Publication
Moderated Online Social Therapy for Carers of Early Psychosis Clients in Real-World Settings: Cluster Randomized Controlled Trial (Preprint)
Publisher:
JMIR Publications Inc.
Date:
03-04-2023
DOI:
10.2196/PREPRINTS.47722
Abstract: amily carers of youth recovering from early psychosis experience significant stress however, access to effective family interventions is poor. Digital interventions provide a promising solution. ur objective was to evaluate across multiple Australian early psychosis services the effectiveness of a novel online early psychosis intervention for carers. n this cluster RCT conducted across multiple Australian early psychosis services, our digital moderated online social therapy for carers (Altitudes) plus enhanced family treatment as usual (TAU) was compared with TAU alone on the primary outcome of perceived stress and secondary outcomes including mental health symptoms and family variables at 6 months follow-up. 6 caregivers were randomized and data was available for 74 young people in their care. Our primary hypothesis that carers randomized to Altitudes+TAU would report greater improvements in perceived stress at follow-up compared with carers randomized to TAU alone was not supported with the TAU alone group showing more improvement. For secondary outcomes, the TAU alone group showed improved mindfulness over time. Regardless of group assignment, we observed improvements in satisfaction with life, quality of life, emotional over-involvement and burden of care . In contrast, hair cortisol concentration increased. Post hoc analyses revealed more contact with early psychosis services in the intervention group compared to TAU alone and that improvements in perceived stress and social support were associated with use of the intervention in the Altitudes+TAU group. 80% reported a positive experience with Altitudes and 93% would recommend it to others. ur trial did not show a treatment effect for Altitudes in perceived stress. However, our post hoc analysis indicated that amount of use of Altitudes related to improvements in stress and social support. Additional design work is indicated to sustain users’ engagement and to significantly improve outcomes in problem solving, communication, and self-care. CTRN12617000942358