Family connections vs treatment at usual optimized in the treatment of relatives of people with suicidal behavior disorder: study protocol of a randomized control trial

Marco, José H.; Fonseca, Sara; Fernández-Felipe, Isabel; García‐Palacios, Azucena; Baños, Rosa; Pérez, Sandra; García‐Alandete, Joaquín; Guillén, Verónica

doi:10.1186/s12888-022-03965-5

Cited by 6 publications

(12 citation statements)

References 58 publications

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“…However, they also confront the healthy partner with the past, present, and future losses [ 29 ], as losses are not limited to the death of the partner but may include altered relationships or other social and economic changes. In this context it is interesting to note that a program focused on family connections in people with suicidal behavior disorder [ 30 ] may contribute to reducing grief associated with the mental illness of a loved one, and it would be worthwhile to investigate the effects of the family connection program on grief if the loved one eventually dies by suicide.…”

Section: Discussionmentioning

confidence: 99%

“I lost so much more than my partner” – Bereaved partners’ grief experiences following suicide or physician-assisted dying in case of a mental disorder

Snijdewind

Keijser

Casteelen³

et al. 2022

BMC Psychiatry

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Background There is a lack of existing research on grief following the intentional death of people suffering from a mental disorder. Our study aims to provide insight into grief experiences and social reactions of bereaved persons who lost their life partners, who were suffering from a mental disorder, to physician-assisted dying (PAD) or suicide. Methods For this mixed-methods research, we conducted a survey and in-depth interviews with 27 persons living in the Netherlands and bereaved by the death of their life partners. The deceased life partners suffered from a mental disorder and had died by physician-assisted dying (n = 12) or suicide (n = 15). Interviews explored grief experiences and social reactions. In the survey we compared self-reported grief reactions of partners bereaved by suicide and PAD using the Grief Experience Questionnaire. Results Compared to suicide, physician-assisted dying was associated with less severe grief experiences of the bereaved partners. Participants reported that others rarely understood the suffering of their deceased partners and sometimes expected them to justify their partners’ death. Following physician-assisted dying, the fact that the partner’s euthanasia request was granted, helped others understand that the deceased person’s mental suffering had been unbearable and irremediable. Whereas, following suicide, the involvement of the bereaved partners was sometimes the focus of judicial inquiry, especially, if the partner had been present during the death. Conclusion When individuals suffering from a mental disorder die by suicide or PAD, their bereaved partners may experience a lack of understanding from others. Although both ways of dying are considered unnatural, their implications for bereaved partners vary considerably. We propose looking beyond the dichotomy of PAD versus suicide when studying grief following the intentional death of people suffering from a mental disorder, and considering other important aspects, such as expectedness of the death, suffering during it, and partners’ presence during the death.

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Section: Discussionmentioning

confidence: 99%

“I lost so much more than my partner” – Bereaved partners’ grief experiences following suicide or physician-assisted dying in case of a mental disorder

Snijdewind

Keijser

Casteelen³

et al. 2022

BMC Psychiatry

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“…Our fourth objective is to analyze whether the changes related to perceived burden and clinical symptoms that may occur in relatives of patients with ED-PD are related to improvements in the family climate and/or improvements observed in patients with ED-PD. To our knowledge, previous studies on FC have not explored this relationship, except one previous proposal from our research team that consisted of an RCT that explored the bene ts of FC in relatives of patients with suicide behaviors, although there are still no published results from this study [77]. Our last objective was to analyze the perceptions and opinions of families and patients about both intervention protocols.…”

Section: Discussionmentioning

confidence: 99%

“…This is the rst RCT to test an adaptation of FC for relatives of patients with a diagnosis of ED-PD. Until now, previous studies have focused on the effectiveness of FC in relatives of patients with a BPD diagnosis [36,39] and suicide behaviors [77,78] In addition, this study explores the e cacy of FC in Spanish participants. Previous studies have mainly explored the usefulness of FC in English-speaking relatives [34][35][36][37][38], and only some of them have focused on Spanish-speaking participants [28, 55,77].…”

