Training Health Professionals to Conduct Family Education for Families of Patients with First-Episode Psychosis: Adherence to Protocol

Article excerpt

Objective: The implementation of family psychoeducation at the service delivery level is not without difficulty. Few mental health professionals receive special training to work with families especially in Iran. The aim of the present study was to evaluate the effectiveness of training health professionals in terms of their adherence to protocol.

Method: Eight professionals (general practitioners, nurses and social workers) participated in a training program for health professionals as part of the Roozbeh First-Episode Psychosis Program (RooF) to conduct family psychoeducation. Training included a 3-day- workshop and 12 supervision sessions during the course of the implementation of the psychoeducation program. The family psychoeducation sessions (multiple-family group or single-family home-based) were tape-recorded. Transcripts of the audiotaped sessions were analyzed based on the content of the manual and were scored accordingly.

Results: Twenty-four recorded sessions were analyzed in terms of the adherence to protocol, the number of questions and the time for each session. The overall rating showed a 72% adherence to the protocol. Multiple-family group sessions had a higher rate compared to the singlefamily home-based family psychoeducation sessions (79% to 69%) as well as the time spent and questions asked. The rate of adherence to the protocol of conducting the family psychoeducation sessions had not changed over time .

Conclusion: Considering the amount of time taken for training and supervision, the level of adherence to the protocol was satisfactory. Tape recording sessions and regular supervision would be beneficial following specialized training. Further research is needed to tailor the amount of training and supervision required for professionals to conduct family psychoeducation programs in different settings.

Key words: Family Psychoeducation, Guideline adherence, Health education, Inservices training, Psychotic Disorders, Professional education, Staff development,

Iran J Psychiatry 2010; 5:7-10

Working with families of patients with a mental illness has proven to be effective in reducing the relapse rate for these patients and the distress level of their families (1- 2). However, despite this significant research and policy development, implementation of family work at the service delivery level is rarely available and not without difficulty for a number of reasons (3- 4). In addition to limited resources, one main reason is that few mental health professionals have specific skills for working with families (5- 6). On the other hand, despite the growing interest in the assessment of program implementation, little is known about the best way to evaluate whether a particular program has been implemented for the intended service to a minimally acceptable level (7).

The extent to which clinicians can implement empirically validated therapies with adequate fidelity is a crucial factor in treatment programs (8).

There has been a rapid growth of clinical guidelines and training manuals for clinical practices (9). The issue of adherence to these guidelines and manuals is important in terms of quality of the care. Another important consideration is the fact that with our limited resources in the mental health services in Iran, finding the minimum amount of training and supervision required to ensure adherence is also very important.

The aim of the present study was to evaluate the effectiveness of training health professionals in terms of their adherence to a family psychoeducation manual for families of patients with first-episode psychosis.

Materials and Methods

The method used in this study was the evaluation of a training program based on a descriptive analysis. Eight health professionals (general practitioners, nurses and social workers) participated in a training program to conduct family psychoeducation as part of the Roozbeh First-Episode Psychosis Program (RooF). …