Family Education Program Research Articles

Implementation of the Texas Medication Algorithm Project Patient and Family Education Program

This article describes the implementation and utilization of the patient and family education program (PFEP) component of the Texas Medication Algorithm Project (TMAP). The extent of participation, types of psychoeducation received, and predictors of receiving at least a minimum level of education are presented. TMAP included medication guidelines, a dedicated clinical coordinator, standardized assessments of symptoms and side effects, uniform documentation, and a PFEP. The PFEP includes phased, multimodal, disorder-specific educational materials for patients and families. Participants were adult outpatients of 1 of 7 community mental health centers in Texas that were implementing the TMAP disease management package. Patients had DSM-IV clinical diagnoses of major depressive disorder, with or without psychotic features; bipolar I disorder or schizoaffective disorder, bipolar type; or schizophrenia or schizoaffective disorder. Assessments were administered by independent research coordinators. Study data were collected between March 1998 and March 2000, and patients participated for at least 1 year. Of the 487 participants, nearly all (95.1%) had at least 1 educational encounter, but only 53.6% of participants met criteria for "minimum exposure" to individual education interventions. Furthermore, only 31.0% participated in group education, and 42.5% had a family member involved in at least 1 encounter. Participants with schizophrenia were less involved in the PFEP across multiple indicators of utilization. Diagnosis, intensity of symptoms, age, and receipt of public assistance were related to the likelihood of exposure to minimum levels of individual education. Despite adequate resources and infrastructure to provide PFEP, utilization was less than anticipated. Although implementation guidelines were uniform across diagnoses, participants with schizophrenia experienced less exposure to psychoeducation. Recommendations for improving program implementation and modification of materials are discussed.

P41: Farm-based Healthy Lifestyle Education Program for Children and Families

HealthBarn USA offers children from suburban New Jersey unique opportunities to develop improved nutrition and physical activity habits via high-energy educational programming offered on a working farm. Children grow and harvest fruits and vegetables, and learn good nutrition by cooking the foods they grow during each 12-week session. Additionally, there are multiple experiential learning opportunities aimed at improving fruit, vegetable and dairy intake, and reading ingredient lists on purchased foods.

The impact of caregivers’ characteristics, patients’ conditions and regional differences on family burden in schizophrenia: a longitudinal analysis

Impact of caregiver characteristics, patient variables, and regional differences on family burden. Two hundred and eighteen schizophrenia patients and key-relatives of an urban and a rural area were examined five times over 30 months. Patients' psychopathology, service utilization; relatives' burden, coping abilities and contact duration with the patients were recorded. Effects of interpersonal differences and intrapersonal changes over time were analyzed with regression models. Interpersonal differences (patients' positive and negative symptoms, relatives' coping abilities, and patient contact) and intrapersonal changes (relatives' coping abilities, patients' negative symptoms and utilization of community care) predicted family burden. Family education programs should help caregivers to improve their coping strategies. Therapy solutions must address negative symptoms just as much as positive symptoms, as these especially impact caregivers. Intensified community-based care can reduce burden, but provision alone is not sufficient. Psychiatrists and caregivers should motivate patients to take advantage of such offers.

Positionality in Teaching Culturally Diverse Students: Implications for Family and Consumer Sciences Teacher Education Programs

This survey research study was designed to identify FCS teachers' beliefs about their experiences with cultural diversity, with particular interest in identifying implications for FCS teacher education programs. The sample consisted of 83 FCS teachers who together taught students from 37 cultural backgrounds including many with limited English proficiency. Respondents' ratings of selected experiences and beliefs regarding cultural diversity were analyzed using descriptive statistics. More than 70% of teachers adapted teaching strategies, time/instructions for assignments, student grouping patterns, and communication. Fewer than 20% adapted teaching goals, texts, or classroom rules. Teaching strategies used most frequently and perceived as most effective were visual aids, cooperative learning, and alternative assessments. It is recommended that teacher education programs provide an encompassing study of cultures, a repertoire of appropriate teaching adaptations, reflective and critical thinking, and multiple experiences with culturally diverse people.

