Multifamily Group Treatment Research Articles

Athens Multifamily Group Therapy Project (A- MFGT) after FEP: Preliminary clinical results

IntroductionThe Athens Multifamily Group Therapy Project (A- MFGT) aims to provide systemic multifamily therapy to youths who experienced a first psychotic episode and their families.ObjectivesFamily interventions have been shown to reduce the likelihood of relapse for individuals across the spectrum of psychosis and are recommended in practice guidelines for psychosis internationally (Mc Farlane, 2016).MethodsA group of 22 young adults who presented a first psychotic episode participated with their families to multi-family group systemic therapy, after discharged from in-patient treatment. Sessions were conducted by three therapists twice a month, for nine months and supervision meetings were provided once a month. Six groups of families have been conducted since 2017. Clinical outcome was assessed through PANSS at baseline, one month later after patient’s discharge from in-patient treatment, and one year after, at the end of the multifamily group treatment. Time intervals till relapse were also assessed. Participants’ clinical findings were compared with findings from a matched group of 42 patients who did not attend the multifamily therapy program and were treated as usual.ResultsTwo-way mixed ANOVA was conducted to assess PANSS scores change over time (t1: at base line, t2: at one month and t3: one year), while differences were investigated between the two groups of patients and interactions were checked. Regarding PANSS-positive scale and PANSS-general scale, no differences were found between the two groups in neither of the three time points. Regarding PANSS-negative scale, patients attending MFGT presented statistically significantly lower scores in t3 than patients treated as usual, but not in t1 and in t2 (i.e., prior to therapy). Moreover, both patients’ group showed improvement from t1 to t2, but only patients attending MFGT further improved from t2 to t3. Among patients attending MFGT, two (9.1%) had a relapse compared to nine (22.5%) of the patients treated as usual, however this comparison did not reach statistical significance (p = 0.300).ConclusionsIn term to provide early intervention in psychosis, A-MFGT seems to be a viable way to support the patient as well as the whole system facing psychosis, with the aim of preventing relapse and improved quality of life for all the participants.Disclosure of InterestNone Declared

Improving Self-management of Type 2 Diabetes in Latinx Patients: Protocol for a Sequential Multiple Assignment Randomized Trial Involving Community Health Workers, Registered Nurses, and Family Members

The rate of Type 2 diabetes mellitus (T2DM) among Mexican American individuals is 16.3%, about twice that of non-Hispanic White individuals. While a number of education approaches have been developed and shown to improve diabetes self-management behaviors and glycemic control for Spanish-speaking Latinx patients with T2DM, there is little research to guide health practitioners regarding which interventions to apply and when so that resources are used efficiently, and treatment outcomes are maximized. This study aimed to describe an adaptive intervention that integrates community mental health workers, diabetes nurse educators, family members, and patients as partners in care while promoting diabetes self-management for Mexican American individuals with T2DM. The project incorporates four evidence-based, culturally tailored treatments to determine what sequence of intervention strategies work most efficiently and for whom. Given the increasing prevalence of T2DM, achieving better control of diabetes and lowering the associated medical complications experienced disproportionally by Mexican American individuals is a public health priority. Funded by the National Institute of Nursing Research (National Institutes of Health grant R01 NR015809), this project used a sequential multiple assignment randomized trial and included 330 Spanish-speaking Latinx patients with T2DM. In the first phase of the study, subjects were randomly assigned to an evidence-based diabetes self-management educational program called Tomando Control delivered in a group format for 6, biweekly 1.5-hour sessions, led either by a community health worker or a diabetes nurse educator. In the second phase of the study, those subjects who did not improve their diabetes self-management behaviors were rerandomized to receive either an augmented version of Tomando Control or a multifamily group treatment focused on problem-solving. The primary outcome measure was the "Summary of Diabetes Self-Care Activities." Evaluations were made at baseline and at 3, 6, and 12 months. This study was funded in June 2016 for a period of 5 years. Institutional review board approval was obtained in November 2016. Between March 2017 and September 2020, a total of 330 patients were recruited from the outpatient primary care clinics of Olive View-UCLA Medical Center, with a brief hiatus between May 2020 and July 2020 due to COVID-19 restrictions. The study interventions were completed in December 2020. Data collection began in March 2017 and was completed in December 2021. Data analysis is expected to be completed in Spring 2023, and results will be published in Fall 2023. The results of this trial should help practitioners in selecting the optimal approach for improving diabetes self-management in Spanish-speaking, Latinx patients with T2DM. ClinicalTrials.gov NCT03092063; https://clinicaltrials.gov/ct2/show/NCT03092063. DERR1-10.2196/44793.

Development of Multi-Family Group and Mindfulness Treatment for Chronic Pain: Preliminary Outcomes

Development of Multi-Family Group and Mindfulness Treatment for Chronic Pain: Preliminary Outcomes

Multi-family Group Treatment for Veterans with Mood Disorders: A Pilot Study.

