Strengths-Based Family Psychoeducation for Youth Psychosis
Condition: Psychological Stresses
MeSH terms: Stress, Psychological
Study type: Interventional

Summary: 
      The onset of Psychosis forces family members to bear a heavy burden of care. The mental
      well-being of the family is so complicated that it is important to relieve their
      psychological stresses. Although family psychoeducation has been established as an
      evidence-based practice especially for schizophrenia, few studies have primarily intended to
      reduce the distress of the family due to the burden of care. MacFarlane's multifamily
      psychoeducation is one of the representative models of a group setting, which is based on the
      behavioral therapeutic approach. In such psychological interventions, it has been emphasized
      to focus on the strengths that a person originally has for coping with difficulties. The
      intervention of mainly drawing the strengths from the family might empower them and lighten
      their psychological burden.

      The first 2-5 years from the onset of psychosis is regarded as the critical period to improve
      the prognosis, so the intervention including more recent-onset psychotic patients might be of
      use. With regard to a setting of the psychoeducational intervention, a homogeneous group one
      can make the program better fitted for their problems. The present study aims to examine if
      the strength-based family psychoeducaiton for youth psychosis in a group setting in addition
      to the treatment as usual would be more effective for alleviating the psychological
      distresses of the family than the treatment as usual alone. Moreover, its impact on the
      family of recent-onset psychosis is explored as the subgroup.
    

Detailed description: 
      Psychosis, principally involving schizophrenia, is a severe mental illness that commonly
      develops at a young age and often has a chronic course. The onset of Psychosis forces family
      members to bear a heavy burden of care. It has been documented over and over again that the
      mental well-being of the family is complicated. More than a dozen per cent of the family have
      the morbidity corresponding to be depressive and anxiety disorders. It is important to
      relieve their psychological stresses.

      The concept of the burden of care is so broad and complex that its simple definition is a
      challenging issue. It is usually defined as objective impacts on the household and subjective
      consequences, which contain physical, economic, emotional and psychological components. The
      psychological component involves the stigma against psychiatric disorders. The studies of
      intervention to the family having a psychotic member have been mostly conducted for the
      primary interest of reducing the rate of relapse and rehospitalization of the psychotic.
      Their rationale of the intervention is based on the roles of the family that develop the
      illness and cause a relapse (e.g., etiological relationship or expressed emotion). Although
      family psychoeducation has been established as an evidence-based practice especially for
      schizophrenic patients, few studies have primarily intended to reduce the burden of their
      family.

      Among various types of family psychoeducation, the group setting is considered as a better
      method in terms of the creation of social support networks, limited medical resources and
      cost-effectiveness. MacFarlane's multifamily psychoeducation is one of the representative
      models of a group setting, which is composed of joining sessions, an educational workshop and
      structured problem-solving group sessions. MacFarlane's model is based on the behavioral
      therapeutic approach that mainly aims at stopping a vicious cycle. The cycle of schizophrenia
      is peculiarly caused by expressed emotion, which is negative one expressed by the family that
      lead to a high relapse rate (e.g., hostility or criticism).

      In such psychological interventions, it has been emphasized to focus not only on the vicious
      cycle but also on strengths. The strengths are defined as the power that a person has
      originally for coping with difficulties. The intervention of mainly drawing out the strengths
      of the family might empower them to face difficulties voluntarily and lighten their
      psychological burden. However, to date, the effectiveness of family psychoeducation based on
      the strengths approach has not been confirmed.

      The onset of psychosis is generally at a young age. The first 2-5 years from the onset of
      psychosis is regarded as the critical period to improve the prognosis, so the intervention
      including more recent-onset psychotic patients might be of use. Additionally, the family of a
      young patient has been reported to have strong concerns about returning to school, going to
      work and getting married. With regard to a setting of the psychoeducational intervention, a
      homogeneous group one can make the program better fitted for their problems and heighten
      group cohesiveness.

      The present study aims to examine if the strength-based family psychoeducaiton for youth
      psychosis in a group setting in addition to the treatment as usual would be more effective
      for alleviating the psychological distresses of the family than the treatment as usual alone.
      Moreover, its impact on the family of recent-onset psychosis is explored as the subgroup.
    

Intervention name(s): Strengths-based family psychoeducation
Intervention type(s): Behavioral
Intervention description(s): Family psychoeducation in a group setting is performed every two weeks for eight weeks.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Psychotherapy, Psychotic disorders, Caregiver