Wai Tong CHIEN
This randomized controlled tested the effects of Professional-supported Problem-solving-based Self-learning Program (PBSP) for family carers of people with recent-onset psychosis in Hong Kong over a 12-month follow-up. A multi-center, assessor-blind randomized controlled trial with repeated-measures, three-arm design was adopted. One hundred and ninety-eight family dyads (psychotic patients with ≤3 years onset of illness and one of their main family caregivers) were randomly recruited from six integrated community centers for mental wellness (and family care) and then randomly assigned into BPSP, family psychoeducation or usual family care group for 5-month interventions. The recruited family caregivers perceived a moderate to high burden of care (>20 of 50 scores of the Chinese version of Family-Burden-Interview-Schedule). The PBSP comprised of a validated 5-module caregiving self-help manual with problem-solving practices and four facilitator supported group sessions. Psychoeducation groups (12 2-hour sessions; 10-12 participants per group) will be led by one advanced practice psychiatric nurse and guided by a validated treatment protocol based on the research team’s and McFarlane et al.’s psycho-education programs for psychosis. Participants in the PBSP indicated significant greater improvements in social problem-solving and family burden at 1-week, 6-month and 12-month follow-ups, as well as reduction in patients’ psychotic symptoms and lengths of re-hospitalizations at 6- and 12-month follow-ups, when compared with both psychoeducation and usual care group. The improvements of patients’ psychotic symptoms and family burden could reach clinical significance/benefit, which exceeded two SDs of the normative mean values. The findings support the PBSP can be effective to improve both psychotic patients and their family caregivers’ mental health and well-being and thus be offered to community mental health services or organizations for recent-onset psychotic patients in need. The PBSP protocol tested in this project can be disseminated to mental health services and organizations in Hong Kong or other countries to be offered to various types of psychotic patients in need. Future cost-effectiveness study of the PBSP will be considered.