Young Adult Perspectives on Communication with Family and Clinical Providers During First Episode Psychosis Treatment
Bediha Ipekci, PhD (1,2); Heather Thibeau, BA (1); Jada Gibbs, MPH (1); Emily Kline, PhD (1,2)
1. Department of Psychiatry, Boston Medical Center
2. Boston University School of Medicine
Abstract
Background: Treatment non-adherence among individuals who experience first-episode psychosis (FEP) is highly prevalent. Coordinated, multidisciplinary intervention care may deter high dropout rates, and family involvement is a strong proponent of this type of intervention. We asked young adults who recently experienced their first episode of psychosis to share their opinions and experiences of communication with their family and their treatment team.
Methods: Young adults were recruited who had an onset of psychosis within the past 5 years and were between 18-35 years of age. Using a semi-structured interview, participants were asked questions about what treatment they were involved in, how much their family is involved with treatment and their opinions on communication with their treatment team and their family. Research staff then coded to find important themes.
Results: Frequency analysis of the interviews revealed (1) a robust engagement with treatment is influenced positively by therapeutic alliance and clinical benefit and negatively by structural barriers and interpersonal barriers; (2) expectations from family include a deeper understanding of psychosis and current psychological condition of the individual with psychosis; and (3) the quality of communication with family is impacted by the caregiver’s response to the individual’s varying needs for respect, privacy, autonomy, and care.
Conclusion: Listening to young adults’ opinions on their experiences can provide insight into what type of support best facilitates treatment adherence. The results suggest that family-focused interventions that target enhancing communication and interpersonal dynamics between caregivers and young adults might support treatment engagement and the general well-being of the youth. The results also revealed that positive patient-provider relationships, prioritizing therapeutic alliance with a crucial focus on a non-judgmental, caring, and respectful approach, are another key element to treatment engagement.