Indian Journal of Positive Psychology

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Wellness Enhancement Therapy (WET) to Reduce Expressed Emotion and Subjective Burden among the Family Caregivers of Schizophrenia Patients: A Pilot Study


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1 The Graduate School, University of Santo Tomas Manila, Philippines, United States
     

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Expressed emotion of the family caregivers is a reliable predictor of relapse in schizophrenia patients. The subjective burden of care affects the caregiver's quality of life and multiple areas of everyday life, leading to the impairment of caregiving role. The impaired caregiving role has negative impact on patient's well-being, course and prognosis of this disorder. Understanding the situation, the researcher developed the Wellness Enhancement Therapy (WET) to reduce Expressed Emotion (EE) and Subjective Caregiver Burden (SCB) of the primary family caregivers of the individuals with schizophrenia. The intervention integrated Cognitive Therapy (CT) and Dialectical Behavior Therapy (DBT) models. Family Questionnaire for expressed emotion (FQ-EE) and Burden Scale for Family Caregivers (BSFC-s) were used as assessment tools. Interviews and Focused -Group Discussions were carried out to have the clear understanding of the problem. The intervention was subjected to experts' validation by six interdisciplinary experts and a feasibility test was conducted with ten primary family caregivers with high EE and SCB. The results of the pilot study revealed that the Wellness Enhancement Therapy had a positive effect on the respondents to reduce Expressed Emotion and Subjective Caregiver Burden.

Keywords

expressed emotion, subjective caregiver burden, family caregivers, schizophrenia
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  • Caqueo-Urízar, A., Miranda-Castillo, C., & Lemos-Giráldez, S. (2014). An updated review on burden on caregivers of schizophrenia patients. Psicothema, 26(2), 235243. https://doi.org/10.7334/psicothema2013.86

  • Carrà, G., Cazzullo, C. L., & Clerici, M. (2012). The association between expressed emotion, illness severity and subjective burden of care in relatives of patients with schizophrenia. Findings from an Italian population. BMC Psychiatry, 12(1), 140. https://doi.org/10.1186/1471-244X-12-140

  • Cechnicki, A., Bielańska, A., Hanuszkiewicz, I., & Daren, A. (2013). The predictive validity of Expressed Emotions (EE) in schizophrenia: A 20-year prospective study. Journal of Psychiatric Research, 47(2), 208-214. https://doi.org/10.1016/j.jpsychires.2012.10.004

  • Chadda, R. (2014). Caring for the family caregivers of persons with mental illness. Indian Journal of Psychiatry, 56(3), 221. https://doi.org/10.4103/0019-5545.140616

  • Chadda, R. K., Singh, T. B., & Ganguly, K. K. (2010). A prospective study of relationship of caregivers' mental health with the perceived burden and coping in schizophrenia and bipolar affective disorder. Indian Journal of Social Psychiatry, 26(12), 45-51.

  • Chakrabarti, S. (2010). Impact of schizophrenia on caregivers: The Indian perspective. In P. Kulhara, A. Avasthi, and S. Grover (Eds.), Schizophrenia: The Indian scene (pp. 215-262). Chandigarh.

  • Chakraborty, S., Bhatia, T., Anderson, C., Nimgaonkar, V. L., & Deshpande, S. N. (2014). Caregiver's burden, coping, and psycho-education in Indian households with single- and multiple-affected members with schizophrenia. International Journal of Mental Health, 43(1), 30-49. https://doi.org/10.2753/IMH0020-7411430102

  • Graessel, E., Berth, H., Lichte, T., & Grau, H. (2014). Subjective caregiver burden: Validity of the 10-item short version of the Burden Scale for Family Caregivers BSFC-s. BMC Geriatrics, 14(1), 23. https://doi.org/10.1186/1471-2318-14-23

  • Grover, S., Pradyumna, & Chakrabarti, S. (2015). Coping among the caregivers of patients with schizophrenia. Industrial Psychiatry Journal, 24(1), 5-11. https://doi.org/10.4103/0972-6748.160907

  • Harvey, L. J., Hunt, C., & White, F. A. (2019). Dialectical behaviour therapy for emotion regulation difficulties: A systematic review. Behaviour Change, 36(3), 143-164. https://doi.org/10.1017/bec.2019.9

