Exploring the preferences of multiple stakeholder groups for family involvement in early intervention services for...

There is consistent evidence that family involvement leads to improved outcomes in psychosis. However, less is known about various stakeholders' (patients, families, clinicians) preferences. This study aimed to understand stakeholders' views about involving families in care for youth experiencing early psychosis using a cross-sectional mixed-methods design. The study was conducted at an early intervention service for psychosis in Montreal. Nine participants (patients, family members, clinicians) were purposively recruited. They participated in a one-day workshop using nominal group technique, whose discussion was subjected first to thematic and then content analysis to develop statements/recommendations regarding family involvement, which were ranked by participants. Three themes were identified from the thematic analyses of the discussion: Meaning and value of family involvement, Factors influencing family involvement, and Preferred ways and methods of family involvement. Thereafter, 40 statements under 4 questions related to family involvement were extracted from the discussion and ranked by participants from 1-10 in decreasing order of importance through an e-survey. The ranking indicated stakeholder consensus that: families be involved during crises/relapse; maintaining contact with each other is the responsibility of treating teams and families; there be guidelines for family involvement; and even when patients are disinclined to involve families in treatment, teams could receive information from and share general information with families. Patients, families, and clinicians agreed that contact between families and treating teams needs to continue throughout treatment. There were differences among them about the method, frequency, and content of contacts, which were seen as varying based on clinical, familial, and developmental factors. While all agreed that consent/confidentiality be respected, there was consensus that these need not deter family involvement. Our findings highlight the value of trialogue(s) between patients, families and treating teams regarding family involvement in treatment.