Exploring service user and family perspectives of a Culturally adapted Family Intervention (CaFI) for African‐Caribbean people with psychosis: A qualitative study

Abstract

Objectives. In the UK, people of African-Caribbean background have the highest rates of psychosis and greatest inequity in mental health services of all ethnicities. National policies have highlighted the lack of evidence-based psychological interventions for this group. The aim of this study was to examine the acceptability of a novel Culturally adapted Family Intervention (CaFI) for African-Caribbean individuals diagnosed with non-affective psychosis and their relatives. Design. A qualitative design.Methods. Semi-structured interviews conducted with 22 service users and 12 family members following participation in CaFI. The interview topic guide included perceptions of the needs and benefits of CaFI; usefulness, cultural specificity and accessibility of CaFI therapy and supporting materials; content and delivering of CaFI sessions; views and experiences of working with CaFI therapists; and perceived barriers and facilitators to implementation.Results. Deductive framework analysis identified three main themes for service users: perceived benefits, barriers and limitations, and delivery of the therapy. Four themes were identified for family members: perceived benefits, perceptions of therapists, delivery of therapy, and accessibility of therapy content, supporting materials, and cultural appropriateness.Conclusions. CaFI was found to be an acceptable intervention for African-Caribbean service users with psychosis and their relatives. Family interventions considering the needs of ethnic and cultural groups have the potential to improve the mental health care and experiences of service users and their families. Practitioner pointsThe Culturally adapted Family Intervention (CaFI) was viewed as acceptable to African-Caribbean service users with psychosis and their families.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Clinicians’ perceptions of family involvement in the treatment of persons with psychotic disorders: a nested qualitative study

“…Some qualitative studies have investigated patients and relatives’ perspectives on FPE and similar interventions in single- and/or multi-family formats. These often emphasise how improved communication and a reframing of relatives understanding leads to a reduction in conflict and stress ( 18 , 19 , 21 ). Their findings resonate well with the perceived benefits and processes identified in our study, and are consistent with the theory that FPE generates a reframing of relatives understanding, which through a reduction in the level of EE leads to reduced relapse rates ( 17 ).…”

Community-based models of care facilitating the recovery of people living with persistent and complex mental health needs: a systematic review and narrative synthesis

“…Four belonged to the integrated community treatment MoC (35,39,40,42), three to the social and community connection-focused MoC (66,67,69), and one each to rehabilitation and recovery-focused (58), The identified quantitative studies (RCT and pre-post designs) suggested that focused interventions within ongoing care models impact the target, e.g., executive function (29) or treatment self-management (31)-but these changes may not impact recovery. A specific focus on the person's own goals was associated with positive recovery (33), as was greater self-direction of recovery support resources (32). Qualitative data suggested that contextual factors and non-linear experiences could derail the pursuit of goals and impede recovery (31,33), even within a well-defined, goal-pursuing intervention such as IMR (33).…”

“…A specific focus on the person's own goals was associated with positive recovery (33), as was greater self-direction of recovery support resources (32). Qualitative data suggested that contextual factors and non-linear experiences could derail the pursuit of goals and impede recovery (31,33), even within a well-defined, goal-pursuing intervention such as IMR (33). Flexibility and ample timeframes are required for effective goal-setting to support recovery (32,33).…”

“…Furthermore, caring relationships can benefit consumers. An MoC incorporating family involvement ( 33 ) showed both personal and interpersonal benefits for consumers. Family support was also associated with better social integration within a Clubhouse ( 72 ), echoing the findings of Fossey and Harvey ( 108 ).…”

“…Qualitative data suggested that contextual factors and non-linear experiences could derail the pursuit of goals and impede recovery (31,33), even within a well-defined, goal-pursuing intervention such as IMR (33). Flexibility and ample timeframes are required for effective goal-setting to support recovery (32,33). One RCT (29) lacked personal recovery measures or any consumer perspectives.…”