Behavior family therapy for schizophrenics, incorporating education about the disorder and its treatment and training in communication and problem-solving skills, together with neuroleptic drugs, has been shown in a recent study at the UCLA-CRC to significantly reduce relapse rates and improve social functioning. The proposed study seeks to replicate and extend these findings to a population of Mexican-American schizophrenics, many of whom have already been identified and recruited into an ongoing study of family factors related to relapse. BFT plus one fixed-dose neuroleptics will be provided in the home on a decreasing contact basis over a one year period with a second year of follow-up, and will be compared, through random assignment of patients, with an in-home case management (CM) plus neuroleptic intervention. The interventions have been designed to capitalize on the well-documented finding that Mexican-American families most often care for their schizophrenic member at home and resort to the use of mental health facilities only when intra-familial coping mechanisms have been exhausted. It is hypothesized that BFT, in contrast to CM, will result in fewer relapses and rehospitalizations, less family conflict, improved social and family problem-solving skills, improved social functioning, less overall neuroleptic medication and side effects. Measures of expressed emotion, social networks, and acculturation will enable evaluations to be done on the role of these factors in course and outcome of schizophrenia among Mexican-Americans.
