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This paper describes a project in which family interventions in psychosis services were successfully established in a routine clinical setting. This has involved the development of a whole-team training approach, an accredited one-year training course, and a clinical approach which integrates the systemic and cognitive-behavioural psychoeducational approaches. Since the original description of this project (Burbach and Stanbridge, 1998) the training course and service have been evaluated and the clinical approach has been further developed. These developments, particularly the ‘cognitive interactional’ approach and collaborative therapeutic stance, are detailed. The paper explores the factors which have contributed to the successful establishment and maintenance of the service, and describes more recent initiatives to bring about more family/carer-friendly mental health services.