Table 2.

Key elements of the Basic Family Involvement and Support (BFIS) scale

Element	Recommendation/purpose	Items	Key references
Structural/ implementation measures	The unit should:
Training and supervision of health personnel	Provide all clinicians with basic competence and skills, to ensure that family involvement becomes one of the cornerstones of treatment, rather than optional or random.	1	[20, 29]
Family coordinator – General structure and responsibilities	Appoint a family coordinator to help implement and sustain the practice. Relevant tasks may include writing and/or updating written material, arranging information courses for relatives, providing tools, internal training and supervision to local personnel, overseeing implementation efforts and being part of the implementation team.	2	[20]
Implementation measures	Establish an implementation team to organise and supervise the implementation process, and ensure management commitment.	14	[29]
Routines/procedural measures
Identification and documentation of the relatives	Ensure that personnel identify and document the relatives. This is fundamental to establish any kind of family involvement. The scale rates only the penetration rate of identifying and documenting the next of kin and children, but it is also helpful to identify other important persons and the extended network.	5	[20]
Documentation of family involvement in the patient’s discharge report	Ensure that clinicians document family involvement in the patient’s discharge report, so that other clinicians in specialist health services or municipalities, who will care for the patient, get an overview of the family involvement conducted so far to establish a continuity of care.	13	[20, 30, 31]
Clinical measures
Conversation(s) with the patient focusing on family involvement	Offer patients with psychotic disorders at least one consultation/conversation, where the major part is dedicated to discuss family involvement and FPE. A way to standardise the content of such conversations is to employ a checklist, with necessary adjustments to the patient’s specific needs.	3,6,7	[6, 20, 21]
Conversation(s) with the relative(s) focusing on family involvement	Offer relatives at least one conversation without the patient present. This provides them with an opportunity to express how the patient’s illness affect their lives, without fearing how this information might affect the patient. These conversations are modelled after the ‘alliance sessions’ in the FPE-model and can be standardised by using a checklist.	4,8	[16, 19, 20]
Conversation(s) with the patient and relative(s) together focusing on family involvement	Offer the patient and relative(s) a conversation together. This could be an introductory conversation to agree on some rules for the separate conversations, or it could be after the separate conversations to sum up the things that can be shared. The conversation might also constitute the initial phase of FPE. The patient’s primary clinician should attend at least one such conversation to assure the integration between family involvement and other treatment strategies.	9,10	[16, 20]
Developing a crisis/coping plan	Ensure that a crisis/coping plan is made, ideally when the patient is competent and/or in a stable phase of the illness. It should be regularly updated and include the patient’s preferences if the illness worsens, and relevant contacts. Relatives may contribute to, or should at least be made familiar with, its contents.	11	[21, 32–34]
Information meetings/ psychoeducative seminars for relatives	Offer relatives information meetings/psychoeducative seminars. This is particularly important for relatives of patients who refuse to participate in FPE, or refuse any contact between health professionals and relative(s).	12	[11, 20]