FAMILY PSYCHOEDUCATION PROGRAMME: SOUTH LEE MENTAL HEALTH SERVICES

1
FAMILY PSYCHO-EDUCATION PROGRAMME SOUTH LEE
MENTAL HEALTH SERVICES

• MARIAN BRADY BSW MA CBT.
• SOCIAL WORKER ADULT MENTAL HEALTH

2
INTRODUCTION PART B EVIDENCE, RESEARCH FINDINGS
RECOMMENDATIONS

• This part of the presentation will look at
• 1. The evidence-base for family psycho-education
  programmes
• 2. Findings from the evaluation of our 2008
  programme
• 3. Recommendations from the research

3
PREVIOUS RESEARCH EVIDENCE FOR THE EFFICACY OF
FAMILY PSYCHOEDUCATION

• The present available research studies (most
  recent meta-analysis by Lincoln et al., 2007)
  consistently demonstrate that when treatment is
  integrated with antipsychotic medication AND
  family psycho-education, there is
• a significant reduction in short-term rate of
  relapse,
• an increase in the therapeutic link with the
  service and
• a reduction in caregiver burden

4
WHAT DOES THE RESEARCH TELL US?

• Psycho-education solely to individuals with
  schizophrenia ineffective
• Size of effect on relapse and re-hospitalisation
  comparable to medication / CBT
• Effective in reducing negative communication
• Effective in generalising knowledge-gain
• Effective for symptom monitoring
• Effective for relapse while symptoms stable

5
IMPLICATIONS FOR MENTAL HEALTH SERVICES

• The additional effort of integrating relatives
  into treatment is definitely worthwhile. This
  suggests that mental health services should be
  much more prepared to actively include families
  in the treatment and management of their
  relatives with schizophrenia.

6
SOUTH LEE FAMILY PSYCHO-EDUCATION RESEARCH
PROGRAMME 2008

• Research Design
• The research study was a fixed pre-post-test
  design. It measured the effects of the programme
  before-after on
• participant distress, and
• participant knowledge on schizophrenia
• A satisfaction questionnaire was also
  administered after the programme in order to
  identify which components within the programme
  the families found most helpful.

7
THE MEASUREMENTS

• GENERAL HEALTH QUESTIONNAIRE (GHQ-12)
• Screening instrument for distress detection. It
  is a validated screening instrument used
  throughout the world. It measures psychological
  distress and social difficulties.
• KNOWLEDGE ON SCHIZOPHRENIA FAMILY QUESTIONNAIRE
• Measures knowledge on the understanding of
  schizophrenia across six domains (aetiology,
  symptoms, demography, treatment, hospital
  procedures, and coping).

8
MEASUREMENTS USED CONT

• SATISFACTION QUESTIONNAIRE
• Designed by the programme facilitators in order
  to measure satisfaction with the content of the
  programme and to elicit most helpful components

9
(No Transcript)
10
(No Transcript)
11
(No Transcript)
12
(No Transcript)
13
SUMMARY RESULTS FROM MEASUREMENTS

• General Health Questionnaire (GHQ-12)
• Time 1 6 participants scored in the severe
  distress range with an equal distribution across
  gender.
• Time 1 4 participants scored in the borderline
  distress range comprising 1 male and 3 females.
• Time 1 8 participants scored in the typical
  range with equal distribution across gender.

14
General Health Questionnaire (cont)

• Severe Distress Range
• There was an overall mean score of 22.83 (at
  Time 1) to a mean score of 15.66 (at Time 2) with
  2 participants decreasing their score from 26
  each to 15 and 13 at Time 2 (decrease of 11 and
  13 points respectively). The remaining scores in
  this range went from
• 16 12, 24 21, 22 17, and 23 16.

15
General Health Questionnaire (cont)

• Evidence of Distress Range
• 4 participants scored in the evidence of
  distress range with a mean score of 13.5 at Time
  1 and a mean score of 12 at Time 2 bringing the
  participants into the typical range for stress
  levels.
• 8 participants in the typical range with a
  mean score of 9.8 at Time 1 and a mean score of
  9.25 at Time 2.

16
KNOWLEDGE ON SCHIZOPHRENIA QUESTIONNAIRE

• 2 of the 18 participants scored high on the KSCHQ
  (31/39 and 28/39) at Time 1 and their scores
  remained static at Time 2.
• 16 participants experienced an increase in their
  knowledge at Time 2 with the majority showing
  substantial improvements in their overall
  knowledge.
• Significant increases for 10 participants
• Moderate increases for 6 participants
• The mean score at Time 1 was 21.11 and was 27.5
  at Time 2

17
SUMMARY RESPONSES FROM QUESTIONS ON THE PROGRAMME

• The overall helpfulness of the programme was
  rated highly
• The families rated the content and knowledge
  gained highly
• The families valued having their questions
  answered and small group work highly
• The families rated meeting other
  families/sharing experiences highly
• The families valued facilitator attitude highly

18
SUMMARY RESPONSES FROM QUESTIONS ON THE PROGRAMME
(cont)

• Participants views on the programmes overall
  impact on their
• Knowledge and future capacity to cope with the
  illness, and
• Manage their stress and access services, was
• 12 rated the impact as moderately helpful
• 5 rated the impact in these areas highly
• 1 participant rated the impact as low

19
SUMMARY RESPONSES FROM QUESTIONS ON THE PROGRAMME
(cont)

• Participants rated the programmes overall
  impact on their
• Understanding of their relative and their
  relatives behaviour, and
• Their views of the mental health service
• Between moderate and high with 3 participants
  rating the impact as low

20
RELATIONSHIP TO EARLIER RESEARCH FINDINGS

• Effective in reduction of stress levels
• Effective in generalising knowledge and skills
  gain
• Effective in reducing negative communication and
  emotional responses
• Education interventions only are limited
  Programmes should include therapeutic
  components to develop coping, stress
  management, and problem-solving skills

21
RELATIONSHIP TO EARLIER RESEARCH FINDINGS

• Effective for encouraging/developing self-support
  groups
• Contrasts
• In contrast to previous research retention rates
  were high
• In contrast to previous research there was gender
  balance of participation with both males/females
  recording poor rates of stress