Current Research on Family Interventions in Psychosis

<p>The interpretation of events influences emotional outcomes. (B)</p> Signup and view all the answers

<p>Critical/Hostile Relationships (B)</p> Signup and view all the answers

<p>10% (A)</p> Signup and view all the answers

<p>Family Intervention (B)</p> Signup and view all the answers

<p>The need for more sessions (D)</p> Signup and view all the answers

<p>37% (B)</p> Signup and view all the answers

<p>Improved understanding of the patient's environment (A)</p> Signup and view all the answers

<p>It leads to better outcomes for patients. (B)</p> Signup and view all the answers

<p>It ensures consistency in how families are engaged. (B)</p> Signup and view all the answers

<p>Relationships may complicate decision-making. (A)</p> Signup and view all the answers

<p>Using a single designated person for continuity of care. (C)</p> Signup and view all the answers

<p>By being flexible with meeting times and modes of communication. (D)</p> Signup and view all the answers

<p>Improved quality of life (D)</p> Signup and view all the answers

<p>High levels of burden and burnout (D)</p> Signup and view all the answers

<p>It measures family interactions as either positive or negative. (D)</p> Signup and view all the answers

<p>It predicts a higher rate of relapse. (C)</p> Signup and view all the answers

<p>High EE is correlated with poor carer outcomes. (C)</p> Signup and view all the answers

<p>High levels of burnout and stigma (D)</p> Signup and view all the answers

<p>Financial support (A)</p> Signup and view all the answers

<p>30-40% (B)</p> Signup and view all the answers

<p>Greater risk of relapse (A)</p> Signup and view all the answers

<p>Comprehensive/sustainable interventions (C)</p> Signup and view all the answers

<p>All staff members are trained (D)</p> Signup and view all the answers

<p>High levels of grief and loss (B)</p> Signup and view all the answers

<p>It requires community involvement for success (C)</p> Signup and view all the answers

<p>Improve service user functioning and reduce relapse (D)</p> Signup and view all the answers

<p>Involvement of the entire team and continuity of care (B)</p> Signup and view all the answers

<p>Peer support (C)</p> Signup and view all the answers

<p>Systemic family therapy (D)</p> Signup and view all the answers

<p>Implementation difficulties (C)</p> Signup and view all the answers

<p>Feeling isolated and unsupported by services (B)</p> Signup and view all the answers

<p>One-to-one and situation-specific support (A)</p> Signup and view all the answers

<p>Peer supporters have personal experience with similar situations (B)</p> Signup and view all the answers

<p>The OPAL project (D)</p> Signup and view all the answers

<p>One-to-one and situation-specific interventions (A)</p> Signup and view all the answers

<p>They desire assistance to understand their rights (D)</p> Signup and view all the answers

<p>Regular get-togethers for one-to-one discussions (D)</p> Signup and view all the answers

<p>Tailored information and understanding of the MHA (C)</p> Signup and view all the answers

<p>10 planned sessions (C)</p> Signup and view all the answers

<p>The person's medication adherence (B)</p> Signup and view all the answers

<p>Family members are included directly in the therapy process (A)</p> Signup and view all the answers

<p>3 months to 1 year (B)</p> Signup and view all the answers

<p>Friends and advocates who have close contact (B)</p> Signup and view all the answers

<p>Training needs not being met (B)</p> Signup and view all the answers

<p>It influences staff members' commitment to family interventions. (C)</p> Signup and view all the answers

<p>Engaging them early in the intervention (B)</p> Signup and view all the answers

<p>Family Psychoeducation (B)</p> Signup and view all the answers

<p>A shared focus on family involvement (C)</p> Signup and view all the answers

<p>Complex family dynamics can hinder engagement. (A)</p> Signup and view all the answers

<p>Cross-sectional and staff-focused studies (B)</p> Signup and view all the answers

<p>Upon early engagement with families (D)</p> Signup and view all the answers

<p>The resources available to the carer (C)</p> Signup and view all the answers

<p>Timeline (A)</p> Signup and view all the answers

<p>To address sensitive issues with specific legal information. (A)</p> Signup and view all the answers

<p>Beliefs about the management of symptoms (A)</p> Signup and view all the answers

<p>Psychoeducation with discharge planning and community follow-up. (B)</p> Signup and view all the answers

<p>Psychoeducation for the family (D)</p> Signup and view all the answers

<p>It provides a peer support program tailored for specific needs. (B)</p> Signup and view all the answers

<p>They can improve service user functioning and reduce relapse. (D)</p> Signup and view all the answers

<p>High levels of expressed emotion among caregivers (B)</p> Signup and view all the answers

<p>Feelings of isolation from the community (A)</p> Signup and view all the answers

<p>All staff can benefit from being trained to deliver family psychoeducation. (B)</p> Signup and view all the answers

<p>It provides shared experiences and personal insights. (A)</p> Signup and view all the answers

<p>Understanding and empathy (B)</p> Signup and view all the answers

<p>Private and organized regular get-togethers. (B)</p> Signup and view all the answers

