The Effects of a Mindfulness-Based Family Psychoeducation Intervention for the Caregivers of Young Adults with First-Episode Psychosis: A Randomized Controlled Trial

Abstract

Objective: In this study, we investigated the effects of a mindfulness-based family psychoeducation (MBFPE) program on the mental-health outcomes of both caregivers and young adults with first-episode psychosis with an onset in the past three years through a multi-site randomized controlled trial. We also studied the outcomes of three potential mediating effects of interpersonal mindfulness, expressed emotions, and non-attachment on the program. Method: We randomly assigned 65 caregivers of young adults with psychosis to MBFPE (n = 33) or an ordinary family psychoeducation (FPE) program (n = 32); among them, 18 young adults in recovery also participated in the evaluation of outcomes. Results: Intent-to-treat analyses were conducted. No significant time × group interaction effects of MBFPE and FPE programs were found in any of the caregivers’ outcomes. However, the young adults with psychosis reported higher levels of recovery after the MBFPE program than after the ordinary FPE program (F = 8.268, p = 0.012, d = 1.484). They also reported a larger reduction in over-involvement of their caregivers (F = 4.846, p = 0.044, d = 1.136), showing that MBFPE had a superior effect to FPE in promoting recovery and reducing over-involvement. Conclusions: A brief psychoeducation program may not reduce the burden on or improve the mental-health outcome of caregivers of individuals with recent-onset psychosis. However, integrating mindfulness into a conventional family psychoeducation program may reduce the expressed emotions of caregivers, especially over-involvement. Further studies should explore how psychoeducation programs can reduce the impact of psychosis on family through sustainable effects in terms of reducing their burden and expressed emotions, using a rigorous study and adequate sample size.

The Effects of Mindfulness for Youth (MYmind) versus Group Cognitive Behavioral Therapy in Improving Attention and Reducing Behavioral Problems among Children with Attention-Deficit Hyperactivity Disorder and Their Parents: A Randomized Controlled Trial

“…We are unable to conclusively explain the lack of positive effects on parent-related outcomes in the current study although we speculated that the timing of outcome collection during COVID-19 may have contributed to increased stress among parents over time. A recent study by Zhang et al [ 47 ] conducted during the COVID pandemic found similar findings of no significant improvement on mental health outcomes among caregivers of psychosis patients after receiving CBT.…”

Effects of an online mindfulness-based program for parents of children with attention deficit/hyperactivity disorder: a pilot, mixed methods study

“…In this pilot study, the MBP demonstrated some reduction in parenting stress and children’s ADHD symptoms. These results could be explained by a previous study where young adults with psychosis reported significant reductions in their parent’s EE after their parents completed a MBP ( 52 ). This reduction in EE may be a potential mechanism behind the positive changes in MBP for parents.…”

Comparing interventions for early psychosis: a systematic review and component network meta-analysis

“…Prior to the publication of this manuscript, we conducted an updated search to January 2024. As this search identified only four further eligible studies, 64 , 65 , 66 , 67 which would represent an increase of only 10% in our included participants, and would not add any new combinations of components—we felt that their inclusion would be unlikely to result in material changes to our results or conclusions and did not justify repeating our analysis. Finally, although we conducted a methodologically rigorous literature search, we cannot exclude the possibility that we failed to identify relevant published or unpublished studies.…”