Impact of multiple-family groups for outpatients with schizophrenia 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 clinicianís 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 treatmentís 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
Posted by Farzin at August 9, 2004 05:34 AM
Click here to find this article on PubMed
Multiple Group Family Therapy may work for some, but I think the question needs to be askedÖ what is the goal for the individual family groups. Iíve been involved in family support groups for family members who have a child with a mental illness. I did not find the support very helpful or useful. Actually I found it quite depressing. For one, my goal was so much different than the goals of the other members. Many families were fine with keeping their mentally ill child dependent and living at home for as long as the caretakers were alive. This for me is not an acceptable solution. I have no desire for my child to live with me until I die of old age or mental exhaustion. My goal is to help my child create a support network so they can live independently.
Posted by: Moeder at August 14, 2004 01:57 AM
August 14, 2004
Can anyone really help a family deal with psychotic outbursts? I can not imagaine that any number of meetings can help you deal when an offspring is jumping up and down and breaking furniture? I have a 32 year old dependent woman at home who has schizo-affective disorder, These outbursts can break her spirit ( afterwards) and my soul is disturbed for days. She is medicated and the psychiatrist is proud of her recovery. I onlt ask what can I exoect of her future? I am dealing with the daily struggle NOW because I LOVE our daughter and I will not abandon her... Is there any advice of how to cope with these episodes to diminish their longevity and incidence? Who can I turn to? her therapist helps her deal and her MD medicates her . I can not afford a therapist and medical help I have sought says ''LOVE HER" . This , I do. What is next? My mental breakdown?
Posted by: annila at August 14, 2004 09:54 PM
Good points. There needs to be much more attention paid to providing adequate support for the trials and tribulations of families. Many families find support in each other through such web chat resources and also local NAMI chapters. There are also some good books featured on the home page here that can help, including "How to Live With a Mentally Ill Person" written by a mother of a person with schizophrenia. Schizophrenia is such a complex illness and sadly all too often it draws us away from providing the much needed attention and support that families also need.
Posted by: Farzin at August 16, 2004 02:41 PM
CONDUCTING CAREGIVERS GROUP MEETING ON OUT-PATIENT BASIS(SCHIZOPHRENIA/BIPOLAR MOOD DISORDER) IS FOUND TO BE BENEFICIAL FOR THE CONSUMERS AND ITS FEASIBLE FOR THE CARE PROVIDERS WITHOUT ALTERING REGULAR OPD FUNCTIONING.
Posted by: ISMAIL SHIHABUDDEEN at November 2, 2005 08:44 AM