Recent Studies of Family-to-Family
Two studies conducted through the University of Maryland and NAMI
Presented by Alicia Lucksted, PhD
Family to Family Institute at the June 2003 NAMI Annual Convention, Minneapolis
Project #1: Outcomes of the Peer-Taught 12-Week Family-to-Family Education Program for Severe Mental Illness
AUTHORS:
Lisa Dixon, M.D., M.P.H.1, 2
Alicia Lucksted, Ph.D. 1, 2
Bette Stewart, B.S. 1, 2
Joyce Burland, Ph.D.3
Clayton H. Brown, Ph.D.1,2,4
Leticia Postrado, Ph.D.1
Colleen McGuire, M.A.1
Marcia Hoffman, M.A. 1
Affiliations:
1 Center for Mental Health Services Research, University of Maryland Baltimore Department of Psychiatry, School of Medicine.
2 VISN-5 Veterans Affairs Mental Health Research, Education, and Clinical Center (MIRECC)
3 National Alliance for the Mentally Ill
4Department of Epidemiology and Preventive Medicine, University of Maryland Baltimore, School of Medicine.
STUDY SUMMARY:
Objective: Family-to-Family Education Program (FFEP)is a 12-week course for family members of adults with serious mental illness (SMI). This study evaluates the effectiveness of FFEP for several family member outcomes.
Method: The FFEP enrollees on a ‡3-month waiting list were eligible; 95 consenting family members agreed to four interviews (waitlist, pre- FFEP, post-FFEP, and 6 months post-FFEP)regarding subjective and objective burden, empowerment, and depression. Mixed effects ANOVA models tested hypotheses of decreased burden and increased empowerment after FFEP.
Results: The FFEP was associated with reduced subjective burden (P < 0.01) and increased empowerment (P < 0.01)without changes in objective burden. Knowledge about SMI, understanding the mental health system, and self-care also improved. There was no significant decay at 6-month followup.
Conclusion: This study provides evidence that FFEP is helpful to relatives of persons with SMI by reducing subjective burden and worry, and increasing empowerment, knowledge about SMI, understanding the mental health system, and self-care.
For a full copy of the published article about this study please see here.
Project #2: Benefits and Changes for Family to Family Graduates: Report to NAMI of Qualitative Outcome Interviews with FtF Graduates
AUTHORS:
Alicia Lucksted, PhD1
Bette Stewart, BA1,2
Affiliations:
1 Center for Mental Health Services Research, University of Maryland Baltimore Department of Psychiatry, School of Medicine.
2 Family to Family Statewide Coordinator, NAMI- Maryland
STUDY SUMMARY:
Family members of people with serious mental illnesses (SMI) often experience considerable worry, stress, and need for information and support as they try to assist their ill relatives and adjust to the changes that SMI brings to the family system. The Family to Family Education Program (FtF) is a structured, peer-led, 12-week information and support class for such family members, organized and distributed by the National Alliance on Mental Illness (NAMI). Each FtF course is taught by a team of family members who are trained graduates of the program itself. While very popular in many states, FtF has only recently been formally evaluated (Dixon et al. 2004), showing reduced subjective burden and increased empowerment among participants.
The present qualitative study sought to better understand what change processes are catalyzed by FtF participation, ostensibly leading to these benefits. Our purpose was both to understand FtF better and to add to the field’s overall understanding of processes in self-help. We conducted semi-structured audiotaped interviews with 31 FtF graduates, 1-3 months after the course, focusing on changes sparked by the course that had become integrated into their daily lives and what they perceived to have brought them forth. Qualitative data analysis combined several iterative strategies to discern categories of changes, influential aspects of the course, and processes that may link each. These strategies included mapping out each “change link” that a participant described and then integrating these into chains of change – and eventually into an overall diagram depicting the change pathway we discerned from the interviews.
Data indicated that a combination of new factual and emotional information shifted participants’ “usual” frameworks of understanding about SMI, and then, in combination with new skills and perspectives taught in the class, allowed participants to adopt more adaptive perspectives on their relative’s illness and their own care-giving and family roles. These shifts, varying individually, led to both proximal positive changes (better family communication, less anger) and more distal benefits for the FtF participants (less stress, less conflicting relationships). Participants also reflected on other aspects of experiencing the FtF program, including differential benefit depending on when they participated in the course and engagement and retention dynamics.
For a full copy of the report on this study written for NAMI please see here.
This study was published in Acta Psychiatr Scand. 2004 Mar;109(3):207-15.
Alicia Lucksted, aluckste@psych.umaryland.edu or (410) 706-2490
Related Files
Nami Report Final (PDF File)
Waitlist Study published in Acta (PDF File)
Related Links
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