Family Psychoeducation Program Research Articles

Leo program, a short multi-family skill-based psychoeducational program for caregivers of relatives living with a severe mental disorder: a retrospective pilot study.

Caring for a relative with a severe mental disorder (SMD) is associated with high levels of burden and poor physical and mental health. There is a dire need for family psychoeducational programs that can be provided as early as possible. This manuscript describes the pilot testing of "Leo" a motivational-based psychoeducational program for caregivers of individuals with a SMD. The Leo program aims to provide caregivers with skills to best support their relative and to adopt self-care behaviors. We retrospectively analyzed medical records of caregivers who enrolled in a short, multi-family, skill-based psychoeducational program, consisting of eight 3-hour sessions over 8 weeks. Outcomes of interest included: i) adherence to the program, ii) satisfaction and perceived usefulness, and iii) pre-post changes in self-reported levels of depression (CES-D), burden (ZBI), and skills (10 Likert-scaled items). A network analysis was used to investigate the relationships between pre-post changes in self-evaluated skills and pre-post changes in burden and depression levels. Over the 91 enrolled participants, 87 (95.6%) completed the program attending at least 5/8 sessions, 80.5% attending all sessions. Seventy-six caregivers fulfilled the questionnaires at baseline and after the program, and were included in the analysis. Although there was no evidence for significant change in self-reported depression levels (Cohen's d=0.19, p=0.210), burden scores and all evaluated skills were improved post-intervention, with medium to strong effect size (Cohen's ds from 0.47 to 0.87; p<0.001). Network output indicated that increased self-evaluated competence in 5 skills were associated with a global improvement in caregivers' burden and/or depression scores. Post-intervention, 89.7% of caregivers were "very satisfied" and 82.1% found the program "extremely useful". This pilot retrospective study shows high levels of satisfaction, perceived usefulness, and adherence to "Leo", a short, multi-family, skill-based psychoeducational program with promising results in improving caregivers' burden, self-evaluated competence in coping with caregiving demands and in self-care behaviors. This study provides preliminary insights into the mechanisms by which family psychoeducation might alleviate burden of care. A larger-scaled, controlled, randomized study with follow-up assessments is warranted to determine how burden, depression, and skills, as well as their inter-relationships, evolve over time.

Family psychoeducation to improve outcome in caregivers and patients with schizophrenia: a randomized clinical trial.

Schizophrenia is recognized for its severe impact on both patients and caregivers. In a 12-month follow-up randomized clinical trial, we aimed to measure the efficacy of a brief family psychoeducation program in terms of reducing relapse risk and improving medication adherence in patients, as well as reducing caregiver burden, depression and increasing knowledge of the illness. A total of 25 days of patients with schizophrenia (DSM-IV-TR) and family primary caregivers were recruited in a single regional psychiatric outpatient facility located in Bordeaux. In the active group, caregivers received a psychoeducational intervention consisting of six sessions spread over 1.5 months, while the control group was placed on a waiting list. Sociodemographic, symptom severity (PANSS) and medication adherence (MARS) from patients were assessed at baseline and relapse rates was recorded during the 12 months follow-up period. Caregivers' burden (ZBI), depression (CES-D), quality of life (S-CGQoL), knowledge of the disease (KAST) and therapeutic alliance (4PAS-C) were assessed at baseline, three and 6 months. On the 25 patients included, the mean age was 33.3 years (SD = 9.7) with a mean duration of disease of 7.48 years (SD = 7.1). On the 25 caregivers included, the mean age was 50.6 years (SD = 14.0). Twenty-one were female (84.0%), 12 were married (48.0%) and 11 lived alone (44.0%). For patients, the family psychoeducation intervention significantly reduced the risk of relapse with a significant effect found at 12 months follow-up (p = 0.014). No change was observed on medication adherence. For caregivers, the intervention reduced the burden (p = 0.031), decreased the depression (p = 0.019), and increased the knowledge on schizophrenia (p = 0.024). Analyzes for repeated measures showed a statistically significant difference in therapeutic alliance (p = 0.035). As confirmed by previous studies, the brief multifamily program (consisting of six sessions over a period of 1.5 months) was found to be effective in improving outcomes for caregivers (e.g., burden, depression, knowledge) and patients (e.g., preventing relapse) in the context of routine care. Given its short duration, this program is expected to be easily implementable within the community. https://clinicaltrials.gov/, NCT03000985.