Mood disorders affect large numbers of individuals and their families; the ripple effects on relationship functioning can be great. Researchers have advocated for a relational perspective to mood disorder treatment, and several promising treatments have been developed. However, few rigorous evaluations have been conducted within the Veterans Affairs (VA) system. Multifamily group therapy, an evidence-based practice for people living with schizophrenia, has recently been adapted for other psychological disorders with promising results. This report describes the first published evaluation of this treatment modality in the VA system for veterans living with mood disorders. 101 male veterans (74 with major depression and 27 with bipolar disorder) and their family members participated in REACH (Reaching out to Educate and Assist Caring, Healthy Families), a 9-month, manualized, multi-family group treatment, intervention adapted from McFarlane's original multi-family group model. Participants completed self-report questionnaires at four time points across the course of the treatment, and service utilization data for veterans were obtained from VA databases. Both veterans and family members showed improvements in their knowledge about mood disorders, understanding of positive strategies for dealing with situations commonly confronted in mood disorders, and family coping strategies. Veterans also evidenced improvement in family communication and problem-solving behaviors, empowerment, perceived social support, psychiatric symptoms, and overall quality of life. The REACH intervention holds promise as a feasible, acceptable, and effective treatment for veterans living with mood disorders and their families. Further study is warranted.

Cognitive rehabilitation multi-family group intervention for individuals with mild cognitive impairment and their care-partners.

There is increasing need for early, pro-active programs that can delay dementia diagnosis and enhance well-being of individuals with mild cognitive impairment (MCI) and their care-partners (i.e., care-dyads). This randomized controlled trial evaluated the efficacy of a combined cognitive rehabilitation and multi-family group treatment (CR-MFG) that was designed to facilitate adoption of newly learned cognitive strategies into the care-dyads everyday lives. Analyzed data included 23 care-dyads who participated in CR-MFG treatment and 23 care-dyads in standard care (SC). The 3-month intervention consisted of individual joining sessions, an educational workshop, and 20/twice weekly multifamily memory strategy training and problem-solving sessions. Everyday functioning, memory, and psychological functioning (i.e., quality-of-life, depression, coping) were assessed. The CR-MFG intervention was associated with significant post-test group differences and improved post-test performances by the MCI participants on performance-based measures of everyday functioning and neuropsychological tests of memory. There was also some suggestion that CR-MFG care-partners perceived positive change in the everyday functioning of the MCI participants. In contrast, no post-test group differences were found for either care-dyad member on the self-report psychological measures; care-partners in the treatment group did self-report improved coping behaviors at post-test. These 3-month results are preliminary but suggestive that CR-MFG may produce modest, practical everyday functional benefits for persons with MCI.

Implementation of Multifamily Group Treatment for Veterans With Traumatic Brain Injury

This study evaluated the initial efficacy and feasibility of implementing multifamily group treatment for veterans with traumatic brain injury (TBI). Veterans at two Veterans Affairs medical centers were prescreened by their providers for participation in an open trial of multifamily group treatment for TBI. Enrollment was limited to consenting veterans with a clinical diagnosis of TBI sustained during the Operation Enduring Freedom-Operation Iraqi Freedom era, a family member or partner consenting to participate, and a score ≥20 on the Mini-Mental State Examination. The nine-month (April 2010-March 2011) trial consisted of individual family sessions, an educational workshop, and bimonthly multifamily problem-solving sessions. Interpersonal functioning and symptomatic distress among veterans and family burden, empowerment, and symptomatic distress among families were assessed before and after treatment. Providers referred 34 (58%) of 59 veterans screened for the study; of those, 14 (41%) met criteria and consented to participate, and 11 (32%) completed the study. Severity of TBI, insufficient knowledge about the benefits of family involvement, and access problems influenced decisions to exclude veterans or refuse to participate. Treatment was associated with decreased veteran anger expression (p≤.01) and increased social support and occupational activity (p≤.05), with effect sizes ranging from .6 to 1.0. Caregivers reported decreased burden (p≤.05) and increased empowerment (p≤.01). The results supported implementation of a randomized controlled trial, building in education at the provider and family level.

Multifamily Group Treatment for Veterans With Traumatic Brain Injury: What Is the Value to Participants?

This study evaluated the feasibility, acceptability, and helpfulness of implementation of multifamily group treatment for traumatic brain injury (TBI) among veterans who sustained a TBI during the wars in Iraq and Afghanistan and their families or caregivers. Veterans and their family members who participated in an open clinical trial (August 2010-March 2011) of multifamily psychoeducation for TBI at two Veterans Affairs medical centers were invited to one of three focus groups. Participants were asked about problems experienced before and during the intervention, aspects of treatment that were helpful, and improvements that would facilitate effective implementation of multifamily group treatment for TBI. Postintervention focus group transcripts were analyzed by utilizing qualitative content analysis. Participants included eight veterans with TBI and eight family members. Five themes emerged: exploring common struggles and reducing isolation, building skills to cope with TBI and related problems, restoring relationships through communication and understanding, increasing understanding of the interconnection between TBI and posttraumatic stress disorder, and improving the multifamily group experience and increasing treatment engagement of veterans and families. Veterans and family members found multifamily group treatment for TBI highly acceptable and offered recommendations to improve and increase access to the program. The results supported the feasibility and acceptability of multifamily group treatment for TBI. Specific recommendations to improve this psychoeducational intervention and its implementation are offered.

