Psychoeducational interventions for family members of people with schizophrenia: a mixed-method systematic review

This systematic review investigates the effectiveness of psychoeducation in improving the well-being of family members of people with schizophrenia and identifies the common ingredients, implementation considerations, and participants' feedback.

Published articles in either English or Chinese which reported psychoeducational intervention studies that targeted family members of people with schizophrenia as participants, were searched with the keywords schizophrenia and/or psychosis and psychoeducation/psychoeducational interventions in 8 databases (MEDLINE, PsycINFO, CINAHL, EMBASE, Web of Science, Applied Social Sciences Index and Abstracts [ASSIA], Cochrane Reviews Library, and CENTRAL), from the time of inception of the various databases to March 2012.

Fifty-eight articles reporting 44 research studies met all the inclusion criteria and the quality assessment requirement and were included in the review.

Data from trials, quantitative studies, and qualitative research were extracted to address 3 parallel syntheses, following the Evidence for Policy and Practice Information Coordination Centre mixed-method systematic approach.

Psychoeducation was found to be consistently effective in improving family members' knowledge and coping. However, it was less successful in changing family members' psychological morbidities, burden, or expressed emotion. Common ingredients across interventions included coverage of common coping strategies and problem-solving strategies to enhance communication or coping. Particularly valued by family carers were a group format to share experiences with other carers, skillful facilitation by professionals, and knowledge and skill development.

This review indicates that psychoeducation should be routinely provided to family members as early as possible following contact with health services. Suggestions are made for optimal psychoeducational intervention design and its successful implementation, and for further research to establish the enhanced effect of booster sessions, between-session practice, and online delivery.