Religiosity, Psychosocial Adjustment, and Subjective Burden of Persons Who Care for Those With Mental Illness

The purpose of this study was to characterize the nature of religious and spiritual support received by family caregivers of persons with serious mental illness and to test hypotheses that religiosity would be associated with caregiver adjustment. Eighty-three caregivers who participated in a study of the Family to Family Education Program of the National Alliance on Mental Illness were assessed at baseline in terms of their religiosity and receipt of spiritual support in coping. They also completed measures of depression, self-esteem, mastery, self-care, and subjective burden. Hierarchical regression was used to test hypotheses that religiosity would be associated with better adjustment, with confounding variables controlled for. Thirty-seven percent of participants reported that they had received spiritual support in coping with their relative's illness in the previous three months. When age, race, education, and gender were controlled for, religiosity was associated with less depression and better self-esteem and self-care. Personal religiosity was a stronger predictor of adjustment than religious service attendance. Family caregivers of persons with serious mental illness often turn to spirituality for support, and religiosity may be an important contributor to caregiver adjustment. Collaborative partnerships between mental health professionals and religious and spiritual communities represent a powerful and culturally sensitive resource for meeting the support needs of family members of persons with serious mental illness.

Effects of a needs-based education programme for family carers with a relative in an intensive care unit: A quasi-experimental study

Critical illness and subsequent hospitalisation of a relative to an intensive care unit (ICU) can result in many physiological and psychosocial problems for patients and their family members. Caring for the anxiety and frustration of these families is an integral part of critical care nursing. The purpose of this study was to examine the effect of a needs-based education programme provided within the first 3 days of patients’ hospitalisation, on the anxiety levels and satisfaction of psychosocial needs of their families. This was a quasi-experimental study with pre- and post-test design. A convenience sample was recruited over a period of three months, consisting of one primary family carer of each critically ill patient who had been admitted to an ICU in Hong Kong. Conducted by an ICU nurse specially assigned for the purpose, family carers in the experimental group ( n = 34 ) received an individual education programme based on the results of a literature review and an individual family needs assessment carried out at the time of patient admission, using the Critical Care Family Needs Inventory. The subjects in the control group ( n = 32 ) received the usual orientation and explanation given by the ICU nurses. Anxiety and need satisfaction were measured in the two groups at pre- and post-test and their mean scores were compared. Of the ten most important statements identified by the family carers in the two groups, the statements regarding the needs for information and assurance were found to predominate. After the needs-based intervention, the experimental group reported significantly lower levels of anxiety and higher levels of satisfaction of family needs than the control group at the post-test. The findings support the effectiveness of providing families of newly admitted critically ill patients, with a needs-based educational intervention to allay anxiety and satisfy immediate psychosocial needs. The formulation of a family education programme should be based on the results of a needs assessment, in order to meet family carers’ individual needs.

Expanding Interventions for Children With Autism

The number of individuals diagnosed with autism has risen at an alarming rate. Expanding services should be a primary consideration of programs for children and their families. This article presents outcome data from a week-long parent education program for families of children with autism to suggest that parents can learn not only how to effectively implement strategies into their interactions with their children but also to train others who work with their children. Single-case research methods were used to assess the spread of effect of a parent education program from parents to other care providers. Results indicate that parents successfully trained others to implement the techniques presented during the program. Additionally, the children's social communication and behaviors improved during interactions with the other caregivers.

A Home Visiting Asthma Education Program: Challenges to Program Implementation

This study describes the implementation of a nurse home visiting asthma education program for low-income African American families of young children with asthma. Of 55 families, 71% completed the program consisting of eight lessons. The achievement of learning objectives was predicted by caregiver factors, such as education, presence of father or surrogate father in the household, and safety of the neighborhood, but not by child factors, such as age or severity of asthma as implied by the prescribed asthma medication regimen. Incompatibility between the scheduling needs of the families and the nurse home visitors was a major obstacle in delivering the program on time, despite the flexibility of the nurse home visitors. The authors suggest that future home-based asthma education programs contain a more limited number of home visits but add telephone follow-ups and address the broader needs of low-income families that most likely function as barriers to program success.

Family education in schizophrenia: A comparison of two approaches

Background:Family education programme (FEP) for families of persons with schizophrenia is practised in several centres as a part of patient-and family-related services.Aim:This paper describes two models of FEP conducted at the Schizophrenia Research Foundation (SCARF), Chennai.Methods:The first programme was a part of a research study and was structured utilizing standard evaluation instruments. The second was flexible and tailored to the needs of the family members.Results:After the first programme, the psychopathology of patients and the burden of caregiving on primary caregivers did not show any significant difference but there was a significant gain in caregivers' knowledge with information and experience sharing. Most families seemed to prefer the second programme, which recorded better attendance and participation.Conclusion:Informal educational sessions with periodic ‘across-the-table’ re-inforcers may be more effective and practical in the Indian setting.