Adapting the multifamily group model for treating veterans with posttraumatic stress disorder.

The Department of Veterans Affairs (VA) health care system's leadership has endorsed family involvement in veterans' mental health care as an important component of treatment. Both veterans and families describe family participation as highly desirable, and research has documented that having healthy social support is a strong protective factor for posttraumatic stress disorder (PTSD). Family psychoeducation has been shown to be effective in preventing relapse among severely mentally ill, and preliminary evidence suggests that family interventions for PTSD may improve veteran and family outcomes. The multifamily group (MFG) treatment model incorporates psychoeducation, communication training, and problem-solving skill building, and it increases social support through its group format. This article describes the rationale for further adaptation of the MFG model for PTSD, and it reviews issues related to its implementation as a promising adjunctive treatment as part of the continuum of PTSD services available in VA.

Multifamily Group Treatment for Schizophrenia

Multifamily Group Treatment for Schizophrenia

Innovations: Psychoeducation: Multifamily Group Treatment in a Program for Patients With First-Episode Psychosis: Experiences From the TIPS Project

Innovations: Psychoeducation: Multifamily Group Treatment in a Program for Patients With First-Episode Psychosis: Experiences From the TIPS Project

Innovations: Psychoeducation: Multifamily Group Treatment in a Program for Patients With First-Episode Psychosis: Experiences From the TIPS Project

Psychoeducational multifamily group treatment based on the McFarlane model was implemented for adult patients experiencing a first episode of psychosis and for the families of 301 patients. Patients were participants in a research project in Norway and Denmark. Of 301 patients 246 were invited to participate and 147 agreed. Patients' reluctance to participate increased with age. Most had to wait between six and 12 months until a sufficient number was gathered to start a group. Treatment was well received by patients and families. Care should be taken to prevent a long delay before group commencement at this stressful period in the lives of patients and families.

"Quality time" serves families with a parent in recovery.

Families in which a parent or caregiver abuses chemicals face specific and unique problems that affect the health and well-being of the next generation, as well as the quality of current family life. This article reports on an intervention in which the multifamily group treatment method is used to address the needs of families with a parent in addiction recovery. Program participants reported continued sobriety at group's end and follow-up, increased knowledge and awareness of addiction as a disease, and increased closeness and better understanding among family members.

A multi-family group day treatment programme for adolescent eating disorder

We describe a new treatment for the outpatient management of disabling eating disorder in adolescents. The pilot programme has thus far treated 14 adolescents, half with anorexia nervosa and half with bulimia. Most of the young people had been previously admitted or the current referral was for admission. None of the patients has subsequently had to be taken into an inpatient service and the preliminary results suggest that the programme may be beneficial. The programme has elicited a very positive response from the patients and their families. For the professionals involved, the experience of participating in the multi-family group treatment has been unusual and powerful and the training opportunities provided by it seem rather unique. This has led us to make this preliminary communication. We describe the context and structure of the programme and give some details of the patients so far treated. Copyright © 2000 John Wiley & Sons, Ltd and Eating Disorders Association.

A multi‐family group day treatment programme for adolescent eating disorder

We describe a new treatment for the outpatient management of disabling eating disorder in adolescents. The pilot programme has thus far treated 14 adolescents, half with anorexia nervosa and half with bulimia. Most of the young people had been previously admitted or the current referral was for admission. None of the patients has subsequently had to be taken into an inpatient service and the preliminary results suggest that the programme may be beneficial. The programme has elicited a very positive response from the patients and their families. For the professionals involved, the experience of participating in the multi-family group treatment has been unusual and powerful and the training opportunities provided by it seem rather unique. This has led us to make this preliminary communication. We describe the context and structure of the programme and give some details of the patients so far treated. Copyright © 2000 John Wiley & Sons, Ltd and Eating Disorders Association.

Symbiosebehandling i voksenpsykiatrien Kombinerte familie- og individuelle opplegg en forutsetning for en løsning?

At our outpatient clinic young unmarried patients have been treated mainly individually in the social psychiatry tradition; this has helped them to master their daily functions in education and at work. Despite years of individual handling, some with depressive symptoms bordering on schizophrenia have gradually deteriorated. Some have sought their way back to their original homes from their own apartments. Their symbiotic family lifestyle has been less examined or challenged.Our new offer in 1979 was: Multifamily group treatment for 3 years together with an activating group and dance therapy for 2 years. The individual therapists were requested to join the group supervision sessions. A psychologist-researcher followed the project with family Rorschach, SCL90 (self-rating scheme) and global scale.The multifamily group was attended by a 3 son- and 1 daughter-family. Problems centered to communication were striking from the first minutes (with few constructive strategies). Their daily life and the «here and now» situations were commented in a positive way. The problems for the patients between being active or activating were striking.The patients were periodically more aggressive and depressed and needed more regularity, depth and understanding in their individual sessions than they had received before.Two of the SCL90 schemes showed some improvements during the 3 years of approach. Four of the patients have since improved socially, educationally and at work.

Emerging Phenomena in Multi-Family Group Treatment

Emerging Phenomena in Multi-Family Group Treatment