Many clients with severe mental health problem, live in the community with their relatives. Research in the area has indicated that exacerbation of psychotic symptoms in clients is strongly associated with the emotional atmosphere in the family. The presence of high expressed emotion has been linked with relapse. However, recent research suggests that it is the causal attributions which relatives make to explain the illness symptomatology, which is most predictive of relapse. Relatives viewing clients' symptoms as being controllable by the client has been associated with hostility in relatives. Little has been said in the literature about the subjective experiences of clients. The present study investigated the causal attributions which clients and relatives made to explain the manifestation of the illness. Causal attributions made to explain positive symptoms, negative symptoms and behavioural problems were examined and compared. Clients! perception of their relationship with a key relative and their affective state was measured. Participants knowledge about schizophrenia, and relatives levels of distress were also examined. The clients in the present study were men under fifty with a diagnosis of schizophrenia. Key relatives also participated. A cross sectional correlational and comparative methodology was employed. A mixture of quantitative data and qualitative information was generated. A key finding was that the nature of attributions made was determined by symptom category. Positive Symptoms were deemed to be the least controllable symptom and Behavioural Problems were considered the most controllable. Relationships existed between the attributions made by clients and relatives. Depression in clients was related to them attributing their illness to personal factors, and a reporting negative feelings about there relationship with a key relative. Findings are discussed in relation to literature, research and clinical practice.

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