Multifamily Psychoeducation Groups Research Articles

Telehealth of Coordinated Specialty Care in Early Psychosis During COVID-19.

Background: The coronavirus 2019 (COVID-19) pandemic forced health care globally to provide remote services when feasible. In March 2020, psychiatric outpatient services across the United States transitioned to telehealth. Persons with early psychosis (EP) face challenges to maintain connection with care, an important element associated with better outcome. The ongoing pandemic offers the opportunity to review the feasibility of EP services using telehealth and to evaluate implications for continued implementation.Methods: We examined delivery of coordinated specialty care (CSC) for 49 individuals aged 16-30 years enrolled in an EP (first-episode psychosis and clinical high risk) university-affiliated outpatient clinic located in Philadelphia, Pennsylvania, from March 2020 to July 2021, during which most appointments were delivered through telehealth. The services evaluated in this setting include psychotherapy, medication management, employment and educational services, peer support, and multifamily psychoeducation group. We compared completed and missed appointment rates across services and new enrollment rates with in-person versus hybrid telehealth and in-person care pre-COVID-19 and during the pandemic.Results: In 6 months pre-COVID-19 (September 2019-February 2020), the Psychosis Evaluation and Recovery Center enrolled a mean of 4 people/mo compared to during the pandemic (March 2020-July 2021), when a mean of 2.2 people/mo were enrolled. The total number of completed psychology appointments pre-COVID-19 ranged from 51 to 88 and during the pandemic ranged from 72 to 137. The rate of missed psychology appointments ranged from 1.4% to 6.4% pre-COVID-19 and from 3.4% to 11.3% during the pandemic. The total number of completed medication management appointments pre-COVID-19 ranged from 35 to 59 and during the pandemic ranged from 22 to 66. The rate of missed medication management appointments ranged from 2.1% to 8.0% pre-COVID-19 and from 1.7% to 9.1% during the pandemic. The total number of completed supported education and employment services appointments pre-COVID-19 ranged from 5 to 11 and during the pandemic ranged from 3 to 16. Finally, the mean number of family members in attendance at the family psychoeducation group was 8.3 pre-COVID-19 and 17.1 during the pandemic.Conclusions: New and continued engagement across services in EP CSC during the COVID-19 pandemic supports feasibility of telehealth and suggests that offering a hybrid model of in-person and telehealth should be considered once restrictions are lifted.

Cultural competence in multi-family psychoeducation groups: The experiences of Russian-speaking immigrant mothers of adults with severe mental illness.

The successful integration of cultural competence with evidence-based practices in mental health services is still limited for particular cultural populations. The current study explored culturally adapted family psychoeducation intervention for immigrants from the former Soviet Union (FSU) in Israel who care for a family member with severe mental illness (SMI). Semi-structured in-depth interviews were conducted with 18 immigrant mothers about their experience of taking part in Russian-speaking multi-family psychoeducation groups (MFPGs). Qualitative content analysis revealed five salient processes and changes that participants attributed to their engagement in the intervention: 1) from a language barrier to utilization of and satisfaction with services; 2) from a lack of information to acquiring new mental health knowledge; 3) from harboring a family secret to exposure and sharing; 4) from social isolation to cultural belonging and support; 5) from families blurring boundaries to physical and emotional separation. The results showed that these changes-linguistic, cognitive, emotional, socio-cultural and relational-improved family coping and recovery. Implications for cultural adaptation of family psychoeducation for Russian-speaking immigrants are discussed.

Impact of Working Together for adults with autism spectrum disorder: a multifamily group intervention

BackgroundAdults with autism spectrum disorder (ASD) have lower engagement in their communities, higher rates of unemployment/underemployment, and continued difficulties with challenging behavior compared to their neurotypical peers. Multi-family psychoeducation emphasizes education and problem-solving with the goal of improving these outcomes for the individual with the disability.MethodsUsing a randomized waitlist control design, the present study evaluated a multi-family group psychoeducation intervention, Working Together, for adults on the autism spectrum without intellectual disability (n = 40). Five waves of data were collected at 3-month intervals. In this design, families in the intervention condition participated in intervention during the 6 months between baseline and time 3 data collection; the waitlist control condition received the intervention immediately after the time 3 data collection. We compared these two conditions, intervention group (n = 20) vs waitlist control group (n = 20), on key outcomes for the adults with ASD: engagement in work-related activities, engagement in meaningful activities, and behavior problems.ResultsResults indicated medium to large effect sizes associated with the Working Together intervention across key outcomes, including adults on the spectrum experiencing significant increases in meaningful activities and decreases in internalizing problems. Although increases in work-related activities were not statistically significant, an observed one-half of a standard deviation difference from before to after the intervention indicated clinically significant change. We also found maintenance of the treatment effect through 6 months post-treatment for the intervention group and replication of the treatment effect within the control group after they received the intervention.ConclusionWorking Together is a promising multi-family group psychoeducation intervention designed to improve functioning during adulthood. These findings highlight the need for more intervention services research during adulthood and specifically the need for family-centered supports.

