Abstract
The paper describes a family school for learning how to live with schizophrenia, which was founded in 1986 in Vienna, Austria, and is still running today. It was established in cooperation between professionals and the Austrian self-help association HPE of the relatives of persons with mental disorders. It addresses the needs of 10 families at a time, in cases where a son or a daughter was diagnosed with schizophrenia and had already experienced one or several episodes of the illness. The course lasts one and a half years and is organized according to the model of a weekly boarding school, where 10 children, the "residents", stay in the school overnight from Sunday evening to Friday and take part in a structured program on cognitive, social and practical life skills. Ambulatory psychiatric treatment is taking place concurrently outside the school through local routine services. On weekends residents stay with their parents since the school is closed. Parents visit the school regularly to take part in joint activities with the residents. They also undertake night shifts in the school and attend a weekly parents' group. In the regular encounters during everyday activities in the school, "learning by doing" occurs - parents get to know the daughters and sons of other families and can learn to distinguish between disease-related and personality-related behavior. Residents can have similar learning experiences in relation to the parents of other residents. The main aim of the school is that parents learn to provide "protected autonomy" for the daughters or sons in question, in order to assist them after the end of the course in leading a life characterized by as much autonomy as possible after the end of the school.
Highlights
In international guidelines, family involvement in mental health services is an essential component in the treatment of schizophrenia, but its routine implementation in the services themselves is underdeveloped.[1]
In this paper we report on a model of involving families as an external add-on activity to an ongoing treatment in local routine psychiatric services
The authors conclude that the involvement of families may require a cultural and organizational shift, since family work can only be implemented if it is considered a shared goal of all members of a clinical team or mental health service
Summary
Family involvement in mental health services is an essential component in the treatment of schizophrenia, but its routine implementation in the services themselves is underdeveloped.[1]. The respective results of early studies in Switzerland and the US in the 1970s and 1980s8–10 were confirmed by more recent research.[11,12,13,14,15] Variations in course and outcome may be consequences of the very imprecision of the diagnosis of schizophrenia (whose definition is still debated today),[16,17] which has probably led to including heterogeneous groups of patients in these studies The findings of these studies suggest that there is always hope that the course of the disorder in people diagnosed with schizophrenia early in life may not automatically be devastating and that recovery or a somewhat milder course are possible. Box 1: Role of the parents of daughters or sons diagnosed with schizophrenia as experienced in their contacts with psychiatry (1–3), as seen by themselves (4), and from the perspective of an active participant in solving problems (5)
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