TY - JOUR

T1 - Remote care for caregivers of people with psychosis

T2 - Mixed methods pilot study

AU - Romm, K.L.

AU - Nilsen, L.

AU - Gjermundsen, K.

AU - Holter, M.

AU - Fjell, A.

AU - Melle, I.

AU - Repål, A.

AU - Lobban, F.

PY - 2020/7/28

Y1 - 2020/7/28

N2 - Background: A reduced availability of resources has hampered the implementation of family work in psychosis. Web-based support programs have the potential to increase access to high-quality, standardized resources. This pilot study tested the Norwegian version of the Relatives Education and Coping Toolkit (REACT), a web-based United Kingdom National Health Service program in combination with phone-based support by trained family therapists. Objective: We investigated how the program was perceived by its users and identified the facilitators and barriers to its clinical implementation. Methods: Relatives of people with psychosis were offered access to REACT and to weekly family therapist support (with 1 of 2 trained family therapists) for 26 weeks. Level of distress and level of expressed emotion data were collected at baseline and after 26 weeks using the Family Questionnaire and the Relatives Stress Scale. Both family therapists and a subset of the relatives were interviewed about their experiences after completing the program. Results: During the program, relatives (n=19) had a median of 8 (range 4-11) consultations with the family therapists. Postintervention, there was a significant reduction in stress and in expressed emotions in the relatives of people with psychosis. Interviews with the relatives (n=7) and the family therapists (n=2) indicated the following themes as important-the intervention turned knowledge into action; the intervention strengthened the feeling of being involved and taken seriously by the health services; and management support and the ability for self-referral were important, while lack of reimbursement and clinician resistance to technology were barriers to implementation. Conclusions: The service was found to offer a valued clinical benefit; however, strategies that aim to engage clinicians and increase organizational support toward new technology need to be developed. © Kristin Lie Romm, Liv Nilsen, Kristine Gjermundsen, Marit Holter, Anne Fjell, Ingrid Melle, Arne Repål, Fiona Lobban. Originally published in JMIR Mental Health (http://mental.jmir.org), 28.07.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Mental Health, is properly cited. The complete bibliographic information, a link to the original publication on http://mental.jmir.org/, as well as this copyright and license information must be included.

AB - Background: A reduced availability of resources has hampered the implementation of family work in psychosis. Web-based support programs have the potential to increase access to high-quality, standardized resources. This pilot study tested the Norwegian version of the Relatives Education and Coping Toolkit (REACT), a web-based United Kingdom National Health Service program in combination with phone-based support by trained family therapists. Objective: We investigated how the program was perceived by its users and identified the facilitators and barriers to its clinical implementation. Methods: Relatives of people with psychosis were offered access to REACT and to weekly family therapist support (with 1 of 2 trained family therapists) for 26 weeks. Level of distress and level of expressed emotion data were collected at baseline and after 26 weeks using the Family Questionnaire and the Relatives Stress Scale. Both family therapists and a subset of the relatives were interviewed about their experiences after completing the program. Results: During the program, relatives (n=19) had a median of 8 (range 4-11) consultations with the family therapists. Postintervention, there was a significant reduction in stress and in expressed emotions in the relatives of people with psychosis. Interviews with the relatives (n=7) and the family therapists (n=2) indicated the following themes as important-the intervention turned knowledge into action; the intervention strengthened the feeling of being involved and taken seriously by the health services; and management support and the ability for self-referral were important, while lack of reimbursement and clinician resistance to technology were barriers to implementation. Conclusions: The service was found to offer a valued clinical benefit; however, strategies that aim to engage clinicians and increase organizational support toward new technology need to be developed. © Kristin Lie Romm, Liv Nilsen, Kristine Gjermundsen, Marit Holter, Anne Fjell, Ingrid Melle, Arne Repål, Fiona Lobban. Originally published in JMIR Mental Health (http://mental.jmir.org), 28.07.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Mental Health, is properly cited. The complete bibliographic information, a link to the original publication on http://mental.jmir.org/, as well as this copyright and license information must be included.

KW - Early intervention

KW - EHealth

KW - Family work

KW - Innovation

KW - Mental health service

KW - Psychoeducation

KW - Psychosis

KW - REACT

U2 - 10.2196/19497

DO - 10.2196/19497

M3 - Journal article

VL - 7

JO - JMIR Mental Health

JF - JMIR Mental Health

SN - 2368-7959

IS - 7

M1 - e19497

ER -