Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-23T15:38:11.808Z Has data issue: false hasContentIssue false

Expressed emotion in the therapeutic relationship with schizophrenic patients

Published online by Cambridge University Press:  16 April 2020

FM Stark
Affiliation:
Department of Psychiatry, University Clinic Eppendorf, Martinistr 52, 20246Hamburg, FRGermany
T Siol
Affiliation:
Department of Psychiatry, University Clinic Eppendorf, Martinistr 52, 20246Hamburg, FRGermany
Get access

Summary

Patterns of interaction and attitudes in the relationships of 21 young schizophrenic patients, their parents and therapists were explored and compared with each other in this pilot study. The focus was on expressed emotion (EE), which was revealed to have an important impact on the course of the illness. In this study, the EE status of the relatives as well as of the therapists was rated using the five-minute speech sample method. Furthermore, data on the quality of interaction of therapists and parents with the patients were derived from the therapist/relative-patient interaction scale. Results showed that one-third of both the therapists and the parents were rated high on EE. High-EE relatives were rejected and perceived as inscrutable by the patients. The assessment of the therapeutic and familial relationships demonstrated the patients’ need for unequivocal communication. Differences and similarities in the interaction styles, and their implications for research and therapy are discussed.

Type
Original article
Copyright
Copyright © European Psychiatric Association 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alanen, YCFrom the mothers of schizophrenic patients to interactional family dynamicsIn: Rosenthal, D, Kety, SS, eels, The Transmission of Schizophrenia Oxford: Pergamon Press, 1968Google Scholar
Benedetti, GPsychotherapeutische BehandlungsmethodenIn: Kisker, KP, ed, Psychiatrie der Gegenwart, 4. Schizophrenien (3. Auflage), Berlin:Springer, 1987Google Scholar
Berkowitz, RLeff, JClinical teams reflect family dysfunction, J Fam Ther 1984;6: 7989CrossRefGoogle Scholar
Birchwood, MJCochrane, RFamilies coping with schizophrenia: Coping styles, their origins and correlates Psychol Med 1990;20: 857-65CrossRefGoogle ScholarPubMed
Brown, GWBirley, JLWing, JKInfluence of family life on the course of schizophrenic disorders: A replication Br J Psychiatry 1972; 121:241-58CrossRefGoogle ScholarPubMed
Ciompi, LToward a coherent multi-dimensional understanding and therapy of schizophreniaIn: Strauss, JS, Böker, WBrenner, HD eds, Psychosocial Treatment of Schizophrenia Toronto: Huher, 1987Google Scholar
Cournos, FThe impact of environmental factors on outcome in residential programs Hosp Community Psychiatry 1987;38: 848-53Google ScholarPubMed
Falloon, IRExpressed emotion: Current status Psychol Med 1988;18: 269-74CrossRefGoogle ScholarPubMed
Falloon, IRBoyd, JLMcGill, CWet al. Family management in the prevention of morbidity in schizophrenia: Clinical outcome of a two-year longitudinal study Arch Gen Psychiatry 1985; 42:887-96CrossRefGoogle ScholarPubMed
Frank, AFGunderson, JGThe role of the therapeutic alliance in the treatment of schizophrenia Arch Gen Psychiatry 1990;47: 228-36CrossRefGoogle ScholarPubMed
Fromm-Rcichmann, PNotes on the development of treatment of schizophrenics by psychoanalytic psychotherapy Psychiatry 1948;11: 263-73CrossRefGoogle Scholar
Goldstein, MJStrachan, AMThe impact of family intervention programs on family communication and the short-term course of schizophreniaIn: Goldstein, MJHand, IHahlweg, K eds. Treatment of Schizophrenia. Family Assessment and Intervention Berlin: Springer, 1986CrossRefGoogle Scholar
