Chen Fang-pei, Gearing Robin E, DeVylder Jordan E, Oh Hans Y
School of Social Work, Columbia University, New York, New York, USA.
Early Interv Psychiatry. 2016 Apr;10(2):122-8. doi: 10.1111/eip.12159. Epub 2014 Jun 4.
Parents and caregivers are confronted with many challenges when caring for adolescents experiencing first-episode psychosis (FEP). Understanding and support for parental help-seeking process is essential for adolescents' timely access to treatment. The study aimed to develop a pathway model of parental help seeking for adolescents experiencing FEP and identify crucial time points for intervention.
Directed content analysis was conducted on semi-structured qualitative interviews of 16 parents whose children had experienced FEP and focused on parents' experiences prior to and during FEP until first hospitalization.
The resultant parental help seeking for FEP model included two stages and six phases. The contemplation stage is composed of phases of initial awareness, recognizing severity and considering options. The action stage entailed help-seeking intention, securing help and service appraisal. All parents promptly began help seeking after recognizing severe symptoms and sought advice from professional and community supports, although parents' lack of initial awareness was common. Further analysis on individual parents' help-seeking trajectories showed that among the 50% parents who reported pre-existing childhood conditions, 87.5% did not report initial awareness of psychotic symptoms.
Findings recommend intervention at three specific periods of help seeking. First, psychoeducation is needed when parents first engage with health care for their children's disabling conditions. Professionals treating childhood conditions need training to vigilantly monitor the overall mental health of the children over time. Second, it is important to enhance the roles of formal and informal community resources in facilitating parental help seeking. Finally, family-focused interventions are essential in supporting the family for securing needed treatment.
在照顾首次发作精神病（FEP）的青少年时，父母和照顾者面临着诸多挑战。理解并支持父母的求助过程对于青少年及时获得治疗至关重要。本研究旨在构建FEP青少年父母的求助途径模型，并确定关键干预时间点。
对16名孩子患有FEP的父母进行半结构化定性访谈，采用定向内容分析法，重点关注父母在FEP之前及期间直至首次住院的经历。
由此产生的FEP父母求助模型包括两个阶段和六个时期。思考阶段由初始意识、认识到严重性和考虑选择等时期组成。行动阶段包括求助意图、获得帮助和服务评估。所有父母在认识到严重症状后都迅速开始求助，并向专业和社区支持机构寻求建议，不过父母缺乏初始意识的情况很常见。对个体父母求助轨迹的进一步分析表明，在报告孩子有既往童年疾病的50%的父母中，87.5%没有报告对精神病症状的初始意识。
研究结果建议在求助的三个特定时期进行干预。第一，当父母首次因孩子的致残状况寻求医疗保健时，需要进行心理教育。治疗童年疾病的专业人员需要接受培训，以便随着时间的推移密切监测孩子的整体心理健康状况。第二，加强正式和非正式社区资源在促进父母求助方面的作用很重要。最后，以家庭为中心的干预对于支持家庭获得所需治疗至关重要。