<p>Cognitive Theory (B)</p> Signup and view all the answers

<p>Discharge planning without additional support. (B)</p> Signup and view all the answers

<p>Having the same person deliver the intervention (D)</p> Signup and view all the answers

<p>The reason for admission and hospital processes (A)</p> Signup and view all the answers

<p>Assessing and obtaining patient consent (A)</p> Signup and view all the answers

<p>By offering meetings via video calls or outside working hours (A)</p> Signup and view all the answers

<p>Focusing on groups consisting of patients, carers, and staff (B)</p> Signup and view all the answers

<p>The carer's personal knowledge of the patient's condition (C)</p> Signup and view all the answers

<p>Understanding the individual and their cultural background (C)</p> Signup and view all the answers

<p>Availability of healthcare staff for consultations (B)</p> Signup and view all the answers

<p>Improved treatment adherence (D)</p> Signup and view all the answers

<p>30-40% (A)</p> Signup and view all the answers

<p>Higher relapse rates (B)</p> Signup and view all the answers

<p>Social isolation (D)</p> Signup and view all the answers

<p>Expressed Emotion (EE) (C)</p> Signup and view all the answers

<p>High EE correlates with increased carer burden (B)</p> Signup and view all the answers

<p>As an adaptive response (D)</p> Signup and view all the answers

<p>Feelings of negativity towards the person being cared for (C)</p> Signup and view all the answers

<p>Frequent family conflicts and criticism (B)</p> Signup and view all the answers

<p>52.9% (C)</p> Signup and view all the answers

People with psychosis who have carers generally have better outcomes and quality of life compared to those without carers.

Accessing appropriate services during the initial stages of psychosis can improve outcomes.

Improving the consistent taking of medication by people with psychosis is crucial for treatment success.

Recognizing early warning signs of relapse in psychosis helps to intervene and prevent a return to illness.

The significant strain and hardship faced by carers of people with psychosis, often impacting their well-being and resources.

A measure of family interactions, characterized as either positive, negative, or critical.

A relationship characterized with high levels of criticism, hostility, or over-involvement, within caregiving relationships.

A tool to assess the qualities of relationships using a carer's interview, to gauge criticism, hostility, & over-involvement.

High EE in a care relationship negatively affects both the person with psychosis and the caregiver.

High EE in relationships correlates with increased risk of relapse in people with schizophrenia.

Carer beliefs about a situation are linked to the way they express emotions (like hostility, criticism, or over-involvement).

A model that explains how we react to events: Activating event (what happens), Beliefs (how we think about the event), and Consequence (our emotional response).

People's understanding of a condition: including its symptoms, cause, curability, consequences, and duration.

How a carer evaluates a situation, including their perception of the situation and available resources to cope.

A model of illness perception used to understand how people perceive and respond to illness, including psychosis.

A set of interventions focused on the family of a patient with a mental health condition.

An intervention teaching family members about a patient's mental health condition.

37% in a comparison group that did not receive family intervention.

Family psychoeducation, FPsy + behaviour/skills training & mutual support and systemic-oriented approaches.

Interventions lasting less than two sessions have unclear effectiveness in reducing relapse; more sessions are needed.

Engaging families early and consistently for better patient outcomes, especially for complex cases.

A unified message within a service about the importance of family participation to ensure consistent and effective family involvement.

Families with complex dynamics that can make family involvement challenging in patient care and crisis planning.

Using strong communication skills to interact with families, which is key for successful family involvement in inpatient care.

Tailoring family involvement methods to individual family needs, preferences, and cultural backgrounds.

A legal process involving the Mental Health Act where support is offered to informal carers (family and friends) of individuals detained under the act.

The provision of aid and resources to family members of individuals admitted to care involuntarily under the Mental Health Act (MHA)

The lack of readily available, personalized interventions for carers of individuals admitted under the MHA, especially when dealing with situation-specific needs.

Personalized support for carers of individuals under the MHA is crucial due to the sensitive nature of the situation and the specific information they require.

A program utilizing the experiences of peers who have navigated the MHA to provide guidance and support to other families in similar situations.

A peer support program, rooted in successful German practices, adapted and tested for families in England.

Interventions to help family members navigate the transition of their loved one from inpatient care to outpatient care, providing ongoing support.

An ongoing research project aiming to improve the well-being of unpaid carers supporting individuals admitted under the Mental Health Act in England.

Psychoeducation, discharge planning, and community follow-up combined, especially when interventions occur both in the hospital and community, have the strongest evidence for reducing relapse rates.

Family Intervention involves a range of interventions tailored for the family of an individual with a mental health condition.

FPsy teaches family members about a person's mental health condition, aiming to equip them with knowledge, skills, and support to navigate the illness.

Meta-analytic data shows that FPsy improves service users' functioning and reduces relapse rates.

Continuity of care involving all staff trained in Family Psychoeducation proves crucial for both effectiveness and implementation.

Family Psychoeducation, behavioral and skills training combined with mutual support groups, and systemic-oriented approaches have all shown success in reducing relapse.

