Advancing treatment while respecting privacy

Patients might fear family involvement because they think the psychiatrist will divulge secrets or because the patient fears being attacked by angry family members. The patient should be reassured that the purpose of the meeting is to promote general treatment goals, such as maintaining optimal functioning with lowest medication doses, and to work on future treatment goals as a team.

When the psychiatrist lays out a clear plan for the meeting, the patient grasps the importance of having everyone on board. This is what we should tell patients: "At the family meeting we will review your family’s concerns and your concerns. Many family members need help understanding your illness, the role of medications, and how best to manage when, for example, you miss a dose of medications or have questions about how closely they need to monitor things.

"If you all agree on what is important and what is less important, things will go more smoothly for you. The main focus is to have a plan going forward of how we should work as a team to get you the best treatment possible, maintain your health, and prevent relapses."

Dr. Heru is with the department of psychiatry at the University of Colorado at Denver, Aurora. She is editor of the recently published book, "Working With Families in Medical Settings: A Multidisciplinary Guide for Psychiatrists and Other Health Professions" (New York: Routledge, March 2013), and has been a member of the Association of Family Psychiatrists since 2002.