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Outcomes and change processes of an established family education program for carers of adults diagnosed with a serious mental health condition

Published online by Cambridge University Press:  29 April 2019

John Farhall Open the ORCID record for John Farhall [Opens in a new window] ,
Marilyn L. Cugnetto Open the ORCID record for Marilyn L. Cugnetto [Opens in a new window] ,
Stephanie Mathews ,
Kirk Ratcliff ,
Sue Farnan ,
Kate Higgins  and
Emma Constantine
John Farhall*
Affiliation:
Academic Psychology Unit, NorthWestern Mental Health, Epping, Australia Department of Psychology and Counselling, La Trobe University, Bundoora, Australia
Marilyn L. Cugnetto
Affiliation:
Academic Psychology Unit, NorthWestern Mental Health, Epping, Australia Department of Psychology and Counselling, La Trobe University, Bundoora, Australia
Stephanie Mathews
Affiliation:
Academic Psychology Unit, NorthWestern Mental Health, Epping, Australia Department of Psychology and Counselling, La Trobe University, Bundoora, Australia
Kirk Ratcliff
Affiliation:
Wellways Australia, Fairfield, Australia
Sue Farnan
Affiliation:
Wellways Australia, Fairfield, Australia
Kate Higgins
Affiliation:
Wellways Australia, Fairfield, Australia
Emma Constantine
Affiliation:
Wellways Australia, Fairfield, Australia
*
Author for correspondence: John Farhall, E-mail: j.farhall@latrobe.edu.au
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Abstract

Background

Family education programs (FEPs) target caregiving-related psychological distress for carers of relatives/friends diagnosed with serious mental health conditions. While FEPs are efficacious in reducing distress, the mechanisms are not fully known. Peer group support and greater mental health knowledge are proposed to reduce carers' psychological distress by reducing stigmatising attitudes and self-blame, and strengthening carers' relationship with their relative.

Methods

Adult carers (n = 1016) who participated in Wellways Australia's FEP from 2009 to 2016 completed self-report questionnaires at the core program's start and end, during the consolidation period, and at a 6-month follow-up. Those who enrolled early completed questionnaires prior to a wait-list period. We used linear mixed-effects modelling to assess the program's effectiveness using a naturalistic wait-list control longitudinal design, and multivariate latent growth modelling to test a theory-based process change model.

Results

While there was no significant change over the wait-list period, psychological distress, self-blame and stigmatising attitudes significantly decreased, and communication and relationship quality/feelings increased from the core program's start to its end. Changes were maintained throughout the consolidation period and follow-up. Peer group support significantly predicted the declining trajectory of distress. Peer group support and greater knowledge significantly predicted declining levels of self-blame and stigmatising attitudes, and increasing levels of communication.

Conclusions

This is the first study to quantitatively validate the mechanisms underlying the effect of FEPs on carers' psychological distress. Peer group support is key in modifying carers' appraisals of their friend/relatives' condition. Continued implementation of FEPs within mental health service systems is warranted.

Keywords

Carerfamily education programpeer supportself-blameserious mental health conditionstigma
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 7 , May 2020 , pp. 1099 - 1109
Copyright
Copyright © Cambridge University Press 2019

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