Families of people with experience of psychosis: exploring the impact of family interventions and understanding the role of young people in their parent’s care
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Background: While literature indicates a positive impact of family interventions (FIs) on people with experience of psychosis, less is known about outcomes for other family members involved with these interventions. Furthermore, there is a paucity of literature offering an understanding of how young people with a parent with experience of psychosis view themselves in relation to their parent’s care. In the context of community care for psychosis, consideration of family views and outcomes is important in establishing how their needs may best be met. Aim: The thesis aims were twofold: (a) to systematically review the literature to explore the impact of single FIs for psychosis on family members, establish whom outcomes are being gathered for, and to what extent children and young people are involved; and (b) to develop an understanding of how young people with a parent with experience of psychosis conceptualise themselves in the context of their parent’s care. Method: A systematic search of the literature was conducted in October, 2016. Additionally, 12 interviews were carried out with 11 young people (aged 14-18 years) with a parent with experience of psychosis. A grounded theory approach was employed. Results: 21 studies were included in the systematic review. 86% revealed at least one positive outcome for family members engaging with FIs. None of the studies included children or young people. In the empirical study, a provisional theory was generated and at the core of this is how young people establish and negotiate their role in relation to their parent’s care in the context of adolescence; balancing caring for and/or living with a parent with experience of psychosis with “being a teenager”. This process appears dependent on young people’s perception of parental needs and supports and among other factors, seems to be facilitated by having appropriate information (that is specific and formulation based). Young people perceiving adults to view them as “too young” appears to be a significant barrier to this. Conclusion: The systematic review points towards a generally positive impact of FIs on family members but involvement of children and young people is lacking. The empirical study highlights that parental psychosis appears to pose additional and unique challenges to young people, particularly in the context of adolescent development; emphasising the need for better support, appropriate information sharing and adults recognising and validating young people’s experiences. Future research would benefit from the exploration of inclusion of children and young people in FIs.