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A qualitative study exploring the acceptability of a telehealth intervention for family members of people experiencing a first episode psychosis: PERCEPTION

Published online by Cambridge University Press:  27 September 2024

David Marshall ,
Donal O’ Keeffe ,
Megan Carroll ,
Emily Cleary ,
Dearbhail Ryan ,
Eimear Counihan Open the ORCID record for Eimear Counihan [Opens in a new window] ,
Sean Naughton Open the ORCID record for Sean Naughton [Opens in a new window] ,
Eoin Geary  and
Mary Clarke
David Marshall*
Affiliation:
DETECT Early Intervention in Psychosis Service, Dublin, Ireland
Donal O’ Keeffe
Affiliation:
ARCHES Recovery College, Dublin, Ireland Mental Health Ireland, Dublin, Ireland
Megan Carroll
Affiliation:
Cluain Mhuire Community Mental Health Services, Dublin, Ireland
Emily Cleary
Affiliation:
Cluain Mhuire Community Mental Health Services, Dublin, Ireland
Dearbhail Ryan
Affiliation:
Cluain Mhuire Community Mental Health Services, Dublin, Ireland
Eimear Counihan
Affiliation:
National Forensic Mental Health Service, Dublin, Ireland
Sean Naughton
Affiliation:
DETECT Early Intervention in Psychosis Service, Dublin, Ireland School of Medicine, Health Sciences Centre, University College Dublin, Dublin, Ireland
Eoin Geary
Affiliation:
St Michael’s Unit, North Lee Mental Health Service, Mercy University Hospital, Cork, Ireland
Mary Clarke
Affiliation:
DETECT Early Intervention in Psychosis Service, Dublin, Ireland School of Medicine, Health Sciences Centre, University College Dublin, Dublin, Ireland
*
Corresponding author: David Marshall; Email: [email protected]
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Abstract

Objectives:

Family members of people experiencing a first-episode psychosis (FEP) can experience high levels of carer burden, stigma, emotional challenges, and uncertainty. This indicates the need for support and psychoeducation. To address these needs during the COVID-19 pandemic, we developed a multidisciplinary, blended, telehealth intervention, incorporating psychoeducation and peer support, for family members of FEP service users: PERCEPTION (PsychoEducation for Relatives of people Currently Experiencing Psychosis using Telehealth, an In-person meeting, and ONline peer support). The aim of the study was to explore the acceptability of PERCEPTION for family members of people who have experienced an FEP.

Methods:

Ten semi-structured interviews were conducted online via Zoom and audio recorded. Maximum variation sampling was used to recruit a sample balanced across age, gender, relatives’ prior mental health service use experience, and participants’ relationship with the family member experiencing psychosis. Data were analysed by hand using reflexive thematic analysis.

Results:

Four themes were produced: ‘Developing confidence in understanding and responding to psychosis’; ‘Navigating the small challenges of a broadly acceptable and desirable intervention’; ‘Timely support enriches the intervention’s meaning’; and ‘Dealing with the realities of carer burden’.

Conclusions:

Broadly speaking, PERCEPTION was experienced as acceptable, with the convenient, safe, and supportive environment, and challenges in engagement being highlighted by participants. Data point to a gap in service provision for long-term self-care support for relatives to reduce carer burden. Providing both in-person and online interventions, depending on individuals’ preference and needs, may help remove barriers for family members accessing help.

Keywords

Familypsychotic disorderspsychoeducationpeer supporttelehealth
Type
Original Research
Information
Irish Journal of Psychological Medicine , First View , pp. 1 - 8
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of College of Psychiatrists of Ireland

