Carers and family-inclusive practice — structured clinical viva

Service problem. Confidentiality misinterpreted as exclusion; missing carer assessments predict missed FPE and unsupported high-EE systems with elevated relapse risk.^[1][4]

EE framing. Criticism, hostility, EOI — robust relapse predictor; family work is skills-based support, not blame.^[1]

Evidence elevator. Dixon EBP family services; McFarlane FPE reviews; Pharoah Cochrane relapse/hospitalisation; Rodolico NMA nearly all models efficacious for relapse prevention; Yesufu-Udechuku carer packages improve carer outcomes.^{[2][3][4][5][6]}

Confidentiality fix. Private content protected; general education, crisis planning, and carer support remain available; negotiate consent; risk-based disclosure when needed.^[4]

FPE plan. Multi-session engagement, education, communication, problem-solving, relapse planning; offer carer mental health screening for mother.^[3][5]

Redesign. Mandate carer identification/assessment fields; staff training; audit invitation rates; supervision for family workers; link to peer carer programmes.^[4]