Young adult perspectives on treatment engagement and family communication during psychosis

Bediha Ipekci, PhD (1,2); Heather Thibeau, BA (2); Emily Barnard, BA (2); Jada Gibbs, MPH (2); Emily Kline, PhD (1,2)
1: Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA
2: Wellness & Recovery After Psychosis Program, Boston Medical Center, Boston, MA

Background: Positive clinical outcomes of novel early psychosis interventions has sparked interest among researchers. However, treatment non-adherence among individuals who experience first-episode psychosis (FEP) is highly prevalent. Family involvement is considered the best practice for FEP treatment. A positive patient-MHP relationship plays an important role in early psychosis treatment in regards to enhancing treatment engagement, clinical outcomes, well-being, and global functioning (Berry et al., 2016). Reducing the duration of untreated psychosis and preventing treatment dropout may be achieved by promoting both positive relationships with MHPs and family involvement in psychosis treatment.

Methods: We conducted qualitative interviews with 12 individuals who have been diagnosed with a psychotic disorder within the past 5 years. Participants were asked about current treatment, family involvement, and opinions on communication with their MHPs and family. Study staff analyzed the data using reflexive thematic analysis.

Results: Findings led to the following major themes: (1) Facilitators and barriers to robust treatment engagement, (2) Family involvement with treatment and communication about psychosis, and (3) Determinants of family communication quality. These themes highlight the pivotal role of the therapeutic alliance, measured family involvement, and positive family communication in facilitating treatment engagement.

Conclusions: The findings highlight the crucial role of the therapeutic alliance, measured family involvement, and positive family communication in facilitating treatment engagement for young adults with psychotic disorders. Communication quality is shaped by the individual preferences of young adults in terms of respect, privacy, autonomy, and support.