Quality standard
Quality statement 3: Family intervention
Quality statement 3: Family intervention
Quality statement
Family members of adults with psychosis or schizophrenia are offered family intervention.
Rationale
Family intervention can improve coping skills and relapse rates of adults with psychosis and schizophrenia. Family intervention should involve the person with psychosis or schizophrenia if practical, and form part of a broad‑based approach that combines different treatment options tailored to the needs of individual service users.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured and can be adapted and used flexibly.
Structure
Evidence of local arrangements to ensure that family intervention is available to family members of adults with psychosis or schizophrenia.
Data source: Local data collection.
Process
a) Proportion of adults with psychosis whose family members receive family intervention.
Numerator – the number in the denominator whose family members receive family intervention.
Denominator – the number of adults with psychosis who live with or are in close contact with family members.
Data source: Local data collection. Data can be collected using the Royal College of Psychiatrists' National audit of schizophrenia: Audit of practice tool, questions 43 and 44.
b) Proportion of adults with schizophrenia whose family members receive family intervention.
Numerator – the number in the denominator whose family members receive family intervention.
Denominator – the number of adults with schizophrenia who live with or are in close contact with family members.
Data source: Local data collection. Data can be collected using the Royal College of Psychiatrists' National audit of schizophrenia: Audit of practice tool, questions 43 and 44.
What the quality statement means for different audiences
Service providers (such as GPs, community health services and mental health services) ensure that systems are in place for family members of adults with psychosis or schizophrenia to be offered family intervention. They should receive this intervention from practitioners with appropriate competencies to deliver it and who have access to training.
Healthcare professionals ensure that they offer family intervention to family members of adults with psychosis or schizophrenia.
Commissioners (such as clinical commissioning groups, NHS England local area teams and local authorities) commission family intervention services and ensure that referral pathways are in place for family members of adults with psychosis or schizophrenia to be referred to this service.
Family members of adults with psychosis or schizophrenia are offered psychological therapies called family intervention. These help support families to work together to help adults with psychosis and schizophrenia cope and to reduce stress.
Source guidance
Psychosis and schizophrenia in adults: prevention and management. NICE guideline CG178 (2014), recommendations 1.3.9.1, 1.4.2.1 and 1.4.4.2 (key priority for implementation)
Definitions of terms used in this quality statement
Family members
Family members include carers and family members who the person with psychosis or schizophrenia lives with or is in close contact with. [NICE's guideline on psychosis and schizophrenia in adults]
Family intervention
Family intervention is a psychological therapy that should:
-
include the person with psychosis or schizophrenia 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 main carer and the person with psychosis or schizophrenia
-
have a specific supportive, educational or treatment function and include negotiated problem solving or crisis management work.
[NICE's guideline on psychosis and schizophrenia in adults, recommendation 1.3.7.2]
Equality and diversity considerations
For adults with psychosis or schizophrenia or members of their family who have a learning disability or cognitive impairment, methods of delivering treatment and treatment duration should be adjusted if necessary to take account of the disability or impairment, with consideration given to 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.