Quality statement 2: Family intervention

Quality statement

Children and young people with a first episode of psychosis and their family members are offered family intervention.

Rationale

Families play an important part in providing care and support to children and young people with a first episode of psychosis. When family intervention forms part of a broad‑based approach that combines different treatment options tailored to the needs of the individual and their family, it can improve coping skills and relapse rates for children and young people with a first episode of psychosis.

Quality measures

Structure

Evidence of local arrangements to ensure that family intervention is an available treatment option for children and young people with a first episode of psychosis and their family members.

Data source: Local data collection.

Process

a) Proportion of children and young people with a first episode of psychosis whose family members receive family intervention.

Numerator – the number in the denominator whose family members receive family intervention.

Denominator – the number of children and young people with a first episode of psychosis.

Data source: Local data collection.

b) Proportion of children and young people with a first episode of psychosis who receive family intervention.

Numerator – the number in the denominator who receive family intervention.

Denominator – the number of children and young people with a first episode of psychosis.

Data source: Local data collection.

Outcome

Relapse rates for children and young people with psychosis.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (such as child and adolescent mental health services and early intervention in psychosis services) ensure that family intervention is an available treatment option for children and young people with a first episode of psychosis and their family members. They should ensure that practitioners are trained and have the appropriate competencies to deliver it.

Healthcare professionals (such as psychologists and psychiatrists) offer family intervention to children and young people with a first episode of psychosis and their family members.

Commissioners (such as clinical commissioning groups and NHS England) commission family intervention services and ensure that referral pathways are in place for children and young people with a first episode of psychosis and their family members to be referred for family intervention.

What the quality statement means for children, young people, parents and carers

Children and young people with a first episode of psychosis and their family members are offered a psychological therapy called family intervention. This helps support families or carers to work together to help children and young people with psychosis cope and to reduce stress.

Source guidance

Definitions of terms used in this quality statement

Family members

Family members include parents and carers, siblings and other family members who the child or young person with a first episode of psychosis lives with or is in close contact with.

[Psychosis and schizophrenia in children and young people (NICE guideline CG155)]

A first episode of psychosis

A first presentation of sustained psychotic symptoms (lasting 4 weeks or more). Symptoms may include 'positive symptoms' such as hallucinations (perception in the absence of any stimulus) and 'negative symptoms' such as emotional apathy, lack of drive, poverty of speech, social withdrawal and self‑neglect.

[Psychosis and schizophrenia in children and young people (NICE guideline CG155) recommendation 1.3.1 (key priority for implementation) and Introduction]

Family intervention

Family intervention is a psychological therapy that should:

  • include the child or young person with psychosis, if practical

  • be carried out for between 3 months and 1 year

  • include at least 10 planned sessions

  • take account of the whole family's preference for either single‑family intervention or multi‑family group intervention

  • take account of the relationship between the parents or carers and the child or young person with psychosis

  • have a specific supportive, educational or treatment function and include negotiated problem solving or crisis management work.

[Psychosis and schizophrenia in children and young people (NICE guideline CG155) recommendation 1.3.27]

Equality and diversity considerations

The delivery and duration of family intervention should be adjusted if necessary to take account of any learning disabilities, autism or cognitive impairment in the child or young person with psychosis or their family members, and healthcare professionals should consider consulting a relevant specialist.

The workforce across agencies should, as far as possible, reflect the local community. Practitioners should have training to ensure that they have a good understanding of the culture of families they are working with. Interpreters should be provided if no practitioner is available who speaks a language in which the family members can communicate easily.