Edinburgh Napier University

  Facilitated self-help and problem-solving strategies can empower and support family carers to cope with caregiving for people with severe mental illness. This single-blind multi-site randomized controlled trial examined the effects of a 5-month family-facilitated problem-solving based self-learning program (PBSP in addition to usual care), versus a family psycho-education group program and usual psychiatric care only in recent-onset psychosis, with a 6-month follow-up. In each of three study sites (integrated community centers for mental wellness), 114 people with early psychosis (≤5 years illness onset) and their family carers were randomly selected and allocated to one of three study groups (n=38). Caregiving burden (primary outcome) and patients’ and carers’ health conditions were assessed at recruitment, and 1-month and 6-month post-intervention. Overall, 106 (94.7%) participants completed the assigned intervention and ≥1 post-test. Generalized Estimating Equations and subsequent contrast tests indicated that the PBSP participants showed significant greater improvements in carers’ burden, caregiving experiences and problem-solving ability, and patients’ psychotic symptoms, recovery and duration of re-hospitalizations over the 6-month follow-up, compared with the other two groups (moderate to large effect size, η2= 0.12-0.24). Family-assisted problem-solving based self-learning program is found effective to improve both psychotic patients’ and their carers’ psychosocial health in over a medium term, thus reducing patients’ risk of relapse.