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Families and caregivers of patients with schizophrenia deal with many emotions including grief, guilt, emotional exhaustion, stress, frustration, anger, and concern about the patient. Some family members experience feelings of guilt, disappointment, and failure. These negative feelings must be addressed for the benefit of the patients and the family. Family meetings with a clinician should be initiated as soon as possible after diagnosis in order to discuss issues such as what to expect with schizophrenia, coping mechanisms for difficult situations, how to improve communication between the patient and those in their environment, and ways that the family can be an effective support system. The family also needs a forum to express their feelings in a controlled setting to prevent a buildup of resentment and hostility as well as a sense of a failure and despair.

In addition to the difficulties directly related to schizophrenia, such as cognitive and social dysfunction, there are many secondary issues that the patient and their family may experience that are related to misperceptions and misunderstandings that they and others may have regarding the impact of the condition in their daily lives. Some of these issues include:

• Stigma of mental illness - There is considerable stigma associated with mental illness in general and especially schizophrenia. Stigma is defined as a negative label that sets someone apart and typically results in social rejection and/or discrimination. It strongly impacts self esteem and wellbeing not only of the patient but also of the family. By advising and teaching family members about the genetic component of schizophrenia (i.e. it is an illness that is genetically determined and does not come become because anyone is "bad"), the stigma does not go away, but at least the family and patient can discuss it with other people and help enlighten them about the condition.
• Guilt - The families of schizophrenic patients often feel that, somehow, the illness is their fault and that they must have done something to cause the patient to acquire schizophrenia. Here also, counseling is very important, including genetic counseling, so that families understand that it was nothing they did to bring it on - that there may be a genetic predisposition for schizophrenia and that certain factors may have triggered that genetic vulnerability.
• Family planning - Family members should be counseled regarding the genetic probability and risk of passing down the condition to their offspring. For adults with schizophrenia who may have a new diagnosis or may not have known about the condition, the genetic implications of schizophrenia can be frightening until it is well explained - particularly if they have young children or are planning to start a family. It is also important for family members to realize that they may be vulnerable to schizophrenia if a family member is diagnosed with the condition, such as siblings, parents, or children, and they may choose to educate themselves and consult with a health provider.
• Support groups - Counselors can direct families to support groups for schizophrenics to provide a venue to share strategies for coping and to interact with others who can identify with their situation and give them tips in making life a little easier. Counselors may also suggest that family members and/or the patient contact professional organizations, such as the National Alliance for Mental Illness (NAMI) for ongoing support and information.