title: A Randomized Controlled Trial of Clinician-Supported Problem-Solving Bibliotherapy for Family Caregivers of People With First-Episode Psychosis.
abstract: Family interventions for first-episode psychosis (FEP) are an integral component of treatment, with positive effects mainly on patients' mental state and relapse rate. However, comparatively little attention has been paid to the effects of family interventions on caregivers' stress coping and well-being, especially in non-Western countries. We aimed to test the effects of a 5-month clinician-supported problem-solving bibliotherapy (CSPSB) for Chinese family caregivers of people with FEP in improving family burden and carers' problem-solving and caregiving experience, and in reducing psychotic symptoms and duration of re-hospitalizations, compared with those only received usual outpatient family support (UOFS). A randomized controlled trial was conducted across 2 early psychosis clinics in Hong Kong, where there might be inadequate usual family support services for FEP patients. A total of 116 caregivers were randomly selected, and after baseline measurement, randomly assigned to the CSPSB or UOFS. They were also assessed at 1-week and 6- and 12-month post-intervention. Intention-to-treat analyses were applied and indicated that the CSPSB group reported significantly greater improvements in family burden and caregiving experience, and reductions in severity of psychotic symptoms and duration of re-hospitalizations, than the UOFS group at 6- and 12-month follow-up. CSPSB produces moderate long-term benefits to caregivers and FEP patients, and is a low-cost adjunct to UOFS.
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong; wai.tong.chien@polyu.edu.hk.
authors.forename: Wai Tong
authors.initials: WT
authors.lastname: Chien
authors.affiliation: Centre for the Heart and Mind, Australian Catholic University, Melbourne, Australia; Department of Psychiatry, University of Melbourne, Melbourne, Australia.
authors.forename: David R
authors.initials: DR
authors.lastname: Thompson
authors.affiliation: Turning Point, Eastern Health and Monash University, Melbourne, Australia.
authors.forename: Dan I
authors.initials: DI
authors.lastname: Lubman
authors.affiliation: Centre for Chronic Disease, College of Health and Biomedicine, Discipline of Nursing, Victoria University, Melbourne, Australia.
authors.forename: Terence V
authors.initials: TV
authors.lastname: McCann
mesh_terms: D000293:Adolescent; D000328:Adult; D001638:Bibliotherapy / Q000379:methods*; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D005190:Family / Q000523:psychology*; D005196:Family Therapy / Q000379:methods*; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011340:Problem Solving; D011618:Psychotic Disorders / Q000451:nursing*; D055815:Young Adult
keywords: burden; experience of caregiving; family intervention; patients; relapse