Department of Psychology, University of Calcutta, Rashbehari Siksha Prangan (Commonly Known As Rajabazar Science College Campus), 92, Acharya Prafulla Chandra Road, Kolkata, West Bengal, 700009, India.
BMC Psychiatry. 2024 Sep 12;24(1):613. doi: 10.1186/s12888-024-05993-9.
End of traditional institutionalized psychiatric care, diagnostic complexities, and associated stigma often negatively impact the social networks of caregivers, making them experience social isolation. Not the "identified patients", caregiver perspectives are typically overlooked further adding to anticipatory stigma resulting in social death among them. Caregiving experience results in developing coping skills, preventing carers from responding to the nuances of the context, and identifying the useful rules- "Experiential Avoidance". Psycho-education is typically combined with other formal treatment programs for case conceptualization, and to provide a clear rationale for the treatment approach but less as a distinct psychotherapy. Borrowing the philosophy of Functional Contextualism, the present study developed a "Present-Moment Awareness" guided psychoeducational intervention. The aim was to reduce schizophrenia caregiver burden and anticipatory stigma and promote the value of caregiver participation as 'experts by experience'.
Five family caregivers of remitted schizophrenia patients were recruited using purposive sampling. Pre-post measure was taken on caregiver burden, caregiving experience, sense of personal mastery, and caregiving competence. Results were analysed quantitatively and qualitatively.
A significant decrease in caregiver burden, stigma, and negative effects on the family in post-intervention was observed. Self-compassion led to a rise in a sense of empowerment.
A caregiver-centred "Present-Moment Awareness" guided psycho-education for schizophrenia caregivers can be considered a possible means to address perceived stigma in caregivers and to reduce associated distress of carers.
传统的制度化精神科护理结束、诊断的复杂性以及随之而来的污名将对照顾者的社交网络产生负面影响，使他们感到社交孤立。照顾者的观点通常被忽视，而不是“确定的患者”，这进一步加剧了预期的污名，导致他们在社会中“死亡”。照顾经历导致发展应对技能，防止照顾者对环境的细微差别做出反应，并识别有用的规则——“经验回避”。心理教育通常与其他正式的治疗方案结合使用，以进行病例概念化，并为治疗方法提供明确的理由，但作为一种独特的心理治疗方法则较少。本研究借鉴功能语境主义的哲学，开发了一种“当下意识”指导的心理教育干预措施。目的是减轻精神分裂症照顾者的负担和预期的污名，并促进照顾者作为“经验专家”的参与价值。
采用目的抽样法招募了 5 名缓解期精神分裂症患者的家庭照顾者。在干预前后对照顾者负担、照顾经验、个人掌控感和照顾能力进行了测量。结果进行了定量和定性分析。
干预后，照顾者负担、污名和对家庭的负面影响显著下降。自我同情导致赋权感的增强。
以照顾者为中心的“当下意识”指导的精神分裂症照顾者心理教育可以被视为一种可能的方法，可以解决照顾者的感知污名，并减轻照顾者的相关痛苦。
