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Service evaluation of a sole-session psychoeducational intervention to improve caregivers’ key illness beliefs after first episode psychosis (FEP)

Published online by Cambridge University Press:  28 July 2020

Cassie M. Hazell Open the ORCID record for Cassie M. Hazell [Opens in a new window] ,
Natasha Lyons ,
Juliana Onwumere ,
Joerg Schulz ,
Naomi Glover ,
Sarah Whittaker ,
Lai Chu Man ,
Caroline Floyd ,
Lucy Brown  and
Gareth James
...Show all authors
Cassie M. Hazell*
Affiliation:
School of Social Sciences and Humanities, University of Westminster, London, UK
Natasha Lyons
Affiliation:
Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
Juliana Onwumere
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
Joerg Schulz
Affiliation:
Department of Psychology and Sports Science, University of Hertfordshire, UK
Naomi Glover
Affiliation:
Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
Sarah Whittaker
Affiliation:
Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
Lai Chu Man
Affiliation:
Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
Caroline Floyd
Affiliation:
Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
Lucy Brown
Affiliation:
Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
Gareth James
Affiliation:
Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
Roya Afshardazegan
Affiliation:
Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
Saal Seneviratne
Affiliation:
Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
Shireen Rahim
Affiliation:
Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
Jonathan Souray
Affiliation:
Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
David Raune
Affiliation:
Harrow and Hillingdon Early Intervention in Psychosis Service, Central and North West London NHS Foundation Trust, London, UK
*
*Corresponding author. Email: c.hazell@westminser.ac.uk
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Abstract

Carers of people experiencing a first episode of psychosis are at an increased risk of developing their own physical and mental health problems. Psychoeducation has been found to improve carer wellbeing and reduce distress. However, few psychoeducation interventions have considered the resource constraints on mental health services and the impact that these can have on the implementation of any such interventions. The present service evaluation aimed to evaluate an abbreviated version (sole session) of a previously tested psychoeducation intervention (three sessions) that targets less adaptive illness beliefs (n = 17). Pre–post effect sizes reveal that all of the carers’ illness beliefs changed in the desired direction, with four out of the 10 illness beliefs associated with large to moderate improvements. When compared with the outcomes obtained in our evaluation of the more intensive, three-session version of the intervention, the between-group effects largely favoured the three-session version but were mostly small. Moderate to large effects in favour of the three-session version were found for two of the 10 illness beliefs. These findings support the further investigation of the sole session psychoeducation intervention as part of a randomised controlled trial.

Key learning aims

  1. (1) To evaluate the impact of a sole-session psychoeducation intervention on illness beliefs.

  2. (2) To compare the outcomes of the sole-session psychoeducation intervention to the previous, more intensive (three-session) version of the same intervention.

  3. (3) To consider the value of research approaches to evaluating psychoeducation interventions for carers of people with psychosis.

Keywords

carersfirst episode psychosisillness beliefspsychoeducationservice implementation
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 13 , 2020 , e28
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

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References

Further reading

Onwumere, J., Glover, N., Whittaker, S., Rahim, S., Chu Man, L., James, G., … & Raune, D. (2017). Modifying illness beliefs in recent onset psychosis carers: evaluating the impact of a cognitively focused brief group intervention in a routine service. Early Intervention in Psychiatry, 12, 1144–1150. https://doi.org/10.1111/eip.12430CrossRefGoogle Scholar
Onwumere, J., Lotey, G., Schulz, J., James, G., Afsharzadegan, R., Harvey, R., … & Raune, D. (2017). Burnout in early course psychosis carers: the role of illness beliefs and coping styles. Early Intervention in Psychiatry, 11, 237–243. https://doi.org/10.1111/eip.12227CrossRefGoogle ScholarPubMed
Poon, A. W. C., Harvey, C., Mackinnon, A., & Joubert, L. (2017). A longitudinal population-based study of carers of people with psychosis. Epidemiology and Psychiatric Sciences, 26, 265–275. https://doi.org/10.1017/S2045796015001195CrossRefGoogle ScholarPubMed
Sin, J., Gillard, S., Spain, D., Cornelius, V., Chen, T., & Henderson, C. (2017). Effectiveness of psychoeducational interventions for family carers of people with psychosis: a systematic review and meta-analysis. Clinical Psychology Review, 56, 13–24. https://doi.org/10.1016/j.cpr.2017.05.002CrossRefGoogle ScholarPubMed

