Kline Emily R, Thibeau Heather, Sanders Aliyah S, English Kelly, Davis Beshaun J, Fenley Alicia R, Keshavan Matcheri S
Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States.
Department of Psychiatry, Harvard Medical School, Boston, MA, United States.
Front Psychiatry. 2021 Apr 1;12:659568. doi: 10.3389/fpsyt.2021.659568. eCollection 2021.
Treatment delay and non-adherence in first episode psychosis is a pressing public health problem. Ambivalence regarding psychiatric intervention and labeling among young people with psychosis is a contributing factor. For these individuals, caregivers often facilitate the pathway to care and support ongoing engagement and adherence. Caregivers describe distress and burden associated with this role. This manuscript describes the development and pilot feasibility testing of a motivational interviewing-derived communication training for caregivers of individuals with untreated or under-treated early course psychosis. Individuals with lived experience were consulted in the intervention development process. The training consisted of four 60-min sessions teaching the philosophy and basic skills of motivational interviewing as well as two brief practice calls. Feasibility was assessed with regard to study enrollment, retention, and completion. Satisfaction was assessed through the Client Satisfaction Questionnaire and qualitative feedback. Thirty-one caregivers consented to this pilot feasibility trial and participated via telehealth over the course of 5 months. Intervention completion and reported satisfaction were high, with 94% of consented participants completing at least three training sessions and 84% reporting that they would "definitely" recommend the training to a friend in similar circumstances. There were no between-clinician differences in MILO session attendance ( = 0.53, = 0.596) or satisfaction total scores ( = 1.03, = 0.371). Brief motivational interviewing skills training appears to be a feasible and valued intervention for caregivers of individuals with poorly managed early course psychosis. ClinicalTrials.gov Identifier: NCT04010747.
首发精神病的治疗延迟和不依从是一个紧迫的公共卫生问题。精神病患者对精神科干预和标签存在矛盾心理是一个促成因素。对于这些个体,照顾者通常会推动其获得治疗的途径,并支持其持续参与治疗和坚持治疗。照顾者描述了与该角色相关的痛苦和负担。本文描述了一种针对未治疗或治疗不足的早期精神病患者照顾者的、源自动机性访谈的沟通培训的开发及初步可行性测试。在干预开发过程中咨询了有实际经验的个体。该培训包括四个60分钟的课程,教授动机性访谈的理念和基本技能,以及两次简短的练习通话。从研究招募、保留和完成情况方面评估可行性。通过客户满意度问卷和定性反馈评估满意度。31名照顾者同意参与这项初步可行性试验,并在5个月的时间里通过远程医疗参与。干预完成率和报告的满意度很高,94%同意参与的参与者完成了至少三次培训课程,84%的人表示他们“肯定会”向处于类似情况的朋友推荐该培训。在动机性访谈学习观察(MILO)课程的出席率(F = 0.53,p = 0.596)或满意度总分(F = 1.03,p = 0.371)方面,临床医生之间没有差异。简短的动机性访谈技能培训似乎是一种可行且有价值的干预措施,适用于早期精神病管理不善的患者的照顾者。 临床试验.gov标识符:NCT04010747。