Therapeutic approach to families in the rehabilitation of patients interned in psychiatric hospitals: report of an experience

DOI: 10.15343/0104-7809.200832.2.17

Abstract

More recent Mental Health practices and policies have been affected by research which points out that approaching families of psychiatric patients
is a decisive step for therapeutic response in these cases. Even the effectiveness of medication has been understood as being related to the social and cognitive
context in which pharmacological treatment is carried through, and in this sense the qualification of the family is undertaken when patients have to pass
through a period of internment. In this work, from a bibliographical survey, we present a historic description of the main approaches in Family Therapy and
the impact of interventions carried through with an isolated family and in multifamily groups. We then discuss the institutional conditions that guarantee the
establishment of a practice of assistance to families, the situations that demand that this guiding is done more urgently and the experience of the authors with
assisting families of patients interned in an important school-hospital of São Paulo city. From this experience, the more frequent therapeutic foci and clinical
settings are pointed out. Finally, we discuss the specific characteristics of families who face some relative becoming ill, characteristics which, from studies
with Expressed Emotion, is understood to be different according to the pathology faced. We describe findings about families of patients with Schizophrenia,
Depression, Borderline Disturbance and those of children with psychiatric disturbances. These studies show that family interventions collaborate with the
reduction of residual psychotic symptoms and more fully develop carers’ resources, also considering that the duration of the illness, the number of internments
and the degree of emotional discomfort the family presents indicate the type of response one obtains with each modality of familiar intervention.