Effectiveness of psychoeducational interventions for family carers of people with psychosis: A systematic review and meta-analysis
Open accessAbstract
Psychoeducational interventions for family carers of people with psychosis are effective for improving compliance and preventing relapse. Whether carers benefit from these interventions has been little explored. This systematic review investigated the effectiveness of psychoeducation for improving carers' outcomes, and potential treatment moderators. We searched for randomised controlled trials (RCTs) published in English or Chinese in eight databases. Carers' outcomes included wellbeing, quality of life, global morbidities, burden, and expressed emotion. Thirty-two RCTs were included, examining 2858 carers. Intervention duration ranged from 4 to 52weeks, and contact times ranged from 6 to 42hours. At post intervention, findings were equivocal for carers' wellbeing (SMD 0.103, 95% CI -0.186 to 0.392). Conversely, psychoeducation was superior in reducing carers' global morbidities (SMD -0.230, 95% CI -0.386 to -0.075), perceived burden (SMD -0.434, 95% CI -0.567 to -0.31), negative caregiving experiences (SMD -0.210, 95% CI -0.396 to -0.025) and expressed emotion (SMD -0.161, 95% CI -0.367 to -0.045). The lack of available data precluded meta-analysis of outcomes beyond short-term follow-up. Meta-regression revealed no significant associations between intervention modality, duration, or contact time and outcomes. Further research should focus on improving carers' outcomes in the longer-term and identifying factors to optimise intervention design.
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The difficulties carers describe in accessing interventions are due in part to a lack of funding or resources, unmet training needs of the workforce, and service priorities centred on patients.
“in part, due to a lack of funding or resources, unmet training needs of the workforce, and service priorities which are centred on patients (Sin et al., 2017;Sin, Gillard, et al., 2016;Sin, Henderson, Spain, Gamble, et al., 2016).”
From eHealth interventions for family carers of people with long term illness: A promising approach? (2018) · cites this paper as Sin et al., 2017
Training family/informal supporters is one of the suggested solutions to their burden.
“Training family/informal supporters is one of the suggested solutions to their burden 321,322 .”
From Ethical challenges in contemporary psychiatry: an overview and an appraisal of possible strategies and research needs (2024) · cites this paper as [322]
With training, supporters' morbidities, perceived burden, and negative expressed emotion have been found to decrease.
“With training, supporters' morbidities, perceived burden, and negative expressed emotion have been found to decrease 322 .”
From Ethical challenges in contemporary psychiatry: an overview and an appraisal of possible strategies and research needs (2024) · cites this paper as [322]
Psychoeducational interventions, especially those delivered in a group format, are widely recommended and practiced around the world.
“Consequently, psychoeducational interventions, especially those delivered in a group format, as a discrete treatment on their own or augmenting other treatments (eg, family intervention or mutual support programs) are widely recommended and practiced around the world [14,18,20].”
From A multicomponent eHealth intervention for family Carers for people affected by psychosis: a coproduced design and build study (2019) · cites this paper as [14]
Poor well-being may hamper carers' caregiving capacity.
“Research evidence also suggests that poor well-being may hamper carers’ caregiving capacity.”
From A multicomponent eHealth intervention for family Carers for people affected by psychosis: a coproduced design and build study (2019) · cites this paper as [14]
Improved knowledge about coping strategies and available resources can lead to a more positive appraisal of caregiving experiences and carers' perceived self-efficacy in coping with demands.
“Improved knowledge about coping strategies and available resources can lead to a more positive appraisal of their caregiving experiences and carers’ perceived self-efficacy in coping with the demands [14,24].”
From A multicomponent eHealth intervention for family Carers for people affected by psychosis: a coproduced design and build study (2019) · cites this paper as [14]
Caring demands can jeopardize carers' well-being.
“Conversely, it is well established that caring demands can jeopardize carers’ well-being [2,13,14].”
From A multicomponent eHealth intervention for family Carers for people affected by psychosis: a coproduced design and build study (2019) · cites this paper as [14]
Carers who feel they are not supported and lack resources to cope are less likely to engage in caring for their loved ones or more likely to exhibit critical or hostile behavior toward the cared-for individuals.
“Carers who feel they are not supported and lack resources (eg, information about the illness condition and related management issues) to cope are less likely to engage in caring for their loved ones or more likely to exhibit critical or hostile behavior toward the cared-for individuals, albeit unintentionally [13,14,17].”
From A multicomponent eHealth intervention for family Carers for people affected by psychosis: a coproduced design and build study (2019) · cites this paper as [14]
With the benefits of access, facilitation, and delivery completely through the internet, our product has the potential to provide an evidence-based psychoeducational intervention with its key ingredients.
“With the benefits of access, facilitation, and delivery completely through the internet, our product has the potential to provide an evidence-based psychoeducational intervention with its key ingredients [14,19].”
From A multicomponent eHealth intervention for family Carers for people affected by psychosis: a coproduced design and build study (2019) · cites this paper as [14]
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- Sin, J., & Norman, I. (2013). Psychoeducational interventions for families of individuals with schizophrenia: A mixed method systematic review. Journal of Clinical Psychiatry, 74(12), e1145-e1162.
- Authors
- Sin, J., Gillard, S., Spain, D., Cornelius, V., Chen, T., & Henderson, C.
- Affiliations
- St George's, University of London (GB)
- King's College London (GB)
- Imperial College London (GB)
- Liverpool School of Tropical Medicine (GB)
- Corresponding author
- Sin, Jacqueline
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2017-08
- Volume
- 56
- Pages
- 13-24
- ISSN
- 0272-7358 (ISSN-L)
- OpenAlex
- W2619827223
- Cited by
- 192
- References
- 94
- Citations by year
- 2026: 15 · 2025: 23 · 2024: 20 · 2023: 18 · 2022: 32 · 2021: 25 · 2020: 26 · 2019: 15 · 2018: 14 · 2017: 2
- FWCI
- 2.39
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Psychology Review (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSTM Online Archive (Liverpool School of Tropical Medicine) (acceptedVersion)
- CentAUR (University of Reading) (acceptedVersion)
- City Research Online (City University London) (acceptedVersion)
- St George's Online Research Archive (St George's University of London) (submittedVersion, other-oa)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Spiral (Imperial College London) (submittedVersion, other-oa)
- Funders
- National Institute for Health and Care Research (PDF-2015-08-035)
- King's College London
- Topics
- Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
- Keywords
- psychoeducation, family caregivers, psychosis, caregiver well-being, caregiver burden, expressed emotion, quality of life, relapse prevention, treatment moderators, intervention duration
- MeSH terms
- Family, Humans, Psychotherapy, Psychotic Disorders, Caregivers
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