References

Abramowitz, I. A., & Coursey, R. D. (1989). Impact of an educational support group on family participants who take care of their schizophrenic relatives. Journal of Consulting and Clinical Psychology, 57, 232–236.CrossRefGoogle ScholarPubMed
Adamson, V., Barrass, E., McConville, S., Irikok, C., Taylor, K., Pitt, S., … & Price, D. (2018). Implementing the access and waiting time standard for early intervention in psychosis in the United Kingdom: an evaluation of referrals and post-assessment outcomes over the first year of operation. Early Intervention in Psychiatry, 12, 979–986. https://doi.org/10.1111/eip.12548CrossRefGoogle ScholarPubMed
Addington, J., Coldham, E. L., Jones, B., Ko, T., & Addington, D. (2003). The first episode of psychosis: the experience of relatives. Acta Psychiatrica Scandinavica, 108, 285–289. https://doi.org/10.1034/j.1600-0447.2003.00153.xCrossRefGoogle ScholarPubMed
Andrew, A., Knapp, M., McCrone, P., Parsonage, M., & Trachtenberg, M. (2012). Effective Interventions in Schizophrenia: The Economic Case. Retrieved from: http://eprints.lse.ac.uk/47406Google Scholar
Askey, R., Holmshaw, J., Gamble, C., & Gray, R. (2009). What do carers of people with psychosis need from mental health services? Exploring the views of carers, service users and professionals. Journal of Family Therapy, 31, 310–331. https://doi.org/10.1111/j.1467-6427.2009.00470.xCrossRefGoogle Scholar
Barrowclough, C., Gooding, P., Hartley, S., Lee, G., & Lobban, F. (2014). Factors associated with distress in relatives of a family member experiencing recent-onset psychosis. Journal of Nervous and Mental Disease, 202, 40–46. https://doi.org/10.1097/NMD.0000000000000072CrossRefGoogle ScholarPubMed
Broadbent, E., Petrie, K. J., Main, J., & Weinman, J. (2006). The brief illness perception questionnaire. Journal of Psychosomatic Research, 60, 631–637. https://doi.org/10.1016/j.jpsychores.2005.10.020CrossRefGoogle ScholarPubMed
Buckner, L., & Yeandle, S. (2011). Valuing Carers – Calculating the Value of Carers’ Support. London, UK: Carers UK.Google Scholar
Carers UK (2007). Real Change, Not Short Change: Time to Deliver for Carers. Retrieved from: http://www.scie-socialcareonline.org.uk/real-change-not-short-change-time-to-deliver-for-carers/r/a11G00000017w3PIAQGoogle Scholar
Carers UK (2014). Carers at Breaking Point. Retrieved from: https://www.carersuk.org/for-professionals/policy/policy-library/carers-at-breaking-point-reportGoogle Scholar
Chien, W. T., & Wong, K. F. (2007). A family psychoeducation group program for Chinese people with schizophrenia in Hong Kong. Psychiatric Services, 58, 1003–1006. https://doi.org/10.1176/ps.2007.58.7.1003CrossRefGoogle ScholarPubMed
Cleary, M., Freeman, A., & Walter, G. (2006). Carer participation in mental health service delivery. International Journal of Mental Health Nursing, 15, 189–194. https://doi.org/10.1111/j.1447-0349.2006.00422.xCrossRefGoogle ScholarPubMed
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences. New York, NY, USA: Routledge Academic.Google Scholar
Eassom, E., Giacco, D., Dirik, A., & Priebe, S. (2014). Implementing family involvement in the treatment of patients with psychosis: a systematic review of facilitating and hindering factors. BMJ Open, 4, 1–11. https://doi.org/10.1136/bmjopen-2014-006108CrossRefGoogle ScholarPubMed
Field, A. (2013). Discovering Statistics Using IBM SPSS Statistics (4th edn). London, UK: Sage.Google Scholar
Fortune, D. G, Smith, J. V., & Garvey, K. (2005). Perceptions of psychosis, coping, appraisals, and psychological distress in the relatives of patients with schizophrenia: an exploration using self-regulation theory. British Journal of Clinical Psychology, 44, 319–331.CrossRefGoogle ScholarPubMed
