The effectiveness of a brief psychoeducational intervention for people with schizophrenia and their families : a dissertation presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University, Palmerston North, New Zealand
In an attempt to replicate and extend previous research, the present study conducted a brief psychoeducational intervention through community organisations designed to overcome methodological shortcomings of past studies. The two session intervention (one session with follow-up phone call) sought to establish if a brief community intervention was effective in both improving family members’ knowledge about schizophrenia and various other indicators linked to improved client functioning. People with schizophrenia and their family members (N = 50) were recruited into a controlled trial of a brief educational intervention. Clients and their corresponding key family members were randomly allocated to a treatment group or a wait-list control group. Measures included those reflecting knowledge about schizophrenia, expressed emotion, perceived coping ability, burden of care and distress. Analyses showed that knowledge increased significantly after the intervention and not after the control condition and was maintained at a nine-month follow-up. Family members’ and clients’ expressed emotion ratings significantly decreased from pre- to post-test with changes in total expressed emotion scores improving across treatment by over twice the magnitude compared to the control condition. All gains were maintained at the nine-month follow-up, with continuing improvement seen in family members’ intrusiveness ratings. A similar pattern of findings was reflected on other indices, with significant improvements in burden of care, coping and distress that were more a function of intervention than the control condition. All gains were maintained at the nine-month follow-up. Additionally, assessment of relapse rates at this follow-up interval indicated that no client had relapsed. Overall the results suggested that although knowledge increased as a result of education, the improvements in all indicators other than knowledge appeared to be due to education combined with some non-specific factors. These non-specific factors may have included expectancy effects, setting effects, sampling bias and other possibilities. These issues are considered in terms of implementation of brief programs in supportive community settings and in terms of future research.