Hatfield, ABSpaniol, LZipple, AMExpressed emotion: A family perspective Schizophr Bull 1987;13: 221-6CrossRefGoogle ScholarPubMed
Herzog, T Expressed Emotion auf Station: Kritische, ablehnende, emotional überengagierte und empathisch-wertschätzende Gefühlsäußerungen von Pflegepersonen gegenüber überwiegend schizophrenen Patienten. Unpublished Diploma Thesis, Dept of Psychology, University of Heidelberg, 1985Google Scholar
Kavanagh, DJRecent developments in expressed emotion and schizophrenia Br J Psychiatry 1992;160: 601-20CrossRefGoogle Scholar
Kuipers, LMacCarthy, BHurry, JHarper, RCounseling the relations of the long-term adult mentally ill. A low cost supportive model Br J Psychiatry 1989;154: 775-82CrossRefGoogle Scholar
Leeb, BFeinstein, EMüller, UHahlweg, KDose, MDie kreuzkulturelle Validierung der ‘Fünf-Minuten-Sprechstichprobe’ zur Bestimmung des ‘Expressed Emotion'-StatusIn: Buchkremer, GRath, N eds, Therapeutische Arbeit mit Angehörigen schizophrener Patienten: Meßinstrumente, Methoden. Konzepte Bern, Stuttgart, Toronto: Huber, 1989Google Scholar
Magaña, ABGoldstein, MJKarno, MMiklowitz, DJJenkins, JFalloon, IRA brief method for assessing expressed emotion in relatives of psychiatric patients Psychiatry Res 1986;17: 203-12CrossRefGoogle ScholarPubMed
Miklowitz, DJGoldstein, MJFalloon, IRDoane, JAInteractional correlates of expressed emotion in the families of schizophrenics Br J Psychiatry 1984;144: 482-7CrossRefGoogle ScholarPubMed
Miklowitz, DJStrachan, AMGoldstein, MJDoane, JASnyder, KSExpressed emotion and communication deviance in the families of schizophrenics J Abnorm Psychol 1986;95: 60-6CrossRefGoogle ScholarPubMed
Parker, GHadzi-Pavlovic, DExpressed emotion as a predictor of schizophrenic relapse: An analysis of aggregated data Psychol Med 1990;20: 961-5CrossRefGoogle ScholarPubMed
Siol, T Merkmale therapeutischer und familiärer Beziehungen bei schizophrenen Patienten: Eine empirische Untersuchung zu Expressed Emotion und Beziehungseinschätzung der Interaktionspanner. Unpublished Med Dissertation, Dept of Medicine, University of Handling, 1991Google Scholar
Smith, JBirchwood, MRelatives and patients as partners in the management of schizophrenia - the development of a service model Br J Psychiatry 1990;156: 654-60CrossRefGoogle ScholarPubMed
Stark, FMBuchkremer, GDas Fünf-Minuten-lnterview: Eine Kurzfassung zur Erfassung des Expressed Emotion-Status (The five-minute-speech-sample: A brief method for assessing expressed emotion) Nervenarzt 1992;63: 42-3Google Scholar
Stark, FMLewandowski, LBuchkremer, GTherapist–patient relationship as a predictor of the course of schizophrenic illness Eur Psychiatry 1992;7: 161-9Google Scholar
Strachan, AMLeff, JGoldstein, MJDoane, JABurtt, CEmotional attitudes and direct communication in the families of schizophrenics: A cross-national replication Br J Psychiatry 1986; 149:279-87CrossRefGoogle ScholarPubMed
Tarrier, NBarrowelough, CFamily interventions for schizophrenia Behav Modif 1990; 14-4:408-40CrossRefGoogle Scholar
Vaughn, CELeff, JThe measurement of expressed emotion in families of psychiatric patients Br J Soc Clin Psychol 1976;15: 157-65CrossRefGoogle ScholarPubMed
Zubin, JSpring, BVulnerability – a new view of schizophrenia J Abnorm Psychol 1977;86: 103-26CrossRefGoogle ScholarPubMed
Zubin, JMagaziner, JSteinhauer, SRThe metamorphosis of schizophrenia: from chronicity to vulnerability Psychol Med 1983; 13:551-71CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.