Family Therapy in Trouble: Psychoeducation as Solution and as Problem

The authors cite clinical literature attesting to the importance of recognizing the family, rather than the individual, as the proper locus of conceptualizing, diagnosing, and treating mental illnesses. Specifically with regard to severe psychiatric illnesses, in particular schizophrenia, family dysfunction contributes to the emergence of the illness, significantly affects its course, and strongly influences the achievement and maintenance of treatment gains. Currently, a movement is afoot to limit sharply the amount and kind of treatment offered to schizophrenic patients and their families. Rooted in a “medical model” or “biogenic” view of the etiology of schizophrenia, this school of thought prescribes psychoeducation as the family treatment of choice. The present article looks at some misconceptions regarding treatment that prompted a widespread turning away from psychoanalytically oriented family psychotherapy for schizophrenic patients and their families, examines the reductionism (biological and behavioral) inhering in the exclusive use of psychoeducation, and looks at the clinical dangers of such reductionism. Finally, it proposes that family psycho-therapists should not abandon a concern with the inner lives of severely ill patients and their families in the face of spuriously generalized claims made by reductionist researchers.     

Spiritual and emotional determinants of health

Within our present health care system, there is a growing movement that argues that our perceptions of health and illness are in need of change. This change includes redefining what we mean by health in terms of the whole person—the emotional, social, and spiritual dimensions of our being, as well as the physical. An increasing number of health professionals and social scientists believe our concepts of health and illness must consider all these aspects of life. It is believed that the quality of life may be enhanced by such perceptions of health, which include social and spiritual factors. Using data from the 1985 Akron Area Survey—The Subjective Quality of Life in the Akron Area—this study explores the effects of spiritual well-being and emotional well-being on health satisfaction. Results indicate that emotional and spiritual factors do significantly contribute to the subjective evaluation of health, especially for individuals who are physically limited.An earlier draft of this paper was presented at the joint session of the Association for the Sociology of Religion and the American Sociological Association, August 20, 1986. The author would like to thank Margaret Poloma, Ph.D., The University of Akron, and Mark Tausig, Ph.D., The University of Akron, for their helpful comments.