In adolescents (aged 12+) with first-episode psychosis, how effective is family therapy, compared to standard treatment, in improving patient outcomes?
There is limited evidence comparing family therapy to standard
treatment. Two randomised controlled trials were found which
compared different types of family therapy in adolescents. The
results showed a benefit of family therapy in improving family
communication and reducing some patient symptoms. Both trials were
small and had some weaknesses but overall there is evidence that
this could be a true effect.
Clinical and research implications
No evidence was found comparing the efficacy of family therapy
to standard treatment. Research into this clinical question is
needed, and is highlighted as a recommendation for research in the
form of RCTs in the NICE guidance for the treatment of psychosis in
children and adolescents. Evidence from RCTs however, provided some
evidence on the effectiveness of family therapy in improving
patient outcomes, such as the negative symptoms of psychosis,
decreasing relapse rates and enhancing family communication. This
evidence can be used clinically to support the encouragement of
patients and families in undertaking family therapy if they are
experiencing difficulties in these areas. But there is no evidence
to recommend the use of family therapy as single treatment for
first episode psychosis in adolescents.
Overall it is evident that specific training in communication
and problem solving techniques incorporated into family therapy are
associated with improved patient outcomes. And there is a general
consensus that an increased number of family therapy sessions is
most beneficial. These findings could be used as criteria for
standardising family therapy offered to adolescents with first
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