Our objective is to present a family-centered approach used at the Margaritas Therapeutic Community, an institution dedicated to the care, prevention, and rehabilitation of psychiatric patients.

The family is the social foundation for interaction between children, parents, and the extended family. Ackerman defines it as a basic social structure, configured by the interplay of differentiated roles (father, mother, and children). The patient, by fulfilling a role within the family (the repository of the family's mental illness), makes the family, not the individual, the unit of the illness.

Its primary function is the socialization of its members, which is achieved through relationships of aggression and submission to different types of family authority. This involves both a system of beliefs and attitudes resulting from upbringing and the way in which the individual integrates into the socioeconomic system.

Working with the family group (ideally with the entire family, but often with the available members) is the basis for the selected patient's recovery and fundamental for the initial diagnosis and treatment. It is far more therapeutic than focusing the problem solely on the patient rather than the family. This approach stems from our experience at the Mendao Institute, where we did not admit any patient for inpatient care unless their family also participated in family therapy (since if the family does not acknowledge their role in the patient's pathology, this can be a contributing factor to future relapses).

The first phase of family therapy begins when the family visits the Margaritas Therapeutic Community or consults with the treating physician. During this phase, we explore not only the patient's current condition but also the family dynamics, both conscious and unconscious, which often determine the patient's symptoms.

In many cases, this approach clarifies the reasons for hospitalization and raises awareness within the entire family group about the nature of the pathology, not only in the patient but also within the family itself. This initial phase consists of three to six interviews. The second stage will last while the patient is hospitalized, with the goal of understanding the reason for hospitalization (first admission - relapse), as well as conscious and unconscious family dynamics that determine the pathology.

Diagnostic studies will support the diagnosis, as well as laboratory tests that will provide a more comprehensive diagnosis, including physical aspects. Various therapeutic elements will be used, such as individual therapy an average of three times a week, group therapy twice a week for an hour and a half each session, and family therapy once a week.

Reduced symptoms do not mean the patient is cured, but rather that they will have a way to live more functionally in society and with their family, resume their studies, find work, or seek opportunities for resocialization (partner, friends, etc).

The third stage is discharge from the hospital and continuation of treatment as an outpatient. With reduced symptoms, this is the most vulnerable stage. A decision will need to be made regarding whether the family can administer the medication to the patient or if they can do so themselves. How will they get to the doctor's office? Once the family support group has been established, what will the family's support be, or will a caregiver or therapeutic companion be needed?

The duration of this stage will depend on each patient and the type of illness, as well as the family's progress in understanding the illness and its underlying unconscious factors.