Hazell, C. M., Jones, C. J., Pandey, A., & Smith, H. E. (2019). Barriers to recruiting and retaining psychosis carers: a case study on the lessons learned from the Caring for Caregivers (C4C) trial. BMC Research Notes, 12, 810. https://doi.org/10.1186/s13104-019-4832-9CrossRefGoogle ScholarPubMed
Islam, Z., Rabiee, F., & Singh, S. P. (2015). Black and Minority Ethnic groups’ perception and experience of Early Intervention in Psychosis services in the United Kingdom. Journal of Cross-Cultural Psychology, 46, 737–753. https://doi.org/10.1177/0022022115575737CrossRefGoogle Scholar
Jongsma, H. E., Turner, C., Kirkbride, J. B., & Jones, P. B. (2019). International incidence of psychotic disorders, 2002–17: a systematic review and meta-analysis. The Lancet Public Health, 4, e229–e244. https://doi.org/10.1016/S2468-2667(19)30056-8CrossRefGoogle ScholarPubMed
Kuipers, E., Onwumere, J., & Bebbington, P. (2010). Cognitive model of caregiving in psychosis. British Journal of Psychiatry, 195, 259–265.CrossRefGoogle Scholar
Lal, S., Malla, A., Marandola, G., Thériault, J., Tibbo, P., Manchanda, R., … & Banks, N. (2019). ‘Worried about relapse’: family members’ experiences and perspectives of relapse in first-episode psychosis. Early Intervention in Psychiatry, 13, 24–29. https://doi.org/10.1111/eip.12440CrossRefGoogle Scholar
Lobban, F., Barrowclough, C., & Jones, S. (2005). Assessing cognitive representations of mental health problems. I. The illness perception questionnaire for schizophrenia. British Journal of Clinical Psychology, 44, 147–162. https://doi.org/10.1348/014466504X19497CrossRefGoogle Scholar
McCann, T. V., Lubman, D. I., & Clark, E. (2011). First-time primary caregivers’ experience of caring for young adults with first-episode psychosis. Schizophrenia Bulletin, 37, 381–388. https://doi.org/10.1093/schbul/sbp085CrossRefGoogle ScholarPubMed
NHS England (2019). Who is considered a carer? Retrieved from NHS England website: https://www.england.nhs.uk/commissioning/comm-carers/carers/Google Scholar
NICE (2014). Psychosis and Schizophrenia in Adults: Prevention and Management. London, UK: National Institute for Health and Care Excellence (NICE).Google Scholar
NICE (2016). Implementing the Early Intervention in Psychosis Access and Waiting Time Standard: Guidance. Retrieved from: https://www.england.nhs.uk/mentalhealth/wp-content/uploads/sites/29/2016/04/eip-guidance.pdfGoogle Scholar
Onwumere, J., Glover, N., Whittaker, S., Rahim, S., Chu Man, L., James, G., … & Raune, D. (2017a). Modifying illness beliefs in recent onset psychosis carers: evaluating the impact of a cognitively focused brief group intervention in a routine service. Early Intervention in Psychiatry, 12, 1144–1150. https://doi.org/10.1111/eip.12430CrossRefGoogle Scholar
Onwumere, J., Kuipers, E., Bebbington, P., Dunn, G., Fowler, D., Freeman, D., … & Garety, P. (2008). Caregiving and illness beliefs in the course of psychotic illness. La Revue Canadienne de Psychiatrie, 53, 460–468.Google ScholarPubMed
Onwumere, J., Lotey, G., Schulz, J., James, G., Afsharzadegan, R., Harvey, R., … & Raune, D. (2017b). Burnout in early course psychosis caregivers: the role of illness beliefs and coping styles. Early Intervention in Psychiatry, 11, 237–243. https://doi.org/10.1111/eip.12227CrossRefGoogle ScholarPubMed
Patel, M., Chawla, R., Krynicki, C. R., Rankin, P., & Upthegrove, R. (2014). Health beliefs and carer burden in first episode psychosis. BMC Psychiatry, 14, 1–7. https://doi.org/10.1186/1471-244X-14-171CrossRefGoogle ScholarPubMed
