As part of a controlled study of the effectiveness of a counseling pro
gram for family caregivers of patients with schizophrenia, we conducte
d a comprehensive examination of the process. The particular foci were
on themes that arose during sessions, principal therapeutic intervent
ions offered, and caveats for counselors working in the field. The mos
t striking finding was the diverse range of themes, covering personal,
coping, family, and social aspects of the caregiving experience. This
required a correspondingly broad array of interventions. The implicat
ions are clear: confining counseling for caregivers to such traditiona
l dimensions as education or attempts to reduce emotional expressivene
ss denies them the opportunity to deal with other equally relevant con
cerns.