The integration of psychoeducation, anti-corruption education and christian family education for the fathers of GMIT Laharoi

Gender, religion and race are becoming important considerations in corruption cases. Various management initiatives must be explored to counter corruption, particularly prevention strategies that originate within the family as the cornerstone of religious, moral and anti-corruption values education. This study discusses anti-corruption education at Evangelical Christian Church in Timor GMIT in the context of religion, Christian families and church. The research focuses on integrating anti-corruption education and Christian family education by including fathers in anti-corruption education. The purpose of the study is to integrate Christian family education and psychoeducation programs as part of an effort to prevent corruption cases involving GMIT Laharoi's fathers. The quasi-experimental design with The Posttest Only Design and Nonequivalent Groups was used as the primary method, and the narrative qualitative approach was used as the complementary method. The Mann-Whitney non-parametric test was employed for quantitative analysis. Participants in the quasi-experiments were 16, with eight subjects in the experimental group and eight in the control group. The Mann-Whitney test findings indicate an Asymp Sig. (2-tailed) of 0.005 0.05, indicating a difference between the experimental and control groups' post-test outcomes. As a result, the study found that integration of anti-corruption education and Christian family education can affect GMIT Lahairoi fathers' understanding and involvement in educating their children.

Psychoeducation in Family with Clients Recovering from the Risk of Violent Behavior

Recovery is a change in which a person improves his health and well-being, lives in the direction of life he chooses,and strives to achieve life goals according to all his abilities. Recovery conditions are very necessary for everyclient with mental disorders (ODGJ), where strengthening hope, especially from within ODGJ itself, activates themto be active independently with family, friends, and the community in their environment. ODGJ with ViolentBehavior has anger that is expressed excessively and is not controlled verbally to the point of injuring others andor not harming the environment. Through this research with a pre-test-posttest control group design. The resultsfound in this study, it was found that the average recovery rate of ODGJ in the intervention group was 116.17 andthe average recovery rate of ODGJ in the control group was 94.03 so it can be concluded that the average recoveryrate of the intervention group was 22.14 greater than the control group with a significance of P-Value &lt; 0.05. Theresults showed that there was a significant difference in the recovery rate of ODGJ in the intervention group andthe control group. There was also an increase in the recovery rate in the control group, this was possible becauseof other interventions to increase the recovery of ODGJ with the risk of violent behavior either in the form ofindividual, family, or community interventions. Thus, to take sides with all elements in the ODGJ environment,encourage a sustainable family psychoeducation program policy, and be accompanied by monitoring of familycapabilities, especially effective communication within the family in the form of regular family visits by utilizing atiered health facility system.

Effects of the family support and psychoeducation program based on the Calgary Family Intervention Model on the coping, psychological distress and psychological resilience levels of the family caregivers of chronic psychiatric patients

AimsThis study was aimed at investigating the effects of family support and psychoeducation program based on Calgary Family Intervention Model on coping, psychological distress and psychological resilience levels of families of chronic psychiatric patients. MethodsThe sample of this quasi-experimental study consisted of the caregivers of chronic psychiatric patients who were admitted to the adult psychiatry inpatient and outpatient unit of a university hospital and the caregivers of chronic psychiatric patients registered with the Schizophrenia Solidarity Association. Nonparametric analysis was used in the analysis of the data. ResultsIt was found that there was a significant decrease between the mean distress scores the caregivers participating in the Calgary Family Intervention-Based Family Support and Psychoeducation Program obtained from the measurements before, right after, and 3 and 6 months after the intervention (p < 0.05). There was no statistically significant difference between the coping scores and psychological resilience scores the caregivers obtained from the measurements before, right after, and 3 and 6 months after the intervention (p > 0.05). ConclusionIt was concluded that the family support and psychoeducation program based on the Calgary Family Intervention Model applied to family members giving care to individuals with chronic mental illnesses had positive effects on the general health status of the caregivers.

The Experience of Caregivers with First-Episode Psychosis Children at General Hospital of Dumai, Riau Province

BACKGROUND: Caregivers with first-episode psychosis (FEP) children often encounter problems and challenges. The importance of caregiver role in managing FEP appropriately will influence the life quality of a person with psychosis. AIM: The study aimed to explore the experience of caregivers who have children with FEP at General Hospital of Dumai. METHODS: The study was a qualitative study with a phenomenology approach. In-depth interviews were conducted with eight primary caregivers aged 41–58 years with FEP children at General Hospital of Dumai. The interview transcript was analyzed using the Colaizzi method. RESULTS: Based on the study, five essential themes emerged, for example, caring for FEP is harder than looking after a thousand buffaloes, mixed feelings, believing that the child experiences mystical things, the extended family is a supporter in caring for FEP, and praying and surrender to God. CONCLUSION: The implications for nursing practice are implementing support group therapy and family psychoeducation programs for reduce the caregiver burden.

