Caregiver burden, family treatment approaches and service use in families of patients with schizophrenia.

Over the last several decades the construct of family burden has been used to capture family members' experience of caring for a mentally ill relative. The definitions and operationalization of this experience into subjective and objective components neglects the complexity and the multidimensional nature of the caregiving experience. In addition to problems operationalizing the caregiving experience, family interventions have also neglected to address the range of issues and concerns that impact those caring for mentally ill relatives. These two factors may be significant contributors to the under utilization of family-based services by relatives of individuals with schizophrenia. Two examples of treatment programs that target the multidimensional nature of the caregiving experience (NAMI's Family-to-Family and Journey of Hope), possible integration of these programs with family psychoeducation interventions and implications for service utilization are discussed.