  • Hooley, J. M., & Parker, H. A. (2006). Measuring expressed emotion: An evaluation of the shortcuts. Journal of Family Psychology, 20(3), 386-396. https://doi.org/10.1037/0893-3200.20.3.386

  • Jagannathan, A., Thirthalli, J., Hamza, A., Nagendra, H. R., & Gangadhar, B. N. (2014). Predictors of family caregiver burden in schizophrenia: Study from an in-patient tertiary care hospital in India. Asian Journal of Psychiatry, 8, 94-98. https://doi.org/10.1016/j.ajp.2013.12.018

  • Konerding, U., Bowen, T., Forte, P., Karampli, E., Malmström, T., Pavi, E., Torkki, P., & Graessel, E. (2018). Investigating burden of informal caregivers in England, Finland and Greece: An analysis with the short form of the Burden Scale for Family Caregivers (BSFC-s). Aging and Mental Health, 22(2), 280-287. https://doi.org/10.1080/13607863.2016.1239064

  • Linehan, M. M., & Wilks, C. R. (2015). The course and evolution of dialectical behavior therapy. American Journal of Psychotherapy, 69(2), 97-110. https://doi.org/10.1176/appi.psychotherapy.2015.69.2.97

  • Lippi, G. (2016). Schizophrenia in a member of the family: Burden, expressed emotion and addressing the needs of the whole family. South African Journal of Psychiatry, 22(1), 7. https://doi.org/10.4102/sajpsychiatry.v22i1.922

  • McCann, T. V., Songprakun, W., & Stephenson, J. (2015). Effectiveness of guided selfhelp in decreasing expressed emotion in family caregivers of people diagnosed with depression in Thailand: A randomised controlled trial. BMC Psychiatry, 15(1), 258. https://doi.org/10.1186/s12888-015-0654-z

  • Madianos, M., Economou, M., Dafni, O., Koukia, E., Palli, A., & Rogakou, E. (2004). Family disruption, economic hardship and psychological distress in schizophrenia: Can they be measured? European Psychiatry, 19(7), 408-414. https://doi.org/10.1016/j.eurpsy.2004.06.028

  • Nerkar, A. G., & Bhise, S. B. (2019). Schizophrenia: A review. Current Trends in Pharmacy and Pharmaceutical Chemistry, 1(4), 19. Retrieved from https://www.researchgate.net/publication/339587642_Schizophrenia_A_Review

  • Parabiaghi, A., Lasalvia, A., Bonetto, C., Cristofalo, D., Marrella, G., Tansella, M., & Ruggeri, M. (2007). Predictors of changes in caregiving burden in people with schizophrenia: A 3-year follow-up study in a community mental health service. Acta Psychiatrica Scandinavica, 116(s437), 66-76. https://doi.org/10.1111/j.16000447.2007.01094.x

  • Parija, S., Yadav, A. K., Sreeraj, V. S., Patel, A. K., Yadav, J., & Jain, R. K. (2016). Caregiver burden and expressed emotion in caregivers of patients with schizophrenia. Journal of Psychosocial Rehabilitation and Mental Health, 3(2), 8387. https://doi.org/10.1007/s40737-016-0061-x

  • Partoiy-Ziraki, F., & Hassan, T. (2017). Investigating the effectiveness of dialectical behavior therapy in clinical symptoms, anger control and emotional regulation of bully children. International Journal of Clinical Medicine, 08(04), 277-292. https://doi.org/10.4236/ijcm.2017.84027

  • Pearlin, L. I. (2010). The life course and the stress process: Some conceptual comparisons. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 65B (2), 207-215. https://doi.org/10.1093/geronb/gbp106

  • Peng, M.M., Chen, H.L., Zhang, T., Yao, Y.Y., Li, Z.H., Long, L., Duan, Q.Q., Lin, F.R., Zen, Y., Chen, J., Ng, S.M., Chan, C.L.W., & Ran, M.S. (2019). Disease-related stressors of caregiving burden among different types of family caregivers of persons with schizophrenia in rural China. International Journal of Social Psychiatry, 65(78), 603-614. https://doi.org/10.1177/0020764019866224

  • Perroud, N., Nicastro, R., Jermann, F., & Huguelet, P. (2012). Mindfulness skills in borderline personality disorder patients during dialectical behavior therapy: Preliminary results. International Journal of Psychiatry in Clinical Practice, 16(3), 189-196.