Family Psychoeducation as an Evidence-Based Practice

Family psychoeducation programs have emerged as a strongly supported evidence-based practice in the treatment of schizophrenia and bipolar disorder. Over 30 randomized clinical trials demonstrated that psychoeducation programs reduce relapse, improve symptomatic recovery, and enhance psychosocial and family outcomes. Recent work supports family psychoeducation strategies for other disorders, including major depression, obsessive-compulsive disorder, and borderline personality disorder. This review summarizes the research evidence supporting prominent models of family psychoeducation. Professional and peer-led family education programs are also reviewed and differentiated from family psychoeducation. Directions for future research studies to enhance the evidence base and inform treatment recommendations are proposed. Finally, strategies for implementation of family psychoeducation in routine clinical practice are discussed.

The Advanced Practice Nurse in Gastroenterology Serving as Patient Educator

The role of the advanced practice nurse is evolving in the specialty of gastroenterology, requiring flexibility and an openness to change on the part of the practitioner. The gastroenterology advanced practice nurse performs history and physical assessments, orders diagnostic studies, determines medical and nursing diagnoses, prescribes and evaluates pharmacologic and other therapeutic regimens, manages followup care, and evaluates patient outcomes. The advance practice nurse also provides patient, family, and group education and screening programs. Collaboration with other healthcare professionals; serving as a mentor and as a consultant; participating in continuing education, research and quality management; and providing professional leadership underscore the professional aspects of advance practice nurse activities. The focus of this article is the educational role of the advanced practice nurse. The body of knowledge applicable to the educational role is discussed, in addition to contributory professional activities.

TMAP Shows Promise In Depression Treatment

TMAP Shows Promise In Depression Treatment

Effect of a Family Education Program on the Family Burden of the Stroke

Purpose: The purpose of this study was to evaluate a family education program on the family burden of the patients with Stroke. Methods: This study employed a quasi-experimental one group pre-post test to evaluate the program. The subjects of this study were 36 family caregiver selected by convenience sampling who having stroke patients. Data collection was done using questionnaires before and after the subjects used the program.Results: The results of this study showed that the family burden decreased after used the program(P<.05). Also in subcategories, the physical, social, emotional, and time -dependent burden decreased after used the program(P<.05).There were significance positive correlation between family burden and the degree of paralysis of the patient.Also the results showed that the negative correlation between family burden and the daily living of the patient.Conclusion: The study shows that the family education program have effect on decreasing the family burden of the Stoke patients.

The Hand-to-Hand Family Education Program: A Means of Reducing Parental Stress and Increasing Support in Families of Children with Brain Disorders

Free AccessThe Hand-to-Hand Family Education Program: A Means of Reducing Parental Stress and Increasing Support in Families of Children with Brain DisordersKristen H. Davidson and Mary A. FristadKristen H. DavidsonSearch for more papers by this author and Mary A. FristadSearch for more papers by this authorPublished Online:June 2005https://doi.org/10.1521/capn.9.2.7.33305PDFPDF PLUS ShareShare onFacebookTwitterLinkedInRedditEmail ToolsAdd to favoritesDownload CitationsTrack Citations AboutSuggested ReadingsSisson , D. P., & Fristad, M. A., (2001). A survey of stress and support for parents of children with early-onset bipolar disorder. Bipolar Disorders, 3(2), 58. Crossref, Google Scholar Previous article Next article FiguresReferencesRelatedDetails Cited byCited by1. Creating Partnerships Between Consumer Groups and Professional Psychologists.Online publication date: 1 October 2004. Go to citation Crossref Google Scholar Volume 9Issue 2Mar 2004 Information© The Guilford PressPDF download

The Texas Medication Algorithm Project: Clinical Results for Schizophrenia

In the Texas Medication Algorithm Project (TMAP), patients were given algorithm-guided treatment (ALGO) or treatment as usual (TAU). The ALGO intervention included a clinical coordinator to assist the physicians and administer a patient and family education program. The primary comparison in the schizophrenia module of TMAP was between patients seen in clinics in which ALGO was used (n = 165) and patients seen in clinics in which no algorithms were used (n = 144). A third group of patients, seen in clinics using an algorithm for bipolar or major depressive disorder but not for schizophrenia, was also studied (n = 156). The ALGO group had modestly greater improvement in symptoms (Brief Psychiatric Rating Scale) during the first quarter of treatment. The TAU group caught up by the end of 12 months. Cognitive functions were more improved in ALGO than in TAU at 3 months, and this difference was greater at 9 months (the final cognitive assessment). In secondary comparisons of ALGO with the second TAU group, the greater improvement in cognitive functioning was again noted, but the initial symptom difference was not significant.

