Family engagement can be extremely important in facilitating adherence to treatment and in reducing the risk of relapse. We conducted a study called RAISE-ETP (Recovery After an Initial Schizophrenia Episode Early Treatment Program), which focused on the concept of coordinated specialty care after a first episode of schizophrenia. This approach included not only pharmacotherapy but also individual psychotherapy with the patient, family psychoeducation, and family therapy. In addition, the program included supportive employment and supportive education, with the goal of assisting the patient in successfully returning to work or school. These services, combined with a team-based multidisciplinary approach, are critical when working with first-episode and early phase patients. In RAISE-ETP, individuals who received coordinated specialty care with family participation remained in treatment longer, experienced improved quality of life, and had greater involvement in school and work. The importance of family involvement should not be underestimated. In fact, a meta-analysis of 25 intervention-based studies found that relapse rates were reduced by 20% if relatives were included in the patient’s treatment. However, despite the benefits of family involvement, we often encounter situations where relatives are not included in the treatment program, due to either lack of access to appropriate services or family preference.

In addition to the nonpharmacologic treatment approaches already discussed, beneficial interventions include cognitive behavioral therapy, psychoeducation, cognitive remediation, and social skills training. Interventions focused on diet and exercise have been examined in a few studies but are not yet “ready for prime time” and are not included in the current American Psychiatric Association treatment guidelines for schizophrenia.