Internet-based psychoeducation and support programme for relatives of young people with early psychosis: results of the first German-language intervention

Mar Rus-Calafell; Tobias Teismann; Fine Kullmann; Dilara Alatas; Cristina Ballero-Reque; Julia Holewa; Marilena Rüsberg; Martin Brüne; Mercedes Paino; Silvia Schneider

doi:10.3389/fpsyt.2024.1248526

Internet-based psychoeducation and support programme for relatives of young people with early psychosis: results of the first German-language intervention

Front Psychiatry. 2024 Jan 16:15:1248526. doi: 10.3389/fpsyt.2024.1248526. eCollection 2024.

Authors

Mar Rus-Calafell^{1

2}, Tobias Teismann^{1

2}, Fine Kullmann¹, Dilara Alatas¹, Cristina Ballero-Reque¹, Julia Holewa¹, Marilena Rüsberg¹, Martin Brüne³, Mercedes Paino⁴, Silvia Schneider^{1

2}

Affiliations

¹ Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany.
² German Center of Mental Health (DZPG), Partner Site Bochum/Marburg, Bochum, Germany.
³ LWL University Hospital Bochum, Department of Psychiatry, Psychotherapy and Preventive Medicine, Division of Social Neuropsychiatry and Evolutionary Medicine, Ruhr University Bochum, Bochum, Germany.
⁴ Department of Psychology, University of Oviedo, Oviedo, Spain.

Abstract

Background: International clinical guidelines recommend Family Interventions (FIs) especially for families of people at early stages of psychosis. The German S3 treatment guideline for schizophrenia gives FIs the highest level of clinical recommendation. However, some family relatives have limited access to these services due to health system constrains. Digital interventions have emerged as a solution to overcome this hindered access to evidence-based family interventions.

Objective: The present pilot study evaluates the feasibility and potential efficacy of the first German moderated online psychoeducation and support programme (ePSP) for relatives of people with early psychosis, with the additional purpose to improve accessibility and reduce waiting times.

Methods: A pre-post study was performed. A brief recruitment period was pre-established (10 weeks) to test potential improvement of regular therapy waiting times in Germany. A total of 25 relatives of people with early psychosis were recruited and received the 12-week moderated online intervention. Assessments were conducted at baseline and at post intervention. Acceptance of the intervention and the user's experience were also evaluated at post intervention.

Results: Recruitment, retention rates and qualitative data support the feasibility and acceptability of the ePSP. Significant positive effects of the interventions were found on key therapeutic targets, including both primary outcomes (i.e., perceived stress and beliefs about the illness). Twenty-one participants also completed the open-ended questions of the user experience questionnaire, which yielded three main themes: most important modules, difficulties in using the programme and ways to improve ePSP.

Discussion: These results provide preliminary efficacy estimates for a fully powered RCT to investigate superiority (or equipoise) effects of the ePSP in comparison to the routine face-to-face family therapy groups. This future RCT will also allow further exploration of ePSP to improve access to psychological therapy for relatives of young people with psychosis, also in relation to the new ground-breaking Digital Healthcare Act in Germany.

Keywords: digital mental health; digitalisation; early psychosis; family intervention; psychotherapy access.

Grants and funding

This study was partially supported by the Sofja Kovaleskaja Award (Alexander von Humboldt Foundation and Ministry of Education and Research, Germany), awarded to the first author MR-C.