Unresolved Issues In Family Psychoeducation
a critical assessment
Although studies of family psychoeducation (FPE) have shown impressive effects, questions remain as to appropriate format and content, optimal duration, manualization, and cultural adaptation. Should content be adapted to patients' age, different kin relationships, the family life cycle, or stages in the illness trajectory? With assisted living community residence, should FPE be targeted to case managers or staff of residential facilities rather than to family caregivers? This chapter discusses the continuing salience of high express emotion (EE) as a basic feature of FPE is discussed, in light of research that demonstrates diagnostic differences in response to emotional overinvolvement. Research suggests that families place greater emphasis on issues that cannot be fully dealt with in FPE. These include patients' denial and nonadherence to medications, disruptive and problem behaviors, negative symptoms and moods, family relationships, and handling issues of dependence and independence. FPE is arguably just one element in an integrated system of care. It should be accompanied by a forum for advocacy that can insure public and legislative support for a high-level system of care.
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