The Effectiveness of Relapse Prevention Intervention on the Ability of Patients and Their Families to Prevent Psychotic symptoms of Relapse among Patients with Schizophrenia: Systematic Literature Review

Background: Most patients with schizophrenia have family support. The role of a family as a carepartner has the capability of expanding the patient’s recovery and solving the family’s need for awareness,encouragement, and improves skills. Objective: Assessing the effectiveness of relapse preventionintervention on the ability of patients and their families that are reported to prevent psychotic symptomsof relapse among patients with schizophrenia. Method: A systematic review was conducted followingPreferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines for the studiespublished between 2010 and 2020. Results: Twelve retrieved studies were shown the relapse preventionintervention increases the ability of patients and their families to minimize and prevent psychotic symptoms.The relapse prevention interventions in this review including; optimal case management, multifamily grouppsycho-education, integrated psychological intervention, psychosocial treatment, Information TechnologyAided Schizophrenia Relapse Prevention, family-focused therapy, and Family psycho-education programs.Conclusion: Various relapse prevention interventions have been reported to reduce the risk of relapse rate,prevent psychotic symptoms, and sustain remission by incorporating and emphasize the importance ofeffective cooperation families with patients with psychotic relapse.

Transitioning Together: A Multi-family Group Psychoeducation Program for Adolescents with ASD and Their Parents.

Currently there are few evidence-based programs available for families of individuals withASD during the transition to adulthood. The present study provided a preliminary evaluation of a multi-family group psychoeducation intervention using a randomized waitlist control design (n = 41). Families in the intervention condition participated in Transitioning Together, an 8-week program designed to reduce family distress and improve social functioning for adolescents. Findings indicated significant improvements in parental depressive symptoms and problem solving from pre- to post-intervention for parents in the intervention condition but not for parents in the control condition. Social interactions also improved for youth in the intervention condition relative to controls. Parents reported satisfaction with the program and particularly valued the opportunity to interact with other families.

79.3 Families Rate Multifamily Psychoeducation Groups for Medically Ill Youth as Helpful

The goal of this session is to present the rationale for and specific techniques of a brief multifamily psychoeducational group as a preventative and therapeutic intervention for youth suffering from asthma, their siblings, and parents. Family-rated attitudinal changes from a series of standardized multifamily groups will be presented.

An Exploration of Content in Multifamily Psychoeducation Groups: The Impact of Consumer Choice in a Flexible Curriculum

The recovery movement in mental health and social work has inspired changes in the conceptualization of mental health services, and there has been a call for increasing consumer focus in family education interventions for populations coping with mental illness. However, providers have concerns that family-driven content may not include information believed critical to effective treatment. This study examines the impact of consumer preference in a multifamily psychoeducation intervention. Participant families (N = 123) tested Psychoeducation Responsive to Families (PERF), in which groups (N = 12) specified curriculum topics and rank order uniquely. The results were compared to existing clinician-generated content in a SAMHSA toolkit on psychoeducation: topics tended to recur across multiple groups and eight of the most frequently chosen had substantial overlap with the SAMHSA toolkit. Findings suggest that allowing consumers greater freedom in meeting their educational needs will not lead to exclusion of material viewed as necessary by professionals.

Effectiveness of online versus live multi-family psychoeducation group therapy for children and adolescents with mood or anxiety disorders: a pilot study.

