Psychological well-being and relationship outcomes in a randomized study of family-led education

Susan A Pickett-Schenk, Judith A Cook, Pamela Steigman, Richard Lippincott, Cynthia Bennett, Dennis D Grey
Archives of General Psychiatry 2006, 63 (9): 1043-50

CONTEXT: Family members of adults with mental illness often experience emotional distress and strained relationships.

OBJECTIVE: To test the effectiveness of a family-led educational intervention, the Journey of Hope, in improving participants' psychological well-being and relationships with their ill relatives.

DESIGN AND SETTING: A randomized controlled trial using a waiting list design was conducted in the community in 3 southeastern Louisiana cities.

PARTICIPANTS: A total of 462 family members of adults with mental illness participated in the study, with 231 randomly assigned to immediate receipt of the Journey of Hope course and 231 assigned to a 9-month course waiting list. Intervention The Journey of Hope intervention consisted of 8 modules of education on the etiology and treatment of mental illness, problem-solving and communication skills training, and family support.

MAIN OUTCOME MEASURES: Participants' psychological well-being and relationships with their ill relatives were assessed at study enrollment, 3 months after enrollment (at course termination), and 8 months after enrollment (6 months after course termination). Mixed-effects random regression analysis was used to predict the likelihood of decreased depressive symptoms, increased vitality, and overall mental health, and improved relationship ratings.

RESULTS: Intervention group participants reported fewer depressive symptoms, greater emotional role functioning and vitality, and fewer negative views of their relationships with their ill relatives compared with control group participants. These improved outcomes were maintained over time and were significant (P<.05 for all) even when controlling for participant demographic and relative clinical characteristics.

CONCLUSION: Results show that family-led educational interventions are effective in improving participants' psychological well-being and views of their relationships with ill relatives.

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