Peer-Education Project Gives Hope Where None Existed

Back to table of contents Previous article Next article Professional NewsFull AccessPeer-Education Project Gives Hope Where None ExistedEve BenderEve BenderSearch for more papers by this authorPublished Online:4 Jul 2003https://doi.org/10.1176/pn.38.13.0010They enter the course as strangers, drawn together by one purpose: to better understand their loved ones with mental illness and help them to recover. At the end of the 12-week course, they emerge as family. Since 1991, the National Alliance for the Mentally Ill (NAMI) has linked families through its Family to Family Education Program (FFEP), which is offered to the public at no cost.NAMI is a nonprofit, grass-roots advocacy organization for patients, families, and friends of people with mental illness. About 210,000 people belong to the organization, which is based in Arlington, Va.The course is taught in 46 states through local NAMI affiliates. Family members congregate in community centers, hospitals, health clinics, and, since 1997, VA hospitals to learn about mental illness (see story at Original article: right).Curriculum Uses Real ExperiencesThe course is led by family members of people with serious mental illness. They teach their peers-other family members- about what to do when someone is experiencing a psychotic break or is suicidal, or how to care for and protect a relative with mental illness without taking too much responsibility for him or her, for instance.During the course, which meets for two and a half hours each week, the teachers often reach into the depths of their personal experiences while dispensing wisdom about good communication strategies, medication side effects, and myriad other topics.Teachers use a course manual developed by a longtime NAMI member and psychologist, Joyce Burland, Ph.D. The curriculum includes topics such as the etiology and prevalence of major mental disorders such as schizophrenia, bipolar disorder, major depressive disorder, panic disorder, and posttraumatic stress disorder. By the end of the course, family members can recite the names of a long list of medications and understand how neurotransmitters work, as well as better appreciate the importance of empathy.According to FFEP Director Lynne Saunders, family members learn "how to advocate for the needs of their loved one" in the last session of the course. Saunders noted that thousands of FFEP graduates have become NAMI members.Knowledge EmpowersEleanor Melcher and her husband, Orville, have been teaching the FFEP course for four years at the Louis Stokes Cleveland Department of Veterans Affairs Medical Center in Brecksville, Ohio, outside of Cleveland. They are the parents of a grown son with paranoid schizophrenia."With knowledge, there is hope and strength," Melcher tells her students, many of whom are as frightened, frustrated, and hopeless as she once was."Our son's mental illness had a horrendous impact on our family," she told Psychiatric News. "Between the time of his first psychotic break as a teenager and his diagnosis at the age of 30, there were many years of uncontrollable behavior," she recalled.Melcher explained that many family members who sign up for the course struggle with "feelings of entrapment" regarding their loved ones with serious mental illness. "They may say, 'I have to deal with this mental illness for the rest of my life, and I won't have a life of my own anymore.' But we offer them hope," she said, by explaining that new medications make it possible for many people with mental illness to rejoin society and function independently.Melcher serves as an example of hope. She, too, once felt trapped by her son's mental illness, but as a one-time student of the course, she applied everything she'd learned about establishing boundaries so her son "could take responsibility for his illness." She said many people may be overprotective of their loved ones with mental illness by keeping them at home, for instance, when they are capable of living independently. Such overprotection "causes them to stay sick longer," she said.Once family members learn about what can be expected of their loved one and stop handling all of his or her responsibilities, Melcher said, the patient can more quickly recover."My son is now standing tall-he lives in his own apartment and can care for himself. We can enjoy our lives more as a result," Melcher said.Melcher said she teaches her peers about empathy-about "walking in the shoes of a person with mental illness." Although her son's mental illness has caused incredible disruption within the family, she said, "people realize their loved one with mental illness has experienced so much more trauma" than many other people.Of her experience teaching the course, Melcher said that each class has increased her respect for her peers, whom she referred to as "heroes.""Everyone tells me, 'I wish I'd known about this course sooner,' " she said.More information about NAMI's Family to Family Education Program can be found on the Web at <www.nami.org/family>. ▪ ISSUES NewArchived

The SAFE Program: A family psychoeducational curriculum developed in a Veterans Affairs medical center.

