Helen Martin MSW, Megan Pope MSc, Manuela Ferrari PhD, Nicole Pawliuk, Srividya N Iyer PhD

Helen Martin

Title of Presentation:
An overview of family recommendations for early psychosis intervention services - preliminary results

Name of Institution:
McGill University
Douglas Mental Health University Institute

Oral Presentation

Rationale: The benefits of family involvement and interventions in improving outcomes in early psychosis are widely acknowledged. However, their implementation in early intervention (EI) services for psychosis is thought to be impeded by unclear policy/program guidelines. It is therefore important to critically assess and analyze existing EI guidelines with respect to their recommendations regarding family involvement/interventions. The current study addresses this need.

Methods: We conducted a scoping review of existing guidelines for EI services for psychosis published from 2000 to present. The identified guidelines were evaluated using the Guidelines Implementability Appraisal 2.0 instrument comprising of eight quality domains i.e., executability, decidability, validity, flexibility, effect on process of care, measurability, novelty/innovation, and computability. The extracted data were synthesized using quantitative and qualitative techniques. outcomes in early psychosis are widely acknowledged.

Results: A total of 7 guidelines were identified. Preliminary results suggest poor consistency across guidelines with respect to family-focused recommendations, i.e., despite sharing a common vision, guidelines differed on all eight implementation quality domains. Recommendations fared well with respect to flexibility, which permits myriad ways of execution. Commonly lacked quality domains are executability, decidability, effect on process of care and measurability, for instance limited description of exactly what to do, under what conditions, it’s impact upon usual workflow in a typical care setting, and indicators to track the effects of implementation of family work recommendations. Overall, guidelines around family involvement were not specific/ambiguous (e.g., Families/carers must be involved wherever possible) and not described in a manner that could be easily operationalized into service delivery or audit criteria. Implications for improving guidelines and EI service delivery with respect to inclusion of families will be presented