Multi-Family Therapy for First Episode Psychosis: Experiences of Families in Singapore.

Wilfred Liang,Astelle Koh,Christopher Loh,Helen Lee

doi:10.3389/fpsyt.2021.788827

Abstract

Aim: This qualitative study examined the experiences of families with Multi-Family Therapy (MFT) provided by the Early Psychosis Intervention Programme (EPIP) in Singapore. The MFT was piloted over a period of 2 years and findings from this study were used to further refine the MFT to better meet the needs of Singaporean families in the service.Methods: Families who completed the MFT were invited to participate in the study. Nine clients and ten carers who consented to participate in the study were allocated to two client and two carer Focus Group Discussions (FGDs) respectively. A semi-structured interview schedule was used to facilitate the discussions. The FGDs were audio recorded, transcribed, and anonymised. The data was analysed using thematic analysis.Results: Four main themes emerged from the analysis: (1) therapeutic processes of MFT, (2) positive changes in family relationships, (3) improvements in coping with psychosis, and (4) suggestions for improvement in MFT. The families suggested some structural changes to the MFT, and more carers than clients would prefer therapists to offer more expert advice.Conclusions: Findings suggest that a Western-based MFT can be adapted to work with Singaporean families. This study sheds light on the therapeutic processes that may be related to the changes in family relationships and coping with psychosis. In addition, it suggests that therapists taking an expert and authoritative approach may not fit with the needs of younger generations in Singapore. It advocates for therapists to take a flexible and fluid stance to work with Singaporean families.

Highlights

Multi-Family Therapy (MFT) is a Western-based model that combines the theory and practise of group and family therapies, and its key therapeutic aim is to foster mutual support and learning between families who face similar difficulties [1]
The study was approved by the National Healthcare Group (NHG) Domain Specific Review Board (DSRB) and the Institute of Mental Health (IMH) Institutional Research Review Committee (IRRC) in Singapore
The emerging themes from the Focus Group Discussion (FGD) were categorised into four overarching themes: [1] therapeutic processes of MFT, [2] positive changes in family relationships, [3] improvements in coping with psychosis and [4] suggestions for improvement in MFT

Summary

Introduction

Multi-Family Therapy (MFT) is a Western-based model that combines the theory and practise of group and family therapies, and its key therapeutic aim is to foster mutual support and learning between families who face similar difficulties [1]. The wide range of MFT models and settings makes it difficult to establish a solid evidence base. A narrative review suggested that MFT has the strongest evidence base for psychosis in comparison to other settings [14]. MFT in psychosis was based on the earlier psychoeducation model developed by McFarlane [15]. Most adaptations of MFT to work with Asian families draw on a psychoeducational model [3,4,5,6] and it was only recently that a MFT based on therapeutic activities was developed in Singapore by same group of authors in this current study [19]

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