August 09, 2004

Impact of multiple-family groups on caregivers' distress and resources.

Hazel NA, McDonell MG, Short RA, Berry CM, Voss WD, Rodgers ML, Dyck DG.
Psychiatric Services. 2004 Jan;55(1):35-41.

Family-member caregivers of people with schizophrenia can have substantial demands placed on their personal, financial, social, and/or emotional resources. Multiple-family group family treatment integrates elements of psychoeducation and behavioral family therapy in a group format with two clinicians and six to eight families. This approach provides information and problem-solving experiences to family members and consumers. The treatment begins with a three-session joining phase, where the clinician�s goal is to develop a solid alliance with the family and consumer, gain information about history, impact of illness and resources available for managing it. Next there is a one-day psychoeducational workshop, followed by one year of bimonthly group sessions focusing on relapse prevention. Finally, there is a year of monthly group sessions that focus on social and career rehabilitation.

Research suggests that multiple-family group treatment has a positive effect on consumers' negative symptoms, use of inpatient and outpatient services and relapse. But, the literature is inconclusive about this treatment�s effect on caregivers' well-being. As a result, this study reexamined the impact of multiple-family group treatment on caregivers' outcomes by focusing more specifically on caregivers' distress. They found that over the two-year course of the intervention, caregivers of persons who received multiple-family group treatment experienced greater reductions in distress when compared to caregivers of consumers who received standard psychiatric care.

They also found that contrary to what they expected, there were no significant differences between the multiple-family and standard treatment groups, with respect to increases in caregivers' resources. This could have been because of statistical reasons (low power because people dropped out) or the measures used to assess resources. Also, there is question about whether the baseline for the groups was different to begin with. It is also possible that multiple-family group treatment simply does not have an effect on psychosocial resources of caregivers.

This study suggests that modifications to multiple-family group intervention may be necessary to positively affect the resources of family caregivers. This could include breakout groups designed to address assessment and improvement of caregivers' resources. Also, further research is needed to see whether multiple-family group treatment can also affect caregivers' physical and psychological health, as well as to determine the mechanisms by which this treatment helps caregivers. Nevertheless it is encouraging to see research on more family driven treatments that focus on both the consumer and the caregiver.

This study was supported by grant R01-52259 from the National Institute of Mental Health

Click here to find this article on PubMed

Author: Farzin Irani


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