Family Intervention — MRCPsych Paper B MCQ

Instant feedback + full explanation. One question, done properly.

EasySchizophrenia & PsychosisFamily InterventionMRCPsych Paper B

A 32-year-old man with schizophrenia is clinically stable on antipsychotic medication but has experienced two relapses following periods of escalating criticism, conflict and emotional over-involvement at home. He lives with his parents, who remain in close contact with him and are willing to participate in treatment. Which additional intervention would best address this relapse risk?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Family intervention

The correct answer is **B, family intervention**. Criticism, conflict and emotional over-involvement indicate a high-expressed-emotion family environment, which is associated with relapse. NICE recommends family intervention when relatives live with or are in close contact with a person with schizophrenia, particularly when relapse risk is present. It should include at least 10 planned sessions over 3 months to 1 year and incorporate supportive or educational work, negotiated problem-solving and crisis management. CBTp can reduce distress and address persistent symptoms but does not specifically target the family interaction pattern described. Social skills training addresses interpersonal functioning, while art therapy is mainly considered for negative symptoms. Clozapine augmentation is not indicated without adequately treated clozapine-resistant illness.

Reference: NICE. Psychosis and schizophrenia in adults: prevention and management (CG178), recommendations 1.3.7.2 and 1.5.4.2–1.5.4.3, 2014. https://www.nice.org.uk/Guidance/CG178/chapter/recommendations