Easier Said Than Done: The Challenge to Teach “Personal Recovery” to Mental Health Professionals Through a Short, Targeted and Structured Training Programme

This study assesses the effectiveness of our short Personal Recovery Training Program (PRTP) for mental health professionals. Fifty-two healthcare professionals from Italian mental health services and forty students in psychiatric rehabilitation completed the Recovery Knowledge Inventory (RKI) pre- and post-training, divided into two groups: the PRTP (N = 45) and the Family Psychoeducational Training Program (FPTP; N = 47). Participants’ understanding of personal recovery improved more significantly for those in the PRTP than for those in the FPTP group in two domains, “Roles and responsibilities” and “Non-linearity of the recovery process”; the FPTP group showed a significant improvement in the “Role of self-definition and peers in recovery” domain. Two consumers were involved in the PRTP and represented a resource to help participants understand the personal recovery process. Our findings indicate that a brief PRTP supported by consumers can improve staff and students' recovery orientation. The translation of the training into clinical practice remains unevaluated.

The Family Psychoeducation Fidelity Scale: Psychometric Properties

This study examined psychometric properties and feasibility of the Family Psychoeducation (FPE) Fidelity Scale. Fidelity assessors conducted reviews using the FPE fidelity scale four times over 18 months at five sites in Norway. After completing fidelity reviews, assessors rated feasibility of the fidelity review process. The FPE fidelity scale showed excellent interrater reliability (.99), interrater item agreement (88%), and internal consistency (mean = .84 across four time points). By the 18-month follow-up, all five sites increased fidelity and three reached adequate fidelity. Fidelity assessors rated feasibility as excellent. The FPE fidelity scale has good psychometric properties and is feasible for evaluating the implementation of FPE programs. Trial registration ClinicalTrials.gov Identifier: NCT03271242.

Prévention du risque suicidaire dans la schizophrénie : importance de la psychoéducation des familles

ObjectivesAlthough mortality by suicide in schizophrenia seems to have decreased in some countries over the last 30 years, it remains much higher than in the general population. Studies have shown this risk to impact around 5% of patients, corresponding to a risk almost 2.5 times higher than in the general population. Family psychoeducation in schizophrenia has been demonstrated to lead to symptom reductions and to an improvement of the quality of life, two factors that should contribute to decreasing the suicidal risk. Therefore, if families attend an efficient psychoeducation program, we can expect a decrease in the patient suicidal risk. Attending a family psychoeducation program at the beginning of the disease would also be associated with a stronger preventive effect on suicidal mortality. The objective of this study is to describe the suicide attempt rate of patients who suffer from schizophrenia before and one year after one of their relatives participated to the family psychoeducation program Profamille. MethodWe performed a retrospective study on 1209 people who attended the Profamille (V3.2 version) Family Psychoeducation Program. This program has 2 modules: an initial training module of 14 weekly or fortnightly sessions, and a consolidation module of 4 sessions over 2 years. Sessions last 4 hours and follow a precise and structured course. Data were collected from 40 different centers in France, Belgium and Switzerland and were based on participants assessed at the beginning and one year after the first module. Self-assessment from the relatives participating in the program provided the measure of patients’ suicide attempts. An assessment at T0 explored the attempts over the 12 months before the beginning of the program while the assessment at T1 analyzed those during the 12 months following the end of the Program. The Chi2 test was used to compare the suicide attempt rates for each period, using a significance threshold of 0.05. Since the risk of suicide is greater in the first years of the illness, rates of attempts are also calculated according to the age of disorder. The analysis was carried out with the statistical software R. ResultsThe number of participants reporting that their relative had attempted suicide in the previous 12 months decreased from 41 to 21. The annual attempts rate was evaluated at 6.4 % before the Profamille program and decreased to 2.4 % a year after the end of the program (P=0.0003). The reduction of the attempt rate was observed even for patients with schizophrenia for more than 10 years. ConclusionThis study shows the positive impact of Profamille on reducing the rate of suicide attempts in patients with schizophrenia. It has been shown that the risk is highest at the beginning of the disorder. Therefore, based on our results, it would seem appropriate to propose the Profamille program at an early stage.

