School of Health Sciences, University of Manchester, Manchester, UK.
Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
Psychol Psychother. 2023 Sep;96(3):697-715. doi: 10.1111/papt.12464. Epub 2023 Apr 5.
There is a significant risk of negative outcomes for families when a parent experiences serious mental illness. Family-focused practice (FFP) emphasises the "whole family" as the unit of care and has been found to improve outcomes for service users and their families. Despite its benefits, FFP is not routinely implemented in UK adult mental health services. This study explores adult mental health practitioners' experiences and views of FFP within Early Intervention Psychosis Services in the UK.
Sixteen adult mental health practitioners employed in three Early Intervention Psychosis teams in the Northwest of England were interviewed. Interview data were analysed using thematic analysis.
Five core themes were generated: (1) A limited understanding of FFP, (2) Our practitioners, (3) Our approach, (4) Our families and (5) Our services. Practitioners' understanding of FFP was limited and typically excluded dependent children. Practitioners' age, professional and personal experience, and preconceptions of families influenced delivery, and in turn, the engagement approach they adopted impacted families' responsiveness. The diversity and dynamics of service user families such as age, socioeconomic status, culture and stigma impacted FFP. An operational context characterised by insufficient resources reduced FFP; however, organisational structures such as leadership, clinical supervision and multi-disciplinary teams facilitated FFP.
FFP is not yet embedded within Early Intervention Services. Practice recommendations include agreeing on a formal definition of FFP and its scope; the development of FFP policy; clarity in relation to staff responsibilities and identities; the adoption of a collaborative approach which encourages service user choice and for time to be ring-fenced to prioritise FFP. Future research should ascertain service user and family views on the facilitators and barriers to engaging with FFP in Early Intervention Services.
当父母患有严重精神疾病时，家庭会面临重大的不良后果风险。以家庭为中心的实践（FFP）强调“整个家庭”作为护理单位，已被发现可改善服务使用者及其家庭的结果。尽管有其益处，但 FFP 在英国成人心理健康服务中并未常规实施。本研究探讨了英国早期精神病干预服务中成年心理健康从业者对 FFP 的经验和看法。
对英格兰西北部三个早期精神病干预小组中 16 名成年心理健康从业者进行了访谈。使用主题分析对访谈数据进行了分析。
产生了五个核心主题：（1）对 FFP 的理解有限，（2）我们的从业者，（3）我们的方法，（4）我们的家庭和（5）我们的服务。从业者对 FFP 的理解有限，通常排除了受抚养子女。从业者的年龄、专业和个人经验以及对家庭的成见会影响服务提供，进而影响他们采用的参与方法，从而影响家庭的反应能力。服务使用者家庭的多样性和动态性，如年龄、社会经济地位、文化和耻辱感，会影响 FFP。资源不足的运作环境会减少 FFP；但是，领导能力、临床监督和多学科团队等组织结构有助于 FFP。
FFP 尚未嵌入早期干预服务中。实践建议包括就 FFP 的正式定义及其范围达成一致；制定 FFP 政策；明确工作人员的职责和身份；采用鼓励服务使用者选择并为 FFP 留出时间的协作方法。未来的研究应确定服务使用者和家庭对早期干预服务中参与 FFP 的促进因素和障碍的看法。