[1] To highlight the effectiveness of multi-family psychoeducation group therapy (MFPGT) in children with mood or anxiety disorders; [2] to measure change in knowledge and awareness of mood and anxiety disorders in families and children; and [3] to compare the relative effectiveness of online compared to live MFPGT. Participants included families of children (12 years or younger) referred with a mood or anxiety disorder to the Division of Child and Adolescent Psychiatry at Queen's University (n=16) who were on a waitlist to see a psychiatrist. Change was measured through questionnaires for all parents before and after the program. Using SPSS v22, comparisons between the online (n=6) and live (n=10) groups were made using the Mann-Whitney U test and within group comparisons were made using Wilcoxon signed-rank test. The online and live education groups showed similar overall improvements in knowledge acquisition and expressed emotion in participating families. However, statistical significance must be interpreted with caution due to the small sample size. Online MFPGT may be an effective way to increase knowledge, provide resources and support and build on skills thus giving individuals more control and confidence when dealing with a mood or anxiety disorder while on a waitlist. MFPGT showed equal efficacy in live and online groups, indicating that the online program has the potential to be a more convenient and accessible program for families. More research is needed with a greater sample size.

Family Psychoeducation for Hepatitis C Patients and Their Families: Recommendation for Clinicians

ABSTRACTPsychoEducation Responsive to Families for Persons coping with Hepatitis C (HCV-PERF) is a multifamily psychoeducation group model designed to help patients with hepatitis C virus infection (HCV) and their families navigate the illness and improve their readiness for treatment. The purpose of this article is to provide information and recommendations for clinicians interested in using the HCV-PERF model. The article provides details of the intervention model and presents thematic categories that evolved from analysis of interviews with clinicians with experience conducting and facilitating HCV-PERF groups. Based on these findings, recommendations were developed to inform and guide the use of HCV-PERF.

Multifamily Group Psychoeducation in New York State: Implementation and Fidelity Outcomes.

The study examined implementation outcomes from a large state initiative to support dissemination of multifamily group (MFG) psychoeducation in outpatient mental health settings. Thirty-one sites participated in the project. Baseline training in the MFG model was followed by monthly expert consultation delivered in either a group (16 sites) or individual format (15 sites). Research staff assessed fidelity to the MFG model by telephone at baseline and 12, 18, and 24 months and documented time to completion of three key milestones: holding a family joining session, a family educational workshop, and an MFG meeting. Intent-to-train analyses found that 12 sites (39%) achieved high fidelity to the MFG model, and 20 (65%) achieved moderate or high fidelity. Mean scores on the Family Psychoeducation Fidelity Assessment Scale increased over time. Twenty-five sites (81%) conducted at least one joining session, and 20 (65%) conducted at least one MFG. Mean±SD time from baseline to the first group was 11.75±4.78 months. Programs that held the first joining session within four to 12 months after training were significantly more likely than programs that did not to conduct a group (p<.05). No significant differences were found by consultation format. Implementation of moderate- to high-fidelity MFG programs in routine outpatient mental health settings is feasible. Sites that moved very quickly or very slowly in early implementation stages were less likely to be successful in conducting an MFG. More research on the efficiency and effectiveness of consultation formats is needed to guide future implementation efforts.

Intervening early in children with bipolar disorder: is there a pot at the end of the Rainbow?

Children with bipolar disorder (BD) have considerable impairments in school, peer and family functioning and high rates of illness comorbidity.1 With age, their risk increases for suicide attempts, hospitalisation, substance...

Early psychosis intervention services: a work in progress.

Early psychosis intervention services: a work in progress.

Adults with Autism: Outcomes, Family Effects, and the Multi-Family Group Psychoeducation Model

Although an increasing number of individuals with autism spectrum disorders are entering adulthood, currently there are few evidence-based programs for individuals later in the life course. In this paper we present an overview of recent research on outcomes for adolescents and adults with ASD and highlight the role of the family for individuals with ASD during the transition to adulthood. We also discuss multi-family group psychoeducation as a promising model for use with individuals with ASD who are transitioning to adulthood.

ProFamilies: a psycho-educational multi-family group intervention for cancer patients and their families

This paper describes a psycho-educational multi-family discussion group intervention for cancer patients and their families (proFamilies) which was implemented and evaluated at the IPOFG - CROC (Portuguese Cancer Institute, Regional Centre of Coimbra). It is a brief and highly structured programme which involves educational and support components and is based on multi-family discussion groups, including patients and non-patient family members. Five groups were established, involving 19 families, and a total of 57 people. The paper focuses on the practical aspects of the intervention, its development and its evaluation. Our results suggest that the programme responds to the patients' and their families' needs and that participation in proFamilies prevents an increase in the patient's level of psycho-social maladjustment, promotes an adequate level of family cohesion and diminishes the perceived stress of patients and family members.

