The effectiveness of a group intervention program and family psychoeducation to improve functioning and reduce self-stigma

Schizophrenia is a mental health problem that results in multifaceted losses for patients and their relatives. In addition to psychopharmacological treatments, psychosocial interventions involving patients and their relatives aim to improve the lives of patients and their relatives. In this quasi-experimental study, a 9-session cognitive-behavioral group psychotherapy program was developed for schizophrenia patients to increase the level of functioning and reduce self-stigma. At the same time, a psychoeducation intervention consisting of 10 booklets was designed for the caregivers of the patients, aiming to reduce the burden of caregiving and self-stigmatization of relatives. The study was completed with a total of 38 patients and their relatives. In one condition of the study, relatives received the psychoeducational intervention and patients participated in group psychotherapy (n = 13). In the other condition, only patients participated in group psychotherapy (n = 11). Patients and relatives in the control condition did not receive any intervention other than standard treatment practices throughout the study (n = 14). Functional Remission of General Schizophrenia Scale and Functioning Assessment Short Test were used to measure functionality, Self-Stigma Inventory for Patients and Social Stigmatization Due to Seeking Psychological Help Scale were used to measure stigmatization, and life satisfaction levels were measured with the Life Satisfaction Scale. The caregiver burden was measured with the Perceived Family Burden Scale, stigmatization levels were measured with the Self-Stigma Inventory for Families, negative beliefs about mental illness were measured with the Beliefs Towards Mental Illness Scale and life satisfaction was measured with the Life Satisfaction Scale. Measurements were taken from both patients and their relatives before the intervention, within one week after the intervention and three months after the last measurement. Repeated Measures Analysis of Variance and Kruskal-Wallis H Test statistical analyses were used to test the research hypotheses. The findings of the study show that there was an improvement in the functionality levels of the patients after the intervention in the condition in which the patient and the relative received intervention together, compared to the non-intervention condition and this improvement was maintained during the three-month follow-up period. No significant change was found in patients' self-stigmatization and life satisfaction scores after the intervention. In terms of the relatives; the caregiving burden and self-stigmatization scores perceived by the relatives in the condition in which the relatives participated in psychoeducation compared to the non-intervention condition showed a significant decrease after the intervention and this decrease was maintained during the 3 month follow-up period. Life satisfaction scores of family members who participated in psychoeducation increased significantly compared to the other two conditions. The findings indicate that the psychosocial interventions developed within the scope of the study are beneficial for patients, but when families are included in the intervention, the effect is greater and more permanent in terms of both patient and caregiver variables. The findings are consistent with the literature. It is thought that designing interventions tailored to the needs of both the family and the patient in future studies may have a positive effect on the well-being levels and quality of life of schizophrenia patients and their relatives.