Table 1

Family involvement models in acute mental healthcare

ModelCountryDescription
Calgary Family Assessment and Intervention Models40 CanadaGuidelines for family nursing practice and assessment that draw on systems, communication and change theory. In acute care, interventions may target cognitive, affective and behavioural domains of family functioning to invoke change. Staff are trained to use systemic tools such as genograms for the assessment of social relationships.
ERIC (Equipe Rapide d’Intervention de Crise)36 FranceNurses, doctors and psychologists work together as a large multidisciplinary team in a mobile service. Brief psychotherapy is provided, usually in the patient’s home, with the aim of ‘enveloping’ (containing) the crisis. There is strong emphasis on the role of communication and the competence of the family unit to deal with future crises.
Family Psychoeducation Models33–35 43–45 UK, USAThe most widely used model globally, developed from research into the role of family communication in relapse. Specialist teams provide a package of support including at least (1) an educational component about the patient’s diagnosis and the recommended treatment; (2) problem-solving and/or communication training to simplify communication for the patient and (3) emotional support for the family.
Family Systems Approach, SYMPA (systems therapy methods in acute psychiatry)30 31 37 GermanyAll staff across disciplines are trained to assess and treat patients within a systemic framework. This includes changing language use to less-medicalised terms. Staff are also trained as ‘negotiators’ between the patient and the organisation about matters such as medication and compulsory measures.
Open Dialogue32 60 61 FinlandA multidisciplinary mobile crisis team attend the patient’s home within a short time from referral. Meetings including the patient’s wider social network take place daily, and continue until a ‘joint understanding’ is reached of the patient’s distress. The process of listening and responding is considered central in reducing the patient’s distressed state.
Somerset Model38 39 UKService-wide approach, developed to address policy and advocacy-led calls for more family-inclusive services. All families are offered an initial needs assessment and information about the service and may be referred to more intensive provision.