Effectiveness of a brief family strengths‐oriented therapeutic conversation intervention for patients with schizophrenia and their caregivers

Abstract

Purpose: To examine the effects of a brief family strengths-oriented therapeutic conversation (FAM-SOTC) intervention on symptom severity of patients with schizophrenia and family coping and caregiver burden for family caregivers. Design:A quasi-experimental research design with repeated measures. Methods:A convenience sample of 72 dyads of patient-family caregivers was recruited from randomized inpatient psychiatric rehabilitation units in a psychiatric hospital in Taiwan. Sixty-one patient-family caregiver dyads that comprised the intervention group (n = 29) and control group (n = 32) completed questionnaires at four time points (baseline, immediate, one-and three-months post-intervention). Demographic questionnaires and clinical information, Brief Psychiatric Rating Scale, Family Crisis-Orientation Personal Evaluation Scales, and Zarit Burden Interview were used to collect data. Generalized estimating equations were used to assess the differences in symptom severity, family coping, and caregiver burden between the two groups.Findings: As compared to the control group, the intervention group showed statistically significant improvements over three months in symptom severity as well as family coping, especially acquiring social support, reframing, and mobilizing social support for family caregivers. Caregiver burden in the intervention group was ameliorated immediately and one month after the intervention rather than a three-month post-intervention. Conclusions:A brief FAM-SOTC intervention proved to be favorable for alleviating psychiatric symptoms of patients coupled with an improvement in family coping and burden in family caregivers encountering schizophrenia.Clinical relevance: Integration of a brief family therapeutic conversation intervention into the routine psychiatric rehabilitation services delivery is recommended to help patients and their family caregivers effectively manage schizophrenia.

Family-Oriented Therapeutic Conversations: A Systematic Scoping Review

“…For example, in the RCT conducted by Ågren et al (2019), the FAM-TC improved the stress of families with a critically ill member after 3 months of the intervention, but not after 12 months. Similarly, Hsiao et al (2022) found that the FAM-TC improved caregivers' burden of patients with schizophrenia and their family caregivers at intermediate and 1 month, but not at 3 months. This lack of sustainability over time of the effectiveness of the family interventions was mainly shown in the measured outcomes that referred to the negative effects of the disease.…”

“…Participation acceptance rates varied among studies, ranging from 49% (Jonsdottir et al, 2021a) to 90% (Aass et al, 2020; Åberg Petersson et al, 2021; Holst-Hansson et al, 2020). In the same way, the intervention completion rates varied, ranging from 50% (Ågren et al, 2019; Broekema et al, 2021) to 100% (Hsiao et al, 2022; Jonsdottir et al, 2021a; Petursdottir et al, 2020).…”

“…This review found that there were differences in acceptance rates, varying between 49% in Jonsdottir et al (2021a) and 94% for the intervention group in Sigurdardottir et al (2013). Similarly, the intervention completion rates showed variability, with the lowest completion rate at 46.26% for both, intervention, and control groups in Broekema et al (2021) and a 100% completion rate in 4 studies (Dorell et al, 2016;Hsiao et al, 2022;Jonsdottir et al, 2021a;Petursdottir et al, 2020). It is noticeable that one study had the lowest acceptance rate, but, nevertheless, it also had one of the highest completion rates (Jonsdottir et al, 2021a).…”

“…FAM-TC have been tested in various populations and health care settings, such as oncology care (Holst-Hansson et al, 2020), pediatric care (Svavarsdottir et al, 2020), cardiovascular care (Østergaard et al, 2018), and psychiatric care (Hsiao et al, 2022). The number of studies reporting the benefits for the patient and the family after receiving a FAM-TC has also increased in recent years (Zimansky et al, 2020).…”

Effectiveness of the enhanced psychological well-being intervention on the psychological well-being and the burden of care for family caregivers of the persons with schizophrenia

“…In contrast, some intervention measures could effectively decrease the burden of care and increase self-efficacy, such as an interpersonal psychotherapy technique and psychoeducation 14 , a brief family strengths-oriented therapeutic conversation intervention 69 and a group psychoeducational intervention. 70 A previous study found that higher levels of hopefulness in the family caregiver was associated with low family caregiver's burden.…”