Effect of family psychoeducation and access to information on illness negative perceptions: a study on French families of persons experiencing schizophrenia

Abstract Background A better understanding of schizophrenia, a chronic disease often leading to heavy negative consequences both on users and families, has been shown to reduce those difficulties. Studies recommend family psychoeducation, as this structured educative intervention reduces parents’ depressive symptoms, enhances family mood, and decreases risks of relapse for users. Our objective is to assess whether family psychoeducation and access to information has an effect on close relatives’ illness negative perceptions. Methods Our sample consists in 27 close relatives of persons with schizophrenia. We used a semi-structured interview assessing access to psycho-education and information about illness and diagnosis. We also used the Brief Illness Perception Questionnaire, which explores various illness negative perceptions, as well as probable causes of the illness. Results A better access to diagnosis for families is associated with a shorter perceived probable illness duration (p=.044). Family psychoeducation programs, followed by 38,5% of close relatives, reduces their perception of the frequency of user’s present symptoms (p=.029). This could be caused by a better understanding of real symptoms, or by an enhancement of family mood. Also, family psychoeducation has an effect on causal attributions: 50% of close relatives with access to family psychoeducation believed in a substance abuse causality, opposed to 12,5% of the others (p=.036). Conclusions Family psychoeducation could help allowing a shift in causal attributions and more generally enhancing family reaction to the disease, which, in turn, can have an impact on the user’s recovery process. Thus, this intervention deserves more attention and should be more systematically proposed to French families, alongside with an easier access to information.

A Brief Mindfulness-Based Family Psychoeducation Intervention for Chinese Young Adults With First Episode Psychosis: A Study Protocol.

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.

Evaluating the effectiveness of a culturally adapted behavioral family psycho-educational program for Egyptian patients with schizophrenia.

Although a growing body of evidence supports the effectiveness of behavioral family therapies for patients with schizophrenia, few studies have been carried out on the effectiveness of such programs for Egyptian patients. The current study translated and culturally adapted the Behavioral Family Psycho-Education Program (BFPEP) and conducted a preliminary efficacy evaluation for outpatients suffering from schizophrenia. Thirty patients received 14 sessions of culturally adapted Program (CA-BFPEP) and 30 received treatment as usual; all were followed up for 6 months. Pre- and post-intervention assessment included primary outcome measures that assessed the clinical, social, quality of life and attitude towards medications. The CA-BFPEP group demonstrated significant treatment effects as they had greater reductions in psychotic symptoms (PANSS), improvement of social function (SFQ), quality of life (QoL), and attitude towards medications (DAI), compared to patients in the control group. These results demonstrate the feasibility of implementing family therapy interventions in different cultural settings with relatively minor modifications. These promising findings invite further efforts to maximize the benefits of family therapy interventions internationally and to encourage mental health policy makers to integrate this mode of therapy in routine care management plans for patients with schizophrenia.

Family-focused interventions and resources for veterans and their families.

Accelerated by the decreasing military presence in Iraq and Afghanistan, many military members are currently transitioning out of active duty into civilian life. Many of these new veterans have recently experienced combat deployment(s), and some are struggling with the aftermath of combat exposure, separation from family, and reintegration stressors. These challenges often follow these military families as they enter the civilian world, a time with its own major life changes vocationally, socially, and interpersonally. Although numerous resources have been developed to assist service members during their transition to the civilian world, relatively fewer exist for partners, children, and broader family systems. Family psychoeducation is a nonpathologizing, strengths-focused model of care that has documented benefits in the arena of mental illness. This article describes some manualized family psychoeducational programs and online and phone-based resources that may be useful to veteran families during this time of change. The programs and resources described herein are all available for free, primarily online. Because of a wide variety of barriers and limitations for family based care in the Veterans Affairs health care system, veteran families are and will continue to seek mental health care in public sector settings. Community providers can enhance their military culture competence by familiarizing themselves with these resources and drawing upon them in working with transitioning military families. (PsycINFO Database Record

P.2.013 - The role of family psychoeducation in the management of tics and tic-related impairment in grade school children