Section: Discussionmentioning

confidence: 99%

“…Until now, previous studies have focused on the effectiveness of FC in relatives of patients with a BPD diagnosis [36,39] and suicide behaviors [77,78] In addition, this study explores the e cacy of FC in Spanish participants. Previous studies have mainly explored the usefulness of FC in English-speaking relatives [34][35][36][37][38], and only some of them have focused on Spanish-speaking participants [28, 55,77]. Thus, this work extends the knowledge about the usefulness, e cacy, and acceptability of the program in non-English speaking countries.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the contributions of this study, we have to highlight some limitations. First, as we highlighted in a previous work [77], one of the objectives of this study is to explore the relationship between improvements in family members and improvements in patients. However, the complicated relationship between patient-parent in the ED context often makes the collaboration and assessment of patients di cult, thus affecting the results.…”

Section: Discussionmentioning

confidence: 99%

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Family Connections vs Treatment at Usual Optimized in the treatment of relatives of people with eating disorders and personality disorders: Study protocol of a randomized control trial

Guillén

Pérez

García‐Alandete

et al. 2022

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Background Family members of patients with eating disorders (ED) often experience high levels of burden, suffering, grief, and helplessness. If, in addition to ED, the patient has a personality disorder (PD), the psychological distress experienced by family members can be devastating. However, few treatments have been developed for family members of people with ED and PD. Family Connections (FC) is a program that has been shown to be effective in relatives of people with borderline personality disorder. The general objectives of this research project are: (a) to adapt and test the FC intervention protocol designed specifically for family members of patients with ED-PD in the Spanish population (FC: ED-PD); (b) to analyze, in a randomized controlled trial, the efficacy of the FC: ED-PD program versus a control condition consisting of optimized treatment as usual (TAU-O); (c) to analyze the feasibility and acceptability of the intervention protocol; (d) to analyze whether the changes that may occur in family members are related to improvements in the family climate and/or improvements observed in patients; and (e) to analyze the perceptions and opinions of families and patients about the two intervention protocols. Methods The study design consists of a two-arm randomized controlled trial with two conditions: FC: ED-PD or Treatment as usual optimized (TAU-O). Participants will be relatives of patients who meet DSM-5 criteria for ED and PD or dysfunctional personality traits. Participants will be assessed at pre- and post-treatment and one-year follow-up. The intention-to-treat principle will be used when analyzing the data. Discussion These results will also confirm the program’s efficacy and acceptance by family members. Trial registration ClinicalTrials.gov Identifier: NCT05404035. Accepted: May 2022.

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Family connections in the treatment of relatives of people with eating disorders and personality disorders: study protocol of a randomized control trial

et al. 2023

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Background Eating disorders (EDs) are serious disorders that significantly affect not only the lives of patients, but also those of their family members who often experience high levels of burden, suffering and helplessness. If, in addition to ED, the patient has a personality disorder (PD), the psychological distress experienced by family members can be devastating. However, few treatments have been developed for family members of people with ED and PD. Family Connections (FC) is a programme that has been shown to be effective for family members of people with borderline personality disorder. The overall aims of this work are: (a) to adapt FC for application to family members of patients with BPD-PD (FC: ED-PD); (b) to analyse, in a randomised controlled clinical trial, the efficacy of this programme in a Spanish population, compared to a control condition consisting of treatment as usual optimised treatment (TAU-O); (c) to analyse the feasibility of the intervention protocol; (d) to analyse whether the changes that may occur in relatives are related to improvements in the family climate and/or improvements observed in patients; and (e) to analyse the perceptions and opinions of relatives and patients about the two intervention protocols. Methods The study uses a two-arm randomised controlled clinical trial with two experimental conditions: adaptation of FC programme (FC: ED-PD) or Treatment as usual optimised (TAU-O). Participants will be family members of patients who meet DSM-5 criteria for ED and PD or dysfunctional personality traits. Participants will be assessed before and after treatment and at one-year follow-up. The intention-to-treat principle will be used when analysing the data. Discussion The results obtained are expected to confirm the effectiveness of the programme and its good acceptance by family members. Trial registration ClinicalTrials.gov Identifier: NCT05404035. Accepted: May 2022.

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Family connections vs treatment at usual optimized in the treatment of relatives of people with suicidal behavior disorder: study protocol of a randomized control trial

Cited by 6 publications

References 58 publications

“I lost so much more than my partner” – Bereaved partners’ grief experiences following suicide or physician-assisted dying in case of a mental disorder

“I lost so much more than my partner” – Bereaved partners’ grief experiences following suicide or physician-assisted dying in case of a mental disorder

Family Connections vs Treatment at Usual Optimized in the treatment of relatives of people with eating disorders and personality disorders: Study protocol of a randomized control trial

Family connections in the treatment of relatives of people with eating disorders and personality disorders: study protocol of a randomized control trial

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