Early Intervention Teams offer family intervention for all eligible patients, ensuring a standardized approach and ongoing monitoring. All staff are trained in FPsy, contributing to improved outcomes.

Peer support shows potential as a key ingredient for improving family interventions in the future.

Family Intervention (FI) is a type of therapy that involves families of people with psychosis. It aims to help families understand the illness, cope with its challenges, and support the person with psychosis.

NICE recommends FI for people with psychosis, including at least 10 sessions over 3-12 months. It emphasizes family involvement and personalized approaches.

A carer is anyone who has regular close contact with a person with psychosis and provides support, including family members, friends, or advocates.

FI focuses on providing education, support, and treatment to families. It aims to help them navigate challenges, manage crisis situations, and build positive relationships.

Multi-family groups involve multiple families coming together to discuss shared experiences, learn from each other, and receive support.

People with psychosis who have carers generally have better outcomes including accessing services, improving treatment adherence, identifying early signs of relapse, and reducing admission and relapse rates. They also show greater gains from psychological therapy and enhanced cognitive flexibility.

Carers of individuals with psychosis often experience high levels of burden, burnout, and social isolation due to the demands of their role and stigma associated with mental illness.

Expressed Emotion (EE) is a measure that assesses the emotional climate within a family, particularly the level of criticism, hostility, and over-involvement towards the person with psychosis.

High EE is a predictor of relapse in schizophrenia, leading to higher rates compared to low EE relationships. It's also linked to carer burden, impacting their well-being.

The Camberwell Family Interview (CFI) is used to measure EE by assessing dimensions of criticism, hostility, emotional overinvolvement, warmth, and positive remarks.

High EE in a relationship is associated with carer burden leading to stress, distress, low self-esteem, and less effective coping strategies.

Evidence suggests that a combination of psychoeducation, discharge planning, and community follow-up, with interventions provided both in the hospital and the community, are highly effective in reducing relapse rates.

Family Psychoeducation (FPsy) involves educating family members about psychosis, equipping them with knowledge, skills, and support to navigate the illness.

Research has shown positive results with Family Psychoeducation, behavioral and skills training combined with mutual support groups, and systemic-oriented approaches in reducing relapse rates.

Peer support shows immense potential to improve family interventions, as individuals with lived experience can offer unique understanding and support.

The thoughts and assumptions carers have about psychosis, affecting their emotional responses and interactions with the individual.

This model examines how people understand and respond to illness, focusing on five dimensions: identity, cause, cure/control, consequences, and timeline.

This model highlights how carers' appraisals of the situation and their perceived coping resources impact their burden, regardless of the client's severity of experience.

Family interventions (FI) have proven effective but face implementation challenges. This involves ensuring staff training, incorporating a system-wide focus on FI, and addressing reservations about family involvement.

Common barriers to implementing FI include insufficient training, lack of system-wide support, reservations about family involvement, and difficulties engaging families effectively.

Engaging families is crucial for FI success. It involves tailoring approaches to individual family needs, addressing complex family dynamics, and building strong communication.

Early engagement with families during the initial stages of psychosis is essential for better patient outcomes.

Consistency is key: ensuring a shared message across all staff about the importance of family involvement to ensure effective implementation.

Staff require adequate training in FI to effectively implement interventions and provide appropriate support to families.

Implementing FI requires a system-wide shift in attitudes and practices, ensuring FI is prioritized within the organization.

FI becomes more complex when families have complicated relationships or require specialized support. It requires a willingness to share power and control with families.

Effective communication and collaboration are crucial for success in mental health care. This includes navigating 3-way meetings with patients, families, and clinicians.

Tailoring care to individual needs and cultural backgrounds is crucial. This includes respecting family preferences, listening actively, relinquishing control, and adapting delivery methods to accommodate busy schedules.

Having the same person or team involved throughout the intervention process improves consistency and communication.

Obstacles to family engagement include identifying carers, assessing patient consent, sharing complex information, engaging carers, and systemic constraints.

Involving family in the right moments is key, including information provision, care planning, discharge planning, and adopting a supportive approach.

A meeting with the newly admitted patient, their carer, and clinician within 7 days of admission is recommended. Topics should include reason for admission, information provision, and collaborative care and discharge planning.

The Mental Health Act (MHA) review aims to provide support to informal carers (family and friends) of people detained under the act.

Carers need personalized, one-to-one support when a relative is detained under the MHA, as the situation is sensitive and they require specific information.

The OPAL project is an evidence-based peer support program, adapted and tested for England, aiming to improve the well-being of unpaid carers supporting individuals admitted under the Mental Health Act.

Interventions are needed to help families navigate the transition from inpatient care to outpatient care, providing ongoing support and resources.

Interventions that combine psychoeducation, discharge planning, and community follow-up, especially when they occur both in the hospital and the community, have the strongest evidence for benefit in reducing relapse.

Early Intervention Teams offer family intervention to all eligible patients, ensuring a standardized approach and ongoing monitoring. All staff are trained in Family Psychoeducation (FPsy), contributing to improved outcomes.