Informal caregivers in early psychosis: evaluation of need for psychosocial intervention and unresolved grief

Mulligan, John; Sellwood, William; Reid, Graeme; Riddell, Suzanne; Andy, Natasha

doi:10.1111/j.1751-7893.2012.00369.x

Cited by 8 publications

(9 citation statements)

References 67 publications

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“…There is little emphasis on the relationship between the functioning of people with psychosis and carers’ feelings of grief in the literature. Discussions tended to focus on grief regarding parental-child relationships (Godress et al 2005) and family interventions (Mulligan et al 2013). This study extends this work to all carers and shows that the feelings of grief in carers are largely related to their perception of deterioration in the functioning of their relatives with psychosis.…”

Section: Discussionmentioning

confidence: 99%

A longitudinal population-based study of carers of people with psychosis

Poon

Harvey²,

Mackinnon

et al. 2016

Epidemiol Psychiatr Sci

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Section: Discussionmentioning

confidence: 99%

A longitudinal population-based study of carers of people with psychosis

Poon

Harvey²,

Mackinnon

et al. 2016

Epidemiol Psychiatr Sci

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“…Although individuals experiencing FEP may have a diagnosis of a schizophrenia spectrum disorder, the early intervention research focuses on engaging individuals when they first seek treatment for psychosis (Dawson et al, 2012;Onwumere et al, 2017). Research on caregivers' experiences of adults with FEP has documented the frequent presence of caregiver grief (Hinojosa-Marqués et al, 2019;Mulligan et al, 2012), the positive relationship between perceived grief and caregiver expressed emotions (Hinojosa-Marqués et al, 2019), and the importance of providing these caregivers with both education and support alongside their loved one (Dixon et al, 2015). The shift to include caregivers in treatment is a welcome change to treatment where caregivers or family members are often excluded from communication about treatment because of the privacy laws.…”

Section: Literature Reviewmentioning

confidence: 99%

Grief experiences in parents of adult children with serious mental illness

Williams-Wengerd

Solheim

2021

J of Family Theo & Revie

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Because of systemic changes in mental health treatment since deinstitutionalization, parents have taken on more involved roles for their children with serious mental illness (SMI), even when their children have reached young adulthood. However, the changes in parental roles and relationships with their adult children with SMI, and the grief that stems from those changes, have not been adequately reflected in research or treatment interventions. Studies primarily focus on individual perspectives and neglect the relational nature of grief within a family. The absence of a family perspective in treatment systems leave parents to navigate grief and loss on their own. In this article, we systematically review 12 papers on the grief experiences of parents of an adult child with SMI. Through a thematic analysis of the findings it becomes clear that there is a need for employing a family theoretical perspective to address the inherent relational nature of grief. Ambiguous loss theory provides a relationally grounded model which expands our understanding of parents' grief and gives direction for more effective interventions for families. K E Y W O R D S adult children, grief, parents, serious mental illnessAccording to the National Institutes of Mental Health (n.d.), serious mental illness (SMI) 1 impacts approximately 4.5% of the US population. Research on SMI has largely been studied from a biomedical perspective, with a primary treatment focus on the reduction of an individual's symptoms. Systemic shifts in the treatment of SMI from institutionalization to 1 The National Institutes of Mental Health (n.d.) define SMI as "a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities." The American Psychological Association (n.d.) also provides guidance on specific diagnoses which could be included in SMI (e.g., schizophrenia, schizoaffective disorder, or bipolar disorder). For this systematic review, the definition used for SMI is a mental health impairment that lasts for 2 years or longer, and/or a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder.

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“…Reports of burden can also be found among carers in the early illness phase (Onwumere et al., ). Reports of loss and grief are often high in psychosis carers and not dissimilar to levels reported by those following bereavement (Lowenstein, Butler, & Ashcroft, ; McCann, Lubman, & Clark, ; Mulligan, Sellwood, Reid, Riddell, & Andy, ; Patterson, Birchwood, & Cochrane, ). As part of their role, many carers will be faced with difficult and problematic behaviours from their relatives, which may include violence (Onwumere, Hunter, & Kuipers, ), delusional and persecutory beliefs (Onwumere et al., 2008a), and negative symptoms (Dyck et al., ; Ukpong, ).…”

Section: Introductionmentioning

confidence: 97%

Delivering Cognitive‐Behavioural Family Interventions for Schizophrenia

Onwumere

Grice

Kuipers

2016

Australian Psychologist

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Background:In 1993, Kavanagh and colleagues outlined outcomes from a training programme designed to equip mental health practitioners to deliver evidence-based cognitive-behavioural family interventions within routine care. The authors highlighted how the training had not been able to deliver notable increases in the numbers of families being seen by the trained clinicians. There were significant issues in the translation and provision of family interventions within clinical settings, specifically difficulties with the integration of family interventions and caseload demands, and insufficient time within job plans and service settings to undertake the work. The authors posed the question: what can the matter be? Interestingly, the same question was being asked over a decade later. Objective: The current article provides a narrative review of the issues on implementation of family interventions in psychosis. Results: Current evidence suggests that while there exist pockets of good practice and provision for family interventions, it was a mistake to assume that care coordinators would be able to include these family interventions as part of their role, effectively to add duties without significant modification to their current roles and duties. It also seems to have been an underestimate of the skills required for delivering family work in psychosis and the ongoing requirements for high-quality supervision. Conclusion:We argue for carer specialists to be involved in mental health teams, particularly early intervention teams, and for a triage system to offer families a range of evidence-based support, as well as family interventions for more complex problems and presentations.Key words caregivers; family interventions; implementation; psychosis; schizophrenia. Approximately 25 years ago, Kavanagh et al. (1993) evaluated the implementation outcomes and issues in a sample of 48 therapists who had completed specialist training on family interventions during the preceding 3 years. The sample were multiprofessional (e.g., psychiatrists, psychologists) but with most being psychiatric nurses. Less than 20% had offered family interventions to three or more families, and an average of 1.4 families were seen by each therapist. Almost 25% reported finding it extremely difficult or impossible to use the intervention; more than half cited difficulties with time made available to undertake the work and combine with other responsibilities. What is already known on this topicThe following article reviews the issues surrounding implementation of family interventions and considers service initiatives offered in response. IntroductionSchizophrenia affects more than 21 million people worldwide (World Health Organization, 2015) and has long been identified (Eaton et al., 2008;Gustavsson et al., 2011;Kennedy et al., 2014; Wu, Shi, Birnbaum, Hudson, & Kessler, 2006). Epidemiological data confirm that psychosis conditions can affect anyone, with their first onset typically observed during late adolescence and early adulthood. The common...

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Informal caregivers in early psychosis: evaluation of need for psychosocial intervention and unresolved grief

Abstract: Results appear to support these assessments' utility as measures of need for psychosocial intervention and grief among relatives supporting service users experiencing a first episode of psychosis.

Cited by 8 publications

References 67 publications

A longitudinal population-based study of carers of people with psychosis

A longitudinal population-based study of carers of people with psychosis

Grief experiences in parents of adult children with serious mental illness

Delivering Cognitive‐Behavioural Family Interventions for Schizophrenia

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