Providing information to relatives and patients about expressed emotion and schizophrenia in a community-support setting : a randomized, controlled trial

The present study aimed to enhance family members’ knowledge about schizophrenia and expressed emotion (EE), as well as awareness of their current coping strategies, by conducting a brief educational intervention designed to overcome methodological shortcomings of past studies. People with schizophrenia were recruited into the study along with family members. Relatives and patients were randomly allocated to a treatment group or a waitlist control group. Analyses showed that knowledge increased significantly after the intervention and was maintained at a three-month follow-up. The control condition reflected no changes in knowledge. Other results showed that both relatives’ and patients’ EE ratings significantly decreased from pretest to posttest. Changes in total EE scores improved after treatment by over twice the magnitude compared to the control condition. All gains were maintained at the three-month follow-up, with continuing improvement seen in family members’ attitudes. The analyses overall suggested that although knowledge increased as a result of education, the decreases in EE appeared to be due to education, perhaps combined with non-specific factors such as social and community support. These issues are considered in terms of implementation in community settings and in terms of future research.