Abstract
Although many people with psychosis are parents, managing the dual demands of poor mental health and parenting can be stressful and may contribute to poorer outcomes for both parent and child. Parenting interventions have the potential to improve outcomes for the whole family but need evaluation of feasibility in this context. The Triple-P Self-Help Workbook was implemented with guidance and support with 10 parents experiencing psychosis in a multiple baseline case series study. Sessions were weekly and home-based. Outcome measures examined facets of parenting, child behavior, self-efficacy and parental mental health. Follow up interviews explored parents' perspectives of the perceived impact of the intervention and apparent mechanisms of change. The program resulted in clinically significant change (>25% improvement) in mental health, parenting and child behavior measures post-intervention for the 50% who completed all 10 sessions and improvements were maintained at 3 and 6 month follow up. Interviews with those who completed the program revealed it to have been transformative: parents reported positive changes in parenting style; they were empowered with regard to their parenting and had a greater sense of control over their mental health. This study provides preliminary evidence that self-directed Triple P might be able to reduce the symptoms of psychosis by improving family functioning. Findings could inform the future development or adaptation of evidence-based parenting interventions for parents with psychosis in order to improve their mental health, aid recovery, and intervene early in the lives of children at risk of poor long-term outcomes.
Highlights
Serious mental illness (SMI), such as psychosis, can be debilitating and interfere with social, emotional and psychological functioning
This is the first study to systematically explore the use of a guided self-help parenting intervention with parents experiencing psychosis
Preliminary indications arising from this study are that a home-visiting parenting intervention for parents experiencing psychosis could be feasible, effective and valuable
Summary
Serious mental illness (SMI), such as psychosis, can be debilitating and interfere with social, emotional and psychological functioning. The chronicity and severity of symptoms experienced in psychosis can have multifaceted and debilitating implications for daily life [1]. The impact on mood, relationships and quality of life can be profound [2]. Such challenges can be further exacerbated when people with psychosis have dependent children with elevated emotional reactivity to stress, making parenting a stressful aspect of their lives. It has been estimated that up to 55% of men and 62% of women experiencing psychosis are parents [7] but current treatments may neglect the challenges experienced by these parents, mothers [4] The parental role can create meaning, belonging and increase self-worth and as such, Triple P for Psychosis is an important part of self-identity for both men and women with psychosis [3, 4] and may be an important focus for recovery [5, 6].
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