  • Phongtankuel, V., Reid, M. C., Czaja, S. J., Teresi, J., Eimicke, J. P., Kong, J. X., Prigerson, H., Shalev, A., Dignam, R., Baughn, R., & Adelman, R. D. (2020). Caregiver-reported quality measures and their correlates in home hospice care. Palliative Medicine Reports, 1(1), 111-118. https://doi.org/10.1089/pmr.2020.0055

  • Sadath, A., Kumar, R., & Karlsson, M. (2019). Expressed emotion research in India: A narrative review. Indian Journal of Psychological Medicine, 41(1), 18-26. https://doi.org/10.4103/ijpsym.ijpsym_235_18

  • Satyakam, M., & NM, R. (2013). Expressed emotion in psychiatric disorders. Eastern Journal of Psychiatry, 16(1 & 2), 17-22.

  • Stanley, S., Balakrishnan, S., & Ilangovan, S. (2017). Psychological distress, perceived burden and quality of life in caregivers of persons with schizophrenia. Journal of Mental Health, 26(2), 134-141. https://doi.org/10.1080/09638237.2016.1276537

  • Venkatasubramanian, G., & Amaresha, A. (2012). Expressed emotion in schizophrenia: An overview. Indian Journal of Psychological Medicine, 34(1), 12. https://doi.org/10.4103/0253-7176.96149

  • Wang, X., Chen, Q., & Yang, M. (2017). Effect of caregiver's expressed emotion on the care burden and rehospitalization rate of schizophrenia. Patient Preference and Adherence, 11, 1505-1511. https://doi.org/10.2147/PPA.S143873

  • Wiedemann, G., Rayki, O., Feinstein, E., & Hahlweg, K. (2002). The family questionnaire: Development and validation of a new self-report scale for assessing expressed emotion. Psychiatry Research, 109(3), 265-279. https://doi.org/10.1016/S0165-1781(02)00023-9

  • Yusuf, A. J., & Nuhu, F. T. (2011). Factors associated with emotional distress among caregivers of patients with schizophrenia in Katsina, Nigeria. Social Psychiatry and Psychiatric Epidemiology, 46(1), 11-16. https://doi.org/10.1007/s00127-009-0166-6

  • Zalewski, M., Lewis, J. K., & Martin, C. G. (2018). Identifying novel applications of dialectical behavior therapy: Considering emotion regulation and parenting. Current Opinion in Psychology, 21, 122-126. https://doi.org/10.1016/j.copsyc.2018.02.013


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  • Wellness Enhancement Therapy (WET) to Reduce Expressed Emotion and Subjective Burden among the Family Caregivers of Schizophrenia Patients: A Pilot Study

Abstract Views: 380  |  PDF Views: 1

Authors

Roby James
The Graduate School, University of Santo Tomas Manila, Philippines, United States
Joy Tungol
The Graduate School, University of Santo Tomas Manila, Philippines, United States

Abstract


Expressed emotion of the family caregivers is a reliable predictor of relapse in schizophrenia patients. The subjective burden of care affects the caregiver's quality of life and multiple areas of everyday life, leading to the impairment of caregiving role. The impaired caregiving role has negative impact on patient's well-being, course and prognosis of this disorder. Understanding the situation, the researcher developed the Wellness Enhancement Therapy (WET) to reduce Expressed Emotion (EE) and Subjective Caregiver Burden (SCB) of the primary family caregivers of the individuals with schizophrenia. The intervention integrated Cognitive Therapy (CT) and Dialectical Behavior Therapy (DBT) models. Family Questionnaire for expressed emotion (FQ-EE) and Burden Scale for Family Caregivers (BSFC-s) were used as assessment tools. Interviews and Focused -Group Discussions were carried out to have the clear understanding of the problem. The intervention was subjected to experts' validation by six interdisciplinary experts and a feasibility test was conducted with ten primary family caregivers with high EE and SCB. The results of the pilot study revealed that the Wellness Enhancement Therapy had a positive effect on the respondents to reduce Expressed Emotion and Subjective Caregiver Burden.

Keywords


expressed emotion, subjective caregiver burden, family caregivers, schizophrenia

References





DOI: https://doi.org/10.15614/ijpp%2F2022%2Fv13i1%2F212291