Abstract
Family psychoeducation (FPE) has been recommended as a major component in the treatment of psychosis. Many previous studies have implemented an intensive program design that often only emphasized improvements in patients’ illness outcomes but the benefits for caregivers were limited. There have been calls for a time-limited but cost-effective FPE program to mitigate the looming reality of the suffering of people with psychosis and their families. A Brief Mindfulness-Based Family Psychoeducation for psychosis program is developed to reduce caregivers’ burden and promote young adult’s recovery. A randomized controlled trial will be conducted to compare this intervention with an ordinary FPE intervention. Both arms will involve six sessions, with a total contact time of 12 h. 300 caregivers of young adults who have experienced first episode psychosis within last 3 years will be recruited. Program effectiveness will be assessed by comparing outcomes measuring the caregivers’ burden, mental health symptoms, positive well-being, and the young adult’s mental health symptoms during the study and at 9-month post-randomization. The role of expressed emotions, interpersonal mindfulness, and non-attachment in mediating these outcomes will be explored. An additional qualitative approach Photovoice is selected to explore the complex family experiences and the benefits of mindfulness from the caregivers’ personal perspectives.Trial Registration: The trial is registered with the United States Clinical Trials Registry (ClinicalTrials.gov): NCT03688009.
Highlights
Psychosis and Its Impact on Young Adults and FamiliesPsychosis is defined as a mental, behavioral, or emotional disorder that has been medically diagnosed for at least 1 year
As studies have selected emotion regulation as a change mechanism of mindfulness (Gratz and Tull, 2010; Roemer et al, 2015), we explore if Mindfulness-based interventions (MBIs) can reduce expressed emotions (EEs) that can lead to reduction of caregiver burden, other positive and negative mental health indicators and improvements in overall family functioning
The current study will test the following three hypotheses based on the literature: (i) Caregivers who participate in a mindfulness-based family psychoeducation (MBFPE) program will experience less caregiving burden, less anxiety and depressive symptoms, less physical distress, more positive caregiving experiences, higher levels of interpersonal mindfulness, higher levels of well-being, higher levels of perceived family functioning, higher levels of non-attachment, and less unplanned medical consultations than Family psychoeducation (FPE) participants
Summary
Psychosis and Its Impact on Young Adults and FamiliesPsychosis is defined as a mental, behavioral, or emotional disorder that has been medically diagnosed for at least 1 year. Psychosis and Its Impact on Young Adults and Families. The lifetime prevalence of psychosis is around 0.7 to 2.5% of the general population (Kessler et al, 1994; Chang et al, 2017). One study reported that at their first contact with psychiatric service, over 40% of young adults were not in school or employment (Marwaha et al, 2007). A meta-analysis reported that 34.5% of individuals with psychosis perpetrated violent behaviors before their admission to psychiatric services (Large and Nielssen, 2011). Recent studies have found that 42% of patients with first-episode psychosis reported suicidal ideation, and 9.4% committed violent behaviors (Chang et al, 2014, 2015). Young adults with psychosis experience a high-risk period that places immense strain and anxiety on family caregivers
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