A randomised controlled trial of carer-focussed multi-family group psychoeducation in bipolar disorder

In a RCT of family psychoeducation, 47 carers of 34 patients were allocated to one of three groups; Multifamily Group Psychoeducation, Solution Focussed Group Therapy or Treatment as Usual. Carers in both the MFGP intervention and the SFGP arm demonstrated greater knowledge and reduction in burden than those in the TAU arm.

Multi-Family Psycho-Education Group for Assertive Community Treatment Clients and Families of Culturally Diverse Background: A Pilot Study

This study evaluates the incorporation of Multi-Family Psycho-education Group (MFPG) to an Assertive Community Treatment Team developed to serve culturally diverse clients who suffers from severe mental illness. Participants included Chinese and Tamil clients and their family members. Family members’ well-being, perceived burden, and acceptance of clients were assessed before and after the intervention. Focus group interviews with clinicians were conducted to qualitatively examine MFPG. Family members’ acceptance increased after MFPG. Regular attendance was associated with reduction in perceived family burden. Culturally competent delivery of MFPG enhanced family members’ understanding of mental illness and reduced stress levels and negative feelings towards clients.

Grupo psicoeducativo multifamiliar no tratamento dos transtornos alimentares na adolescência

The psycho-educational multifamily group is part of a multidisciplinary treatment offered to adolescents with eating disorders and their families, in the out-patient Program for Children and Adolescents with Eating Disorders - PROTAD - of the Institute of Psychiatry, of Hospital das Clinicas, Medicine College, University of Sao Paulo, PROTAD-AMBULIM-HC-IPq-FMUSP. This article is based at the experience from the monthly meetings with the families and caregivers, from the out-patient program for adolescent patients with eating disorders, and exhibit the employed psycho-educational group model, linking it to the specific literature and the clinical practice.

Multifamily Psychoeducation for First-Episode Psychosis: A Cost-Effectiveness Analysis

Family psychoeducation is considered part of optimal treatment for first-episode psychosis, but concerns about the cost of this intervention have limited its availability. Although evidence suggests that family psychoeducation is cost-effective, many cost-effectiveness analyses have suffered from limitations that reduce their utility in guiding decisions to incorporate this intervention within existing clinical services. These include not presenting results in present-day dollars and not examining whether the intervention would remain cost-effective in situations where the clinical benefits achieved were smaller than those reported in past studies. Thus the goal of this study was to investigate the cost of providing a specific psychoeducation program-multifamily group psychoeducation-to individuals with first-episode psychosis and their families. Statistical simulation was used to estimate the cost and burden of illness associated with usual treatment versus usual treatment plus multifamily group psychoeducation. In addition, the simulation model was rerun to test whether multifamily psychoeducation would remain cost-effective in situations where the clinical benefits achieved were smaller than those reported in past studies. When provided for two years, multifamily group psychoeducation ranged from a cost-effective to a cost-saving intervention, depending on the clinical benefits achieved by staff delivering the intervention. When provided for longer durations (five, ten, or 20 years), multifamily psychoeducation was a cost-saving intervention even in scenarios where the clinical benefits of the intervention were reduced by 90%. The results suggest that multifamily group psychoeducation may not only be a cost-effective intervention for first-episode psychosis but may often be a cost-saving intervention.

Public-Academic Partnerships: Early Intervention for Psychotic Disorders in a Community Mental Health Center

Public-Academic Partnerships: Early Intervention for Psychotic Disorders in a Community Mental Health Center

Factors influencing service utilization and mood symptom severity in children with mood disorders: Effects of multifamily psychoeducation groups (MFPGs).

This study investigated the impact of psychoeducation on service utilization and mood symptom severity in children with mood disorders. Parents' knowledge of mood disorders, beliefs about treatment, and perceptions of children's need for treatment were hypothesized to mediate the relationship between psychoeducation and service utilization and between psychoeducation and mood symptom severity. Linear mixed effects modeling and joint significance test for mediation were used in secondary data analyses of the multifamily psychoeducation group (MFPG) study, a randomized controlled trial of 165 children ages 8 to 12 years with mood disorders. A majority of those sampled were male (73%) and White, non-Hispanic (90%), and the median range of family income was $40,000-$59,000. Participation in MFPG significantly improved quality of services utilized, mediated by parents' beliefs about treatment. Participation in MFPG also significantly improved severity of child's mood symptoms, mediated by quality of services utilized. MFPG appears to be a psychoeducational intervention that helps parents to become better consumers of the mental health system who access higher quality services. Children's symptom severity decreases as a result.