Background Children with tics, as a rule, become very challenging cases for psychologists and psychiatrists. The high prevalence (from 3 to 50 per 1000 children for chronic motor tics and 2.5 to 9.4 per 1000 children for vocal tics.) of these disorders has led to many colloquial ideas and misinformation about appropriate and effective treatment [1]. Patients and their families are frequently unable to correctly identify the symptoms and patients sometimes get stigmatised as a consequence of their tics [2]. Therefore, a lot of authors recommend starting the treatment of tics with psychoeducation involving the patient and his/her parents [3]. Aims The primary aim of this study was to evaluate whether family psychoeducation followed by pharmacological therapy would prove superior for reducing tics. Methods The study included 80 children (from 6 to 12 years old) suffering from chronic tic disorder (CID-10), which were observed during at least 3 months prior to the study, that were randomly divided into 2 groups. The control group included children who received only medication and the experimental group included patients who took part in a family psychoeducation program (2 sessions per week) and received pharmacological treatment. We used the Yale Global Tics Severity Scale to assess the severity of tics at the beginning of the treatment and after 1 and 3 months of therapy. The exclusion criteria were children with mental retardation and Autism Spectrum Disorder. Results Our results show that after the first month there was no significant difference between the control and experimental group. In both groups we noticed a reduction on the YGTSS: from 35.3 [95% CI 34.4-36.3] to 29.8 [95% CI 28.9-30.7] in the control group vs 34.52 [95% CI 27.5-29.9] to 28.7 [95% CI 27.5-29.9] in the experimental group. The average decrease on YGTSS from baseline was 5.5 and 5.7 in the control and experimental group, respectively. However, after 3 months of therapy we found a significantly greater decrease on the Yale Global Tic Severity Scale in children who received additional family psychoeducation: from 28.7 [95% CI 27.5-29.9] to 23.5 [95% CI 22.61 – 24.38] (p Conclusion Pharmacological therapy supported by family psychoeducation resulted in a greater improvement in symptoms among children with chronic tic disorder. In long term therapy we see significant differences appear at 3 months in the study. We believe it is explained by the fact that it takes some time to develop a therapeutic connection and mechanisms of adjustment. The efficacy of family intervention and other psychotherapeutic methods highlights the ethiology of tic disorders, expands treatment options and helps children develop new mechanisms of adjusting and/or adaptation, but does not inhibit tics.

Effect of psycho-educational program on families’ perception of burden and attitudes toward mental illness among caregivers of patients with schizophrenia

Background In recent years, there has been increased interest in the role played by families in the treatment of patients with schizophrenia. Some family interventions may significantly reduce clinical difficulties and may have a positive effect, both emotionally and economically. Aim The aim of this study is to investigate the effect of psycho-educational program on perception of burden and attitudes toward mental illness among caregivers of patients with schizophrenia. Research design A quasi-experimental design was used in this study. Setting This study was conducted at an outpatient clinic in El-Azazi Hospital for Mental Health in Abo-Hamad City. Patients A convenient sample of 50 caregivers of patients with schizophrenia was included. Tools of data collection Three tools were used for data collection: sociodemographic data sheets, Caregiver Burden Scale, and Opinions about Mental Illness Scale. Procedure The sample was randomly divided into a control group (25 caregivers) and an experimental group (25 caregivers), who participated in a family psycho-educational program. The psycho-educational program consisted of thirteen 60-min sessions, held during a period of 2 months. Caregivers in the experimental group were evaluated at inclusion and at the end of the program. Caregivers in the control group were evaluated at inclusion and 2 months later. Results Most caregivers experienced severe burden, and also significant percent of caregivers had negative attitudes toward mental illness before intervention. Compared with the control group, the experimental group showed significantly reduced caregivers’ burden and improved attitudes toward mental illness after intervention. Conclusion The psycho-educational program for family members of patients with schizophrenia significantly reduced caregivers’ burden and improved caregivers’ attitudes toward mental illness. Recommendations There is a need to facilitate access to psycho-educational programs in mental health centers and clinics and to integrate this intervention into the regular treatment plans for patients with schizophrenia.

A culturally adapted family intervention for rural Pacific Island veterans with PTSD.

To pilot Koa, rural Pacific Island dyads (28 veterans and 28 family members) participated via video teleconference and completed pre- and post- intervention measures. Outcome data indicated that participants perceived the intervention to be highly acceptable, useful, and relevant. Relationship quality scores substantially improved postintervention as measured by the Dyadic Relationship Scale (95% CI [-10.97, -1.84], t(22) = -2.9, p = .008, d = -0.53 for veterans; 95% CI [-11.06, -2.47], t(21) = -3.28, p = .004, d = -0.68 for family members). Family caregiving burden also improved significantly. The positive results of this investigation support the development of culturally adapted mental health interventions for culturally distinct subgroups of veterans and their families. (PsycINFO Database Record

Brief family psycho-education program for caregivers of inpatients with severe mental illness

