Therapists and Parents Interacting with Schizophrenic Patients

Abstract

Numerous clinical studies [1-5] have shown that Expressed Emotion (EE) of relatives is a good predictor of relapse in schizophrenic patients. Furthermore, it has been demonstrated that specific and intensive therapeutic care of high-EE families has a protective effect on the course of the illness [1,6-1 1]. Thus, Expressed Emotion is widely acknowledged to be a very influential factor within the vulnerability/stress framework [12,13]. However, a differentiated interpretation of EE is necessary because relatives classified as high EE seem to form a rather heterogeneous group [1,3,14], some of them exhibiting high EE as an (inadequate) coping strategy [15] and some becoming less emotionally involved with the passage of time [10]. By investigating these modulating factors, EE research has made important contributions to understanding interaction in families of schizophrenic patients and has led to effective therapeutic outcomes. Surprisingly, very few studies have transferred the EE concept to nonfamilial settings. Berkowitz & Leff[16] analyzed in detail the difficulties researchers encounter in studying relapses in schizophrenic patients in terms of familial communication styles. They observed negative reactions of the relatives, such as helplessness, anger, or partisanship among family members, in certain high-EE families. Between the clinical and the research team members, almost a duplicate of these