The effect of a culturally informed therapy on self-conscious emotions and burden in caregivers of patients with schizophrenia: A randomized clinical trial.

Abstract

Objective Caring for a family member with schizophrenia often results in high degrees of self-conscious emotions (shame and guilt/self -blame), burden, and other serious mental health consequences. Research suggests that ethnic and cultural factors strongly influence the manner in which family members respond to mental illness. Research further indicates that certain cultural practices and values (spirituality, collectivism) may assist family members in coping with the self-conscious emotions and burden associated with caregiving. With this in mind, we have developed a family focused, culturally-informed treatment for schizophrenia (CIT-S). Method Using a sample of 113 caregivers of patients with schizophrenia (60% Hispanic, 28.2% Caucasian, 8% African American and 3.8% “Other”), we assessed the ability of CIT-S to reduce self-conscious emotions and caregiver burden above and beyond a three-session psychoeducation (PSY-ED) control condition. We further examined whether self-conscious emotions mediated the relationship between treatment type and caregiver burden. Results In line with expectations, CIT-S was found to outperform PSY-ED in reducing guilt/self-blame and caregiver burden. Furthermore, consistent with hypotheses, reductions in guilt/self-blame were found to mediate the changes observed between treatment type and caregiver burden. While caregivers in both treatment groups demonstrated significant post treatment reductions in shame, CIT-S was not found to outperform PSY-ED in reducing levels of this construct. Conclusions Results suggest that caregivers of patients with schizophrenia may respond well to a treatment that specifically taps in to their cultural beliefs, values, and behaviors in helping them cope with schizophrenia in a loved one. Study implications and future directions are discussed.

Free will perceptions and psychiatric symptoms in patients diagnosed with schizophrenia

“…In line with study hypotheses, patients assigned to the CIT-S condition had significantly less severe psychiatric symptoms at treatment termination than did patients assigned to the psychoeducation condition controlling for baseline symptoms (Weisman de Mamani et al 2014b). A later study using data from this project also indicated that CIT-S outperformed a psychoeducation only comparison condition in reducing caregiver burden (Weisman de Mamani & Suro 2015).…”

“…). A later study using data from this project also indicated that CIT‐S outperformed a psychoeducation only comparison condition in reducing caregiver burden (Weisman de Mamani & Suro ).…”

“…This study is part of a larger project on schizophrenia that examines how a family focused culturally informed treatment and other psychosocial factors relate to functioning in patients diagnosed with schizophrenia and their caregivers (for a detailed description, please see Weisman de Mamani et al 2014b, Weisman de Mamani & Suro 2015. Baseline data were also collected to examine a variety of hypotheses regarding correlates of patient and caregiver distress and burden (Suro & Weisman de Mamani 2013).…”

Risk and Protective Factors, Perceptions of Family Environment, Ethnicity, and Schizophrenia Symptoms

“…Results from this intervention study demonstrated that when compared to a psychoeducation only control condition, patients assigned to the CIT-S condition had significantly lower psychiatric symptom severity at treatment termination (while controlling for baseline symptoms; Weisman de Mamani et al, 2014). Furthermore, caregivers in the CIT-S condition also demonstrated reduced levels of caregiver burden at treatment termination in comparison to those in the control condition (Weisman de Mamani & Suro, 2015). Patients without family members were invited to participate in a multifamily group version of the study which we are currently evaluating.…”

Intensive‐invisible mothering: The experiences of mothers of adult children with dual diagnosis

“…A vast body of literature has demonstrated that mental illness and drug addiction are physically, economically, and mentally damaging not only to the individuals who experience these disorders, but also their significant others (Orford et al, ; Weisman de Mamani & Suro, ; Wilkinson & McAndrew, ). These consequences are referred to in the literature as objective and subjective burdens (Biegel et al, ; Brady et al, ).…”