Parents experiencing psychosis can face challenges in addition to those usually associated with being a parent, with their children at increased risk of negative outcomes. Although a strong evidence base has shown that family interventions for psychosis (FIp) can mitigate distress for adult relatives, techniques described in the systemic and parenting literature to facilitate the inclusion of children in family therapy are largely absent from the FIp literature and training. This study used a three-round Delphi survey to investigate what experienced FIp clinicians consider to be best practice regarding the inclusion of children in parental FIp. Findings demonstrated support for including children, with high levels of consensus regarding methods of facilitating their involvement, as well as organisational factors that would support this. The results have important clinical implications given that many FIp practitioners work with families, following brief psychosis specific training, without exposure to the broader literature.
Purpose
Families play an instrumental role in helping relatives experiencing mental health issues to stay well. In the context of wider initiatives promoting family and carer needs, this study aims to evaluate the feasibility, acceptability and potential benefits of bespoke training to develop clinicians’ skills in working with families in crisis.
Design/methodology/approach
The study was an uncontrolled evaluation of a one-day workshop for home treatment team staff using pre- and post-questionnaires.
Findings
In total, 83 staff members participated. Overall, there was a strong agreement for the involvement of families, which increased marginally after training. There were significant changes in views about talking to family members without service user consent (p = 0.001) and keeping them informed of their relative’s well-being (p = 0.02). Qualitative feedback indicated that participants enjoyed the interactive elements, particularly role-playing. Training provided an opportunity to practice skills, share knowledge and facilitate the integration of family work into their professional role.
Research limitations/implications
Confident support for families contributes to effective mediation of crisis and continuation of care; factors important in reducing admission rates and protecting interpersonal relationships. Overall, the consistency of responses obtained from participants suggests that this workshop offers a helpful introduction to a family approach at times of a mental health crisis.
Originality/value
This pilot evaluation suggests this new one-day workshop, is a feasible and acceptable training program, which is beneficial in developing clinicians’ skills in working with families in a crisis.
This study sought to evaluate family intervention (FI) for psychosis that had been offered in routine practice by a dedicated FI service. Method: A retrospective analysis of electronic clinical records was undertaken to examine those who had received FI and their use of acute services (accident and emergency, home treatment, inpatient) in the two years preceding and following FI, as a measure of outcome. The analysis included 29 patients whose families had participated in five or more sessions of FI. Results: The demographics of the sample were diverse. While there was no significant change in the number of admissions following FI, there was a modest reduction in time spent in acute care, particularly use of home treatment. Conclusions: Notable demographic differences between families suggest referral decision-making in routine care warrants further investigation. The study also offers tentative support for the translation of good FI outcomes into routine practice though implementation rates remain low.
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