Family involvement may lead to better patient outcomes in psychosis treatment

According to new research from Boston Medical Center, family involvement in psychosis treatment leads to better patient outcomes. Published in Schizophrenia Research, researchers highlight that learning to use motivational interviewing communication skills may help caregivers to decrease conflict and expressed emotion and improve treatment adherence.

Research showed that families who understand the nature of psychosis symptoms and interventions can support treatment adherence by providing instrumental support for tasks such as scheduling and driving to appointments, filling prescriptions, and communicating with providers about concerning symptoms or behaviors.

The goal is not that the caregiver becomes a therapist to the individual with psychosis, but rather that they learn and use motivational interviewing based communication strategies to decrease expressed emotion and play a more effective role in helping to connect the individual with psychosis to relevant clinical services.

"With the findings from this study, our hope is to understand how supportive home environments can improve patient outcomes across diagnoses," said Emily R. Kline, MD, Director of Psychological Services in the Wellness and Recovery After Psychosis Program at Boston Medical Center and associate professor of psychiatry at Boston University Chobanian & Avedisian School of Medicine.

The study is a pilot randomized controlled trial testing the impact of Motivational Interviewing for loved ones (MILO), a brief five-hour psychoeducational intervention for caregivers, in a sample of family members of individuals with early course psychosis. Using a randomized crossover design, caregivers were randomized to either immediate motivational interviewing for loved ones or a six-week waitlist control condition—all participants eventually received the intervention.

The results of this study showed that caregiver participants experienced large and significant improvements in caregiver well-being, caregiver self-efficacy, family conflict, and expressed emotion. There was no change over time in caregiver-reported patient treatment adherence. Relative to waitlist, MILO had significant effects on family conflict and expressed emotion, a trending effect on perceived stress, and no effect on parenting self-efficacy or treatment adherence.

Researchers believe that interventions that involve and counsel family members may improve patient outcomes, creating a less stressful and more supportive home environment.