Saroca Karen, Sargent John
Department of Psychiatry, Tufts Medical Center, and Tufts University School of Medicine, Boston.
Focus (Am Psychiatr Publ). 2022 Apr;20(2):204-209. doi: 10.1176/appi.focus.20210035. Epub 2022 Apr 22.
Family work is a critical component of psychiatric practice. It is important for psychiatrists to be able to understand the role of family relationships and family systems in individual development across the lifespan. Assessing family factors is an important part of developing a biopsychosocial formulation. Understanding family relationships provides a context for an individual's values and beliefs, which are important components of assessing the patient's mental health challenges. Dysfunctional family relationships can be precipitating or perpetuating factors for mental illness. On the other hand, positive family relationships can offer support, be protective, alleviate emotional and behavioral problems, and lead to improved outcomes. It is important for psychiatrists to be able to work effectively with families by providing support, understanding families' needs, assessing families' strengths and limitations, identifying issues requiring family-based intervention, and facilitating referral to a family therapist when necessary. By engaging families as resources and essential partners in treatment planning, the psychiatrist is able to enhance the quality and success of patient care. This article discusses the role of the psychiatrist in assessing family factors implicated in psychiatric illness; offers general context for understanding the response required by families for improving various emotional and behavioral challenges; and provides an overview of family-based interventions, including family psychoeducation and support, parent management training, and family therapy.
家庭工作是精神科实践的关键组成部分。精神科医生能够理解家庭关系和家庭系统在个体毕生发展中的作用非常重要。评估家庭因素是制定生物心理社会诊断的重要部分。理解家庭关系为个体的价值观和信念提供了背景,而这些是评估患者心理健康挑战的重要组成部分。功能失调的家庭关系可能是精神疾病的诱发因素或持续存在的因素。另一方面,积极的家庭关系可以提供支持、起到保护作用、缓解情绪和行为问题,并带来更好的结果。精神科医生能够通过提供支持、了解家庭需求、评估家庭的优势和局限性、识别需要基于家庭的干预的问题,并在必要时促进转介给家庭治疗师,从而有效地与家庭合作。通过将家庭作为治疗规划中的资源和重要伙伴,精神科医生能够提高患者护理的质量和成功率。本文讨论了精神科医生在评估与精神疾病相关的家庭因素中的作用;为理解家庭为改善各种情绪和行为挑战所需的反应提供了总体背景;并概述了基于家庭的干预措施,包括家庭心理教育与支持、家长管理培训和家庭治疗。