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Family Psychoeducation for Serious Mental Illness$
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Harriet P. Lefley

Print publication date: 2009

Print ISBN-13: 9780195340495

Published to Oxford Scholarship Online: September 2009

DOI: 10.1093/acprof:oso/9780195340495.001.0001

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Families, Schizophrenia, And Other Major Disorders

Families, Schizophrenia, And Other Major Disorders


Family Psychoeducation for Serious Mental Illness

Harriet P. Lefley

Oxford University Press

This chapter provides historical background and discusses etiological theories, deinstitutionalization, and stressors for families coping with psychiatric disorders. Situational stressors involve objective family burden, i.e., investments of time and energy in caregiving, and subjective burden the correlative psychological distress. Societal stressors include stigma and negative social attitudes that result in inadequate services. Iatrogenic stressors, although happily diminishing, may still involve attributions of family causation, ignorance of family burden, and refusal to share needed information with caregivers or involve them in treatment planning. The research on family burden is followed by studies of expressed emotion (EE). EE research is discussed as the beginning of change in mental health systems, ultimately leading to the development of FPE. High EE was viewed not as an etiological agent, but as an environmental stressor based on lack of knowledge that could be changed by supportive education.

Keywords:   family burden, schizophrenia theories, caregiver stress, social stigma, expressed emotion

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