A randomized clinical trial to test the efficacy of a family-focused, culturally informed therapy for schizophrenia.

Abstract

Research strongly suggests that family interventions can benefit patients with schizophrenia, yet current interventions often fail to consider the cultural context and spiritual practices that may make them more effective and relevant to ethnic minority populations. We have developed a family focused, culturally informed treatment for schizophrenia (CIT-S) patients and their caregivers to address this gap. Sixty-nine families were randomized to either 15 sessions of CIT-S or to a 3-session psychoeducation (PSY-ED) control condition. Forty-six families (66.7%) completed the study. The primary aim was to test whether CIT-S would outperform PSY-ED in reducing posttreatment symptom severity (controlling for baseline symptoms) on the Brief Psychiatric Rating Scale. Secondary analyses were conducted to test whether treatment efficacy would be moderated by ethnicity and whether patient-therapist ethnic match would relate to efficacy and patient satisfaction with treatment. Patients included 40 Hispanic/Latinos, 14 Whites, 11 Blacks, and 4 patients who identified as "other." In line with expectations, results from an ANCOVA indicated that patients assigned to the CIT-S condition had significantly less severe psychiatric symptoms at treatment termination than did patients assigned to the PSY-ED condition. Patient ethnicity and patient-therapist ethnic match (vs. mismatch) did not relate to treatment efficacy or satisfaction with the intervention. Results suggest that schizophrenia may respond to culturally informed psychosocial interventions. The treatment appears to work equally well for Whites and minorities alike. Follow-up research with a matched length control condition is needed. Further investigation is also needed to pinpoint specific mechanisms of change.

The Effect of Psychoeducational Interventions on Illness Management in Families of Schizophrenic Patients

“…This result is consistent with the results of the studies conducted by Awad et al (2008), Smith and Segal, (2014), Hasan, Callaghan and Lymn (2015), and Weisman de Mamani, Weintraub, Gurak and Maura (2014), which showed that a change in the emotional attitude of patients' relatives (such as labeling, guilt, anger, and being worried about oneself, the patient and the future) has an important role in the effectiveness of family-based psychoeducational programs in the progression of schizophrenia.…”

Risk and Protective Factors, Perceptions of Family Environment, Ethnicity, and Schizophrenia Symptoms

“…Results from this intervention study demonstrated that when compared to a psychoeducation only control condition, patients assigned to the CIT-S condition had significantly lower psychiatric symptom severity at treatment termination (while controlling for baseline symptoms; Weisman de Mamani et al, 2014). Furthermore, caregivers in the CIT-S condition also demonstrated reduced levels of caregiver burden at treatment termination in comparison to those in the control condition (Weisman de Mamani & Suro, 2015).…”

“…The current study is part of a larger treatment study examining how a family-focused, Culturally Informed Treatment for Schizophrenia (CIT-S) and other psychosocial factors relate to patient and caregiver functioning in individuals diagnosed with schizophrenia and their family members (see Weisman, 2005; Weisman de Mamani et al, 2014 for a more detailed description of the larger project). Results from this intervention study demonstrated that when compared to a psychoeducation only control condition, patients assigned to the CIT-S condition had significantly lower psychiatric symptom severity at treatment termination (while controlling for baseline symptoms; Weisman de Mamani et al, 2014).…”

Free will perceptions and psychiatric symptoms in patients diagnosed with schizophrenia

“…In line with study hypotheses, patients assigned to the CIT‐S condition had significantly less severe psychiatric symptoms at treatment termination than did patients assigned to the psychoeducation condition controlling for baseline symptoms (Weisman de Mamani et al . ). A later study using data from this project also indicated that CIT‐S outperformed a psychoeducation only comparison condition in reducing caregiver burden (Weisman de Mamani & Suro ).…”

“…This study is part of a larger project on schizophrenia that examines how a family focused culturally informed treatment and other psychosocial factors relate to functioning in patients diagnosed with schizophrenia and their caregivers (for a detailed description, please see Weisman de Mamani et al 2014b, Weisman de Mamani & Suro 2015. Baseline data were also collected to examine a variety of hypotheses regarding correlates of patient and caregiver distress and burden (Suro & Weisman de Mamani 2013).…”