| Summary: | Recognition of the negative personal, economic and social consequences of psychosis have led to attempts to identify and intervene with those who are at ultrahigh risk (UHR) of developing psychosis with the aim of improving clinical and functional outcomes. It is important that we understand the processes occurring in this period in order to inform preventative interventions. The importance of the family in psychosis is well established with extensive evidence indicating that families are often adversely affected by caring for a family member with psychosis and that the family can influence the course and outcome of psychosis. The family may be a particularly important influence on the UHR group as they are adolescents and young adults who are likely to be living in the family home. There has however been very little research into the family environment in this group. This study aimed to improve theoretical understanding of the family environment in the UHR group by exploring the experiences of the young people and their family members during this phase. This study used a qualitative design using Grounded Theory methodology. Nine UHR young people and five family members were interviewed about their experiences of their family environment. Analysis of the data produced eight theoretical codes describing the family environment over time. These related to difficult early family experiences, difficulties negotiating life-cycle transitions, lacking a framework to understand the young person's difficulties, reaching a crisis point, reappraising roles and futures, family protecting and constraining the young person and, finally, renegotiating the young person's independence. The data describes the interaction of beliefs and behaviours between these young people and family members and the impact of the stage of psychosis, early family experiences and life-cycle stage on these interactions. The findings have implications for the development of family interventions for the UHR group.
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