Riley, G., Gregory, N., Bellinger, J., Davies, N., Mabbott, G., & Sabourin, R. (2011). Carer’s education groups for relatives with a first episode of psychosis: an evaluation of an eight-week education group. Early Intervention in Psychiatry, 5, 57–63. https://doi.org/10.1111/j.1751-7893.2010.00195.xCrossRefGoogle ScholarPubMed
Rouf, K., Close, H., & Rosen, K. (2008). Managing Psychosis: A Guide for Relatives, Carers & Friends. Oxford, UK: Oxford Cognitive Therapy Centre.Google Scholar
Sadath, A., Muralidhar, D., Varambally, S., Gangadhar, B. N., & Jose, J. P. (2017). Do stress and support matter for caring? The role of perceived stress and social support on expressed emotion of carers of persons with first episode psychosis. Asian Journal of Psychiatry, 25, 163–168. https://doi.org/10.1016/j.ajp.2016.10.023CrossRefGoogle ScholarPubMed
Schmidt, F. L., & Hunter, J. E. (2014). Methods of Meta-Analysis: Correcting Error and Bias in Research Findings (3rd edn). London, UK: Sage Publications.Google Scholar
Sin, J, Moone, N., & Wellman, N. (2005). Developing services for the carers of young adults with early-onset psychosis – listening to their experiences and needs. Journal of Psychiatric and Mental Health Nursing, 12, 589–597. https://doi.org/10.1111/j.1365-2850.2005.00883.xCrossRefGoogle ScholarPubMed
Sin, J., Gillard, S., Spain, D., Cornelius, V., Chen, T., & Henderson, C. (2017). Effectiveness of psychoeducational interventions for family carers of people with psychosis: a systematic review and meta-analysis. Clinical Psychology Review, 56, 13–24. https://doi.org/10.1016/j.cpr.2017.05.002CrossRefGoogle ScholarPubMed
Sin, J., & Norman, I. (2013). Psychoeducational interventions for family members of people with schizophrenia: a mixed-method systematic review. Journal of Clinical Psychiatry, 74. https://doi.org/10.4088/JCP.12r08308Google ScholarPubMed
Smith, L., Onwumere, J., Craig, T., McManus, S., Bebbington, P., & Kuipers, E. (2014). Mental and physical illness in caregivers: results from an English national survey sample. British Journal of Psychiatry, 205, 197–203. https://doi.org/10.1192/bjp.bp.112.125369CrossRefGoogle ScholarPubMed
SNOMED CT (2019). Early Intervention in Psychosis: Recording and Reporting on NICE-Recommended Interventions Using SNOMED CT Codes. London.Google Scholar
Szmukler, G., Kuipers, E., Joyce, J., Harris, T., Leese, M., Maphosa, W., & Staples, E. (2003). An exploratory randomised controlled trial of a support programme for carers of patients with a psychosis. Social Psychiatry and Psychiatric Epidemiology, 38, 411–418. https://doi.org/10.1007/s00127-003-0652-1CrossRefGoogle ScholarPubMed
Tel, H., & Esmek, M. (2006). The effect of education on the approach of relatives to schizophrenia patients and their coping with stress. Neurology Psychiatry and Brain Research, 13, 55–58.Google Scholar
Wainwright, L. D., Glentworth, D., Haddock, G., Bentley, R., & Lobban, F. (2015). What do relatives experience when supporting someone in early psychosis? Psychology and Psychotherapy: Theory, Research and Practice, 88, 105–119. https://doi.org/10.1111/papt.12024CrossRefGoogle ScholarPubMed
Wilson, D. B. (2011). Meta-analysis stuff. Retrieved from: http://mason.gmu.edu/~dwilsonb/ma.html (accessed 3 December 2017).Google Scholar
Worthington, A., Rooney, P., & Hannan, R. (2016). The Triangle of Care. Carers Included: A Guide to Best Practice in Acute Mental Health Care (2nd edn). Retrieved from: www.carers.orgGoogle Scholar
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