A case report of schizophrenia with severe disability: the eclectic family therapy approach

Schizophrenia is one of the most common mental disorders affecting perception, emotion, cognition, thinking, and behaviour of the person. The onset is generally in the second decade. Its manifestation varies from patient to patient but its effects are usually severe and long lasting. It can manifest as ‘positive symptoms' such as hallucinations (hearing voices and seeing things) and delusions (having strange beliefs). People with schizophrenia also suffer from disorganisation and ‘negative symptoms' (such as tiredness, apathy, and loss of emotion). The patient becomes isolated socially and becomes a burden to the family due to lack of proper knowledge about the disease, frequent relapses due to poor drug compliance, side effects, high negative expressed emotions, poor coping skills, and disability. Due to the chronic nature of the disease, the family members and caregivers are also affected. This social casework report describes how a young adult girl with severe disability and dysfunctional family functioning has become hurdle in the treatment and management. Though pharmacotherapy is the mainstay of this disease, social casework based on structural family therapy approach undertaken along with family psychoeducation, behaviour modification techniques, social skills, and coping, and also supportive work with family members help. A home-based rehabilitation plan was worked to provide relief to the caregivers. It illustrates the positive outcome of individual as well as family intervention using structural, behavioural, psychoeducational, and rehabilitative approaches and techniques with an individual after completing 12 sessions and telephonic feedbacks. This resulted in adequate change of the family functioning as they were able to identify their problems, generate solutions, and apply them.