COUNSELLING THE RELATIVES OF THE MENTALLY ILL 775 important subgroup who present particular manage ment difficulties (Compton & Brugha, 1988). Indeed, working with the relatives of such patients may be the only feasible option open to care staff. However, such relatives will face particular problems and burdens not necessarily shared by the group we worked with. The intervention reported here aimed to supplement the efforts of the day-care staff in providing a coherent and integrated service to the family as a unit. Part of what was being ‘¿ treated' therefore, was the relationship between the day-care team and the family unit. We would argue that this sort of specific, time limited group needs to become a routine part of the clinical service offered by community care facilities, even if relatives and patients have achieved an equilibrium in the context of persistent chronic and severe difficulties. Ideally, this should be initiated earlier in a patient's career, to avoid the development of persistent failures of communication between the clinical team and carers. Guidance about attitudes and coping styles is also indicated before these settle into maladaptive but entrenched patterns. However, detailed information and explicit be havioural guidance may not be as crucial a require ment for relatives coping with really long-standing problems. The opportunity to acknowledge and share some pent-up feelings with others in similar circumstances seemed particularly welcome to this group, and may be the best focus for intervention with relatives of the long-term group, who cope with a diverse range of disabilities and deficits. Acknowledgements, references, and authors' details are given at the end of the following paper, on page 782. British Journal of Psychiatry (1989), 154, 775—782 Counselling the Relatives of the Long-Term Adult Mentally Ill II. A Low-Cost Supportive Model LIZ KUIPERS, BRIGIDMAcCARTHY,JANE HURRYand ROD HARPER A psychosocial intervention is describedgearedto the needsof carers of the long-term mentally ill, which is feasible for a busy clinical team to implement: relatives were not selected for the group by patient diagnosis or motivation and little extra staff input was required. An interactive education session at home was followed by a monthly relatives group which aimed to reduce components of expressedemotion (EE)and to alleviate burden. The group facilitators adopted a directive but non-judgemental style, and constructive coping efforts were encouraged. The intervention was effective at reducing EEand improving family relationships. The study offers a realistic model of how to offer support to people providing long-term care for the severely mentally ill. The emotional demands on relatives who provide support for those in continuous and intensive contact with psychiatric services may continue for years. Relatives of the mentally ill have voiced much dissatisfaction with services, and with clinicians who have traditionally blamed or exploited them without recognising that they are an important community resource with needs of their own (Kuipers & Bebbington, 1985). Carers need to have ready access to sympathetic staff who are familiar with their situation and who can help them to ensure that patients maintain and develop skills and independence despite their residual disabilities. Such help needs to be long-term, supportive and geared to maintaining gains rather than to treating symptoms. In the project reported here, we were interested in developing a psychosocial approach which suited the specific needs of supporters of the long-term