Family Perceptions of Benefits and Barriers to First Episode Psychosis Carer Group Participation

Abstract

Families play an important role in relapse-prevention following a person's first psychotic episode.To evaluate an open-ended family group intervention within a public adult mental health service, semi-structured interviews were conducted with: (1) carers who continually attended; (2) carers who attended once only; (3) carers who never attended; (4) case managers and (5) early psychosis clinicians. Benefits to group participation included: reduced isolation, sense of collective experience, opportunity to feel heard, reduced stigma and shame, increased knowledge about mental illness, and enhanced skills in supporting the care recipient. Barriers included: competing family and work commitments, applicability to own experiences of caring, discomfort with social situations and revealing and hearing emotions, and a belief that experiences are private. While attending the group increased knowledge, the benefits most emphasized were in the social connection with other carers and sharing one's story in a safe and reassuring environment.

Barriers and facilitators to implementing family support and education in Early Psychosis Intervention programmes: A systematic review

“…One study reports quantitative intervention participation data (Fjell et al, 2007), the others are qualitative examinations of delivery and use of family support. Three include feedback from programme staff (Nilsen, Norheim, Frich, Friis, & Røssberg, 2015;Petrakis et al, 2014;Slade et al, 2003), 4 include feedback from families (Mccann & Lubman, 2014;Nilsen, Frich, Friis, & Røssberg, 2014;Petrakis et al, 2014;Riley et al, 2011), and 1 includes feedback from the client (Nilsen et al, 2014). Client and family feedback were generally obtained from individuals recruited during or after their programme participation.…”

“…The studied interventions all included some components of family psychoeducation. Five offered primarily multifamily psychoeducation, 3 of these (Fjell et al, 2007;Nilsen et al, 2014Nilsen et al, , 2015 based on the full Macfarlane model (McFarlane et al, 2003) and 2 (Petrakis et al, 2014;Riley et al, 2011) with shorter, modified programmes. The intervention studied by Slade et al (2003) offered a range of services with escalating intensity based on need, including psychoeducation components.…”

“…Supports were instead provided through a structured self-help manual, an approach also known as bibliotherapy. Three of the interventions included the family only (Mccann & Lubman, 2014;Petrakis et al, 2014;Riley et al, 2011), and 4 included both the client and the family (Fjell et al, 2007;Nilsen et al, 2014Nilsen et al, , 2015Slade et al, 2003).…”

“…Some families are disengaged from their ill relative and are not interested in participating (Slade et al, 2003). Others do not believe that support is needed or relevant to their experience (Petrakis et al, 2014;Slade et al, 2003). This may occur if the families do not identify as caregivers and therefore do not see the programme as relevant for them (Riley et al, 2011).…”

“…• Good relationship between staff and client is critical to successful engagement • Clients and families need time to accept illness before they will be ready to participate • The decision whether to participate in multifamily and single family interventions must be individualized • Clinicians should balance rigour and flexibility in programme delivery Petrakis et al (2014) Intervention participation (# eligible not reported):…”