IntroductionFamily psycho-education is an essential part of the treatment for people with severe mental illness (SMI), however this relevant intervention is underutilized. Shortened variations of family psycho-education have been described in attempts to make it more attractive, efficient, and feasible.Objectives/aimsConsidering the lack of manualized intervention for families in Brazil, our study comes up with a proposal to implement and to evaluate the feasibility of brief family psycho-education program (BFPP) during inpatient psychiatric treatment.MethodsAn extensive review using a combination of the words: “family psychoeducation”; “severe mental illness”; “schizophrenia”; “bipolar disorder” was conducted in PubMed/Medline with the aim to select reports of multifamily group psycho-educational programs. Studies involving adults with severe mental illness published until March 2016 were included.ResultsAfter the review of literature and meeting with experts in SMI, the BFPP was developed collaboratively by bipolar disorders’ team at Hospital de Clínicas de Porto Alegre (HCPA). The standard BFPP consists of four sessions: (1) causes, symptoms, course, prognosis and stigma of severe mental disorder; (2) treatment; (3) community resources, communication skills and importance of healthy and regular habits; and (4) problem-solving strategies: preventing relapses and establishing plans for crisis. Each session will occur weekly, lasting 90 min, with 8–12 caregivers. The patients did not attend the group.ConclusionWe purposed a standard, brief, cheap and simple intervention to apply. We believe that BFPP is highly suitable for caregivers of patients with SMI. We hope that this program demonstrates feasibility among participants and become a useful and effective intervention.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Shame: An overlooked factor in conceptualizing and treating borderline personality disorder: Its’ powerful role in the lives and suicides of people with BPD

Shame, a central emotion in borderline personality disorder (BPD), has been overlooked despite its’ relationship to self-injurious behaviour, chronic suicidality, self-esteem, quality of life, and angry-hostile feelings. Patients describe shame when explaining acute feelings of emotional pain. There is a paucity of research exploring the impact of shame on the person with BPD's sense of self and behaviors. BPD symptoms may be the expression of and defenses against this painful emotion. Shame-proneness is related to anger arousal and the tendency to externalize attributions for one's own behavior by blaming others or not taking responsibility for one's behavior. The relationship between shame-proneness and BPD has important implications for treatment. TARA for BPD, an educational and advocacy organization, developed a Family Psycho-education program teaching how shame is often the common denominator of BPD responses, triggering escalations, emotional shifts, volatile reactions, anger and misperceptions. Shame is the response to perceived negative evaluations (judgment, criticism, or blame) and general misinterpretation of social situations. Shame is an impediment to thinking clearly, exaggerates ambiguity and overwhelms cognitive ability in the moment. As shame is often confused with guilt, raising awareness of shame responses is essential for improving family relationships. Families can learn to recognize shame responses and implement evidence based techniques from dialectic behavior therapy (DBT) and mentalization based therapy (MBT) to decrease its’ impact on their loved one with BPD. Demonstration of methodology to address shame in family interactions and data from a TARA Internet survey of The Experience of Shame will be presented.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Family Psychoeducation to Reduce the Risk of New Depressive Episodes: a Randomized Controlled Trial

Introduction More than 80 % of patients experiencing their first depressive episode will have at least one new episode. Effective interventions to reduce the risk of relapse and recurrence are needed. Psychoeducation is a form of interactive education enhancing knowledge about patients’ illness, including its course, symptoms and treatment. Psychoeducational methods can also act as family intervention – already an evidence-based practice in schizophrenia and bipolar disorder. Only few studies have focused on the effect of psychoeducation, including family psychoeducation, in the prevention of new depressive episodes. Purpose Purpose is to evaluate whether an intervention of psychoeducation for family members, compared to a control intervention, is effective in reducing the risk of new depressive episodes among patients that have achieved remission or partial remission of depressive symptoms after the acute phase of antidepressive treatment. Method The project is based on a double-centre, randomized controlled trial where investigator and raters conducting psychometric assessments, will be blinded to treatment allocation. A total of 130 patients with unipolar depression in remission or partial remission will be included together with their closest relative. After baseline assessments, relatives will be randomized to either 4 sessions of a family psychoeducation program or 4 sessions in a social support group without any psychoeducational intervention. Patients will not participate in group sessions and they will continue their outpatient-treatment as usual. Outcome Primary outcome is evaluated after 9 months and include rates of relapse as measured by HAM-D17 and rates of recurrence according to DMS-VI-R and HAM-D17.

Effectiveness of a behavioral family psychoeducational program for Egyptian patients with bipolar disorder and their caregivers

Effectiveness of a behavioral family psychoeducational program for Egyptian patients with bipolar disorder and their caregivers