One of the unintended positive consequences of deinstitutionalization and managed care restrictions has been an increased awareness of the impact of serious mental illness on the family. The Support and Family Education (SAFE) Program: Mental Health Facts for Families is a 14-session curriculum of monthly workshops for caregivers. In contrast to similar programs, the SAFE Program is facilitated by mental health professionals, is not diagnostic specific, and includes attention to posttraumatic stress disorder. Three years of outcome data reveal that program attendance is related to increased understanding of mental illness and enhanced awareness of Veterans Affairs resources. Workshop attendance is positively correlated with improvements in participants' self-care. The entire SAFE Program manual is available free of charge on the Internet (http://w3.ouhsc.edu/safeprogram).

Use and effectiveness of Washington state’s extension forest stewardship program

This paper describes the use by family forest landowners of educational programs provided by Washington State University Cooperative Extension (WSUCE), and the associated use of technical assistance programs provided by state and federal agencies and the private sector. Approximately 100,000 family forest owners controlled 19% or over 1.2 M ha of Washington’s forestland and accounted for 29% of the timber harvested in the state on a volume basis in 1998. A variety of public and private assistance and education programs are available to encourage and help family forest owners manage their forests. In 1999 a mail survey was conducted to evaluate use and effectiveness of Washington’s family forest assistance and education programs. Over half of the 872 responding family forest landowners had contact with an extension educator, program or educational material, and about three quarters of these respondents gave an overall rating of the usefulness of extension programs and materials as good or excellent. Respondents attending WSUCE forestry educational programs have larger median land ownership size, are older, have owned their forests longer, have a higher rate of absentee ownership, and are better educated than non-users. They are more likely to actively manage their forests for timber production and exhibit a clearer understanding of the multiple-use capabilities of their forests.

The Support and Family Education (SAFE) program: mental health facts for families.

Although more than half of adults who have a serious and persistent mental illness live with their families (1), less than 10 percent of families of outpatients with schizophrenia receive support or education (2). Such services fail to be provided despite the fact that family participation in well-designed psychoeducational programs has been documented as reducing relapse and readmission rates, improving involvement and adherence to treatment (3,4), and producing positive outcomes for caregivers, including improved morale, better knowledge of mental illness, enhanced feelings of empowerment, and reduced worry and displeasure about their loved ones (5,6). Moreover, the vast majority of mental health providers believe that educating families about mental illness and its treatment is very important (7). Why, then, do so few clinicians commit the requisite time and energy to providing these effective and much appreciated services? There are four sources of obstacles to the adoption of a psychosocial treatment innovation such as family psychoeducation. The obstacles stem from the psychoeducational program itself (for example, its unfamiliarity and conflicts with the existing treatment ideology); the clinicians (lack of training, experience, and competence in functioning as "teachers" with families); the host agency or institution (countervailing priorities and lack of administrative support); and the process of dissemination (lack of knowledgeable consultants or enthusiastic "champions" or advocates for family psychoeducation and lack of user-friendly curricula or program manuals). These obstacles can be overcome when practitioners and family members work together as stakeholders in the benefits that accrue from ongoing psychoeducation (8). In this month's column, Michelle Sherman, Ph.D., presents the family psychoeducation program she created at the Oklahoma City Veterans Affairs (VA) Medical Center. Dr. Sherman describes how she tailored the intervention to the VA population, thus generating the support not only of the clients and their families but also of her fellow clinicians and the VA administration. Her work demonstrates that when mental health clinicians devote time, energy, and expertise to supporting and educating caregivers, significant benefits emerge for both clients and their families.

Family education and support: just for women only?

Studies of education and support programs for families of adults with mental illness' show that the majority of participants are women. In examining why women are more likely than men to take part in these programs, this article reviews the role of women in caring for an adult with mental illness, with a focus on the demands experienced by mothers, sisters, and adult daughters. Given that most family education and support program participants are caring for male relatives, the differences in the demands of providing care to male versus female relatives also are explored. The ways in which education and support programs may be geared toward helping women cope with their unique caregiving demands, as well as methods to increase the participation of men in these programs, are discussed.