is a paucity of research on family therapy for schizophrenia in the South African context, we found a number of studies conducted in both developed and developing countries. Problems with adherence to medication, lack of psychoeducation and low expressed emotion (EE) were identified as challenges to effective family therapy models. A country such as South Africa has additional challenges of stigmatisation of mental illness as well as cultural perceptions of illness that may influence barriers to mental health care. These should be considered when designing family therapy interventions. We suggest further research endeavour to explore the applicability of family therapy models for people living with schizophrenia in South Africa. EE in relation to different cultural groups in South Africa should be considered.