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References

Boydell, J, Onwumere, J, Dutta, R, Bhavsar, V, Hill, N, Morgan, C, Dazzan, P, Morgan, K, Pararajan, M, Kuipers, E, Jones, P, Murray, R, Fearon, P (2014). Caregiving in first-episode psychosis: social characteristics associated with perceived ‘burden’ and associations with compulsory treatment. Early Intervention in Psychiatry 8, 122–129.Google Scholar
Bowen, M (1966). The use of family theory in clinical practice. Comprehensive Psychiatry 7, 345–374.Google Scholar
Braun, V, Clarke, V (2022). Conceptual and design thinking for thematic analysis. Qualitative Psychology 9, 3–26.Google Scholar
Castelein, S, Bruggeman, R, Davidson, L, Gaag, MVD (2015). Creating a supportive environment: peer support groups for psychotic disorders. Schizophrenia Bulletin 41, 1211–1213.Google Scholar
Chan, SK, Tse, S, Sit, HLT, Hui, CL, Lee, EH, Chang, WC, Chen, EY (2016). Web-based psychoeducation program for caregivers of first-episode of psychosis: an experience of Chinese population in Hong Kong. Frontiers in Psychology 07, 2006.Google Scholar
Claxton, M, Onwumere, J, Fornells-Ambrojo, M (2017). Do family interventions improve outcomes in early psychosis? A systematic review and meta-analysis. Frontiers in Psychology 8, 371.Google Scholar
Davidson, L, Chinman, M, Kloos, B, Weingarten, R, Stayne, D, Tebes, JK (1999). Peer support among individuals with severe mental illness: a review of the evidence. Clinical Psychology: Science and Practice 6, 165–187.Google Scholar
Dijkstra, SA, Rijkeboer, J, Noordhof, A, Boyette, L, Berendsen, S, de Koning, M, Japien Bennen, R, Hofman, T, de Haan, L (2024). Making sense of recovery from first psychosis with antipsychotic medication: a qualitative phenomenological study. Schizophrenia Bulletin. Published online ahead of print. doi:10.1093/schbul/sbae104.Google Scholar
Dillinger, RL, Kersun, JM (2020). Caring for caregivers: understanding and meeting their needs in coping with first episode psychosis. Early Intervention in Psychiatry 14, 528–534.Google Scholar
Gonzalez-Torres, MA, Oraa, R, Aristegui, M, Aranzazu, FR, Guimon, J (2007). Stigma and discrimination towards people with schizophrenia and their family members. Social, Psychiatry and Psychiatric Epidemiology 42, 14–23.Google Scholar
Ibrahim, N, Ong, HC, Wahab, S, Che Din, N, Ahmad, M, Ami, N, Sin Siau, C, Mohamad, MS (2022). Perceived burden, psychological distress, and quality of life among family caregivers of individuals with schizophrenia. Journal of Multicultural Counselling and Development 50, 195–207.Google Scholar
Hyland, P, Shevlin, M, Murphy, J, McBride, O, Fox, R, Bondjers, K, Karatzias, T, Bentall, RP, Martinez, A, Vallières, F (2021). A longitudinal assessment of depression and anxiety in the republic of Ireland before and during the COVID-19 pandemic. Psychiatry Research 300, 1–13905.Google Scholar
Lobban, F, Appelbe, D, Appleton, V, Billsborough, J, Fisher, NR, Foster, S, et al. (2020). IMPlementation of An online relatives’ toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and use. BMC Health Services Research 20, 1–13.Google Scholar
Maheshwari, S, Manoha, S, Chandran, S, Rao, T (2020). Psycho-education in Schizophrenia. In Schizophrenia Treatment Outcomes: An Evidence Based Approach (ed. Shrivastava, A., De Sousa, A.), pp. 275–284. Springer: Cham.Google Scholar
Malterud, K, Siersma, VD, Guassora, AD (2016). Sample size in qualitative interview studies: guided by information power. Qualitative Health Research 26, 1753–1760.Google Scholar
Marriott, C, Bernard, M, Larkin, M (2024). Exploring family experiences and relationship dynamics where one member experiences psychosis: “We’ve been on that journey together”. In Relationships and Mental Health: Relational Experience in Distress and Recovery (ed. Boden-Stuart, Z. and Larkin, M), pp. 137–154. Springer International Publishing: Cham.Google Scholar
Mead, S, Hilton, D, Curtis, L (2001). Peer support: a theoretical perspective. Psychiatric Rehabilitation Journal 25, 134–141.Google Scholar
Mui, EYW, Chan, SK, Chan, PY, Hui, CL, Chang, WC, Lee, EH, Chen, EY (2019). Systematic review (meta-aggregation) of qualitative studies on the experiences of family members caring for individuals with early psychosis. International Review of Psychiatry 31, 491–509.Google Scholar
National Institute for Health and Care Excellence (2014). Psychosis and schizophrenia in adults: Prevention and management. (https://www.nice.org.uk/guidance/cg178/chapter/1-Recommendations). Accessed February 16, 2024.Google Scholar
O’Brien, BC, Harris, IB, Beckman, TJ, Reed, DA, Cook, DA (2014). Standards for reporting qualitative research: a synthesis of recommendations. Academic Medicine 89, 1245–1251.Google Scholar
O’Donoghue, B, O’Connor, K, Thompson, A, McGorry, P (2021). The need for early intervention for psychosis to persist throughout the COVID-19 pandemic and beyond. Irish Journal of Psychological Medicine 38, 214–219.Google Scholar
O’Keeffe, D, Keogh, B, Higgins, A (2021). Meaning in life in long-term recovery in first-episode psychosis: an interpretative phenomenological analysis. Frontiers in Psychiatry 12, 676593.Google Scholar
O’Keeffe, D, Marshall, D, Wheeler, A, Allen, E, Ronan, H, Buckley, A, Counihan, E, Clarke, M (2023). Through COVID-19 and beyond: developing a multidisciplinary telehealth family intervention in first episode psychosis. Irish Journal of Psychological Medicine 40, 503–507.Google Scholar
Rotondi, AJ, Anderson, CM, Haas, GL, Eack, SM, Spring, MB, Ganguli, R, Newhill, C, Rosenstock, J (2010). Web-based psychoeducational intervention for persons with schizophrenia and their supporters: one-year outcomes. Psychiatric Services 61, 1099–1105.Google Scholar
Rotondi, AJ, Haas, GL, Anderson, CM, Newhill, CE, Spring, MB, Ganguli, R, Gardner, W, Rosenstock, JB (2005). A clinical trial to test the feasibility of a telehealth psychoeducational intervention for persons with schizophrenia and their families: intervention and 3-month findings. Rehabilitation Psychology 50, 325–336.Google Scholar
Rus-Calafell, M, Teismann, T, Kullmann, F, Alatas, D, Ballero-Reque, C, Holewa, J, Rüsberg, M, Brüne, M, Mercedes, P, Schneider, S (2024). Internet-based psychoeducation and support programme for relatives of young people with early psychosis: results of the first German-language intervention. Frontiers in Psychiatry 15, 1248526.Google Scholar
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.Google Scholar
Sin, J, Henderson, C, Norman, I (2014). Usability of online psychoeducation for siblings of people with psychosis. International Journal of Technology Assessment in Health Care 30, 374–380.Google Scholar
Wilhelm, K, Handley, T, McHugh, C, Lowenstein, D, Arrold, K (2022). The quality of internet websites for people experiencing psychosis: pilot expert assessment. JMIR Formative Research 6, e28135.Google Scholar
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