Collaborating with families of young adults with first episode psychosis: Psychoeducation or reflexive dialogue?

Early intervention programs for young adults with a first psychotic e ' pisode value and promote collaboration with families. This collaboration is justified in particular by the influence of family tensions on relapse and the importance of redefining ties at this stage of life. However, the implementation of interventions for families remains complex and there are often differences between displayed will and effective practices. Early intervention programs around the world often favor a psychoeducational approach with families. However, an alternative practice with young adults developed in Finnish psychiatry under the name of "open dialogue" involves a discussion about the process of care during family sessions with the aim of improving it. The purpose of this article is to present these two common forms of intervention that differ in how collaboration is implemented. On one hand, we present a psychoeducational approach that is widely developed in the Anglo-Saxon world. In order to illustrate the actual implementation of this practice we present the behavioural family therapy approach of Ian Falloon, a New Zealand psychiatrist and psychotherapist. This approach is based on a neurodeve-lopmental model of psychotic disorders and has the overall aim of transforming strong destructive expressed emotions into more nuanced and supportive ones. It also aims to teach family members some basic care skills and rehabilitation strategies. On the other hand, we present approaches adopting a more reflexive position (i.e. "Open Dialogue") that have been successfully developed in Finnish psychiatry in