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Family Involvement May Lead to Better Patient Outcomes in Psychosis Treatment

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Summary: Study reveals the benefits of family involvement in treatment outcomes for those who suffer from psychosis.

Source: Boston Medical Center

According to new research from Boston Medical Center, family involvement in psychosis treatment leads to better patient outcomes.

Published in Schizophrenia Research, researchers highlight that learning to use motivational interviewing communication skills may help caregivers to decrease conflict and expressed emotion and improve treatment adherence.

Research showed that families who understand the nature of psychosis symptoms and interventions can support treatment adherence by providing instrumental support for tasks such as scheduling and driving to appointments, filling prescriptions, and communicating with providers about concerning symptoms or behaviors.

The goal is not that the caregiver becomes a therapist to the individual with psychosis, but rather that they learn and use motivational interviewing based communication strategies to decrease expressed emotion and play a more effective role in helping to connect the individual with psychosis to relevant clinical services.

“With the findings from this study, our hope is to understand how supportive home environments can improve patient outcomes across diagnoses,” said Emily R. Kline, MD, Director of Psychological Services in the Wellness and Recovery After Psychosis Program at Boston Medical Center and associate professor of psychiatry at Boston University Chobanian & Avedisian School of Medicine.

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The results of this study showed that caregiver participants experienced large and significant improvements in caregiver well-being, caregiver self-efficacy, family conflict, and expressed emotion. Image is in the public domain

The study is a pilot randomized controlled trial testing the impact of Motivational Interviewing for loved ones (MILO), a brief five-hour psychoeducational intervention for caregivers, in a sample of family members of individuals with early course psychosis.

Using a randomized crossover design, caregivers were randomized to either immediate motivational interviewing for loved ones or a six-week waitlist control condition—all participants eventually received the intervention.

The results of this study showed that caregiver participants experienced large and significant improvements in caregiver well-being, caregiver self-efficacy, family conflict, and expressed emotion. There was no change over time in caregiver-reported patient treatment adherence.

Relative to waitlist, MILO had significant effects on family conflict and expressed emotion, a trending effect on perceived stress, and no effect on parenting self-efficacy or treatment adherence.

Researchers believe that interventions that involve and counsel family members may improve patient outcomes, creating a less stressful and more supportive home environment.

About this psychosis research news

Author: Press Office
Source: Boston Medical Center
Contact: Press Office – Boston Medical Center
Image: The image is in the public domain

Original Research: Open access.
“Motivational interviewing for loved ones: Randomized controlled trial of brief training for first episode psychosis caregivers” by Emily R. Kline et al. Schizophrenia Research

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Abstract

Motivational interviewing for loved ones: Randomized controlled trial of brief training for first episode psychosis caregivers

Background

Research shows that family involvement in psychosis treatment leads to better patient outcomes. Interventions that involve and counsel family members may improve patient outcomes by addressing barriers to treatment adherence and lowering family expressed emotion, thereby creating a less stressful and more supportive home environment. Learning to use motivational interviewing communication skills may help caregivers to decrease conflict and expressed emotion and improve treatment adherence.

Methods

The current study is a pilot randomized controlled trial testing the impact of “Motivational Interviewing for Loved Ones” (MILO), a brief five-hour psychoeducational intervention for caregivers, in a sample of family members of individuals with early course psychosis (N = 40). Using a randomized crossover design, caregivers were randomized to either immediate MILO or a six-week waitlist control condition; all participants eventually received the intervention.

Results

Caregiver participants experienced large (d = 1.08–1.43) and significant improvements in caregiver wellbeing, caregiver self-efficacy, family conflict, and expressed emotion. There was no change over time in caregiver-reported patient treatment adherence. Relative to waitlist, MILO had significant effects on family conflict and expressed emotion, a trending effect on perceived stress, and no effect on parenting self-efficacy or treatment adherence.

Conclusions

MILO showed benefits for caregivers of FEP patients in this small, controlled trial. Further testing in a larger randomized controlled trial is warranted to better characterize MILO’s effects for caregivers and patients across a range of diagnoses.

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