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Family Motivational Intervention (FMI).

Quality level: 3

Summary

For cannabis using patients with recent onset of schizophrenia, early intensive interventions are not working due to non-compliance and little insight of clients into their illness. Family Motivational Intervention was specifically developed for this target group. The intervention has an inpatient treatment phase (2 months) and a subsequent outpatient treatment (12 months). Target outcomes are: reduction of cannabis use; increasing medication compliance; increasing well-being among parents; decreasing stress within the family related to the schizophrenic disorder; and improving the communication between parent and child. In a randomized controlled trial, 98 carers of 75 patients with schizophrenia and co morbid cannabis use were assigned to either Family Motivational Intervention (FMI) or psychoeducation (PE). Baseline and follow-up measures by the patients and their caretakers were done by a researcher who was blinded for the allocated condition. The first follow-up measurements (3 months after the last session of FMI) show promising outcomes. The response was 94% in the FMI group and 78% in the PE group. For the patients, the response was 71% in the FMI group and 77% of the PE group. Compared with the PE group, the FMI group showed significant more decrease in mean days of cannabis use and in mean grams of cannabis use, both during the last three months. The groups did not differ significantly in the increase in compliance with medication. In both groups, carers (family members) significantly improved on all outcomes (burden of disease, style of coping and mental health).

Type of intervention:
treatment
Sub-area:
drug free treatment,pharmacologically assisted treatment
Setting:
outpatient, inpatient
Type of approach:
Target group:
children/young people
Age group:
15-26 years
Annual coverage:
Substances addressed:
cannabis
Evaluation type:
outcome evaluation
Country:
The Netherlands
Start date:
01/03/2005
End date:
30/06/2010

Overall objective

Empowering family members by training them in a motivational approach to improve the interaction with the children with early psychosis (enhancing the quality of parent-child interaction) and to facilitate positive behaviour changes in their children to ameliorate the related problems.

Abstract

Treatment for adolescent schizophrenia patients who also use cannabis. For the subgroup (one third) of cannabis using patients with recent onset schizophrenia, the usually applied early intensive interventions are not working due to non-compliance and little insight of clients into their illness. Therefore, the Adolescent Clinic of the Amsterdam Medical Center developed a Family Motivational Intervention (Smeerdijk et al., 2009). The intervention has two phases. First, the inpatient treatment phase of 2 months in order to establishing optimal dosages of antipsychotic medication, to reach a remission or stabilisation of psychotic symptoms and to teach some preliminary treatment education. Additionally, optimal working alliances are created with family members. The second phase exists of an outpatient treatment module of 12 months. The two first months are covering a day hospital programme and subsequent community care (10 months). Client interventions are intensified psychoeducation, medication management training, training of problem solving skills and offering supportive actions for financial problems and employment. Interventions for family members are: 1) six sessions of Interaction Skills Training (Gordon) that has been developed and practiced in the Netherlands in the last five years for parents of patients with schizophrenia and 2) six sessions of training in motivational enhancement techniques to enhance motivation among parents for teaching sessions targeting the improvement of parenting skills. Target outcomes are: reduction of cannabis use; increasing medication compliance; increasing well-being among parents; decreasing stress within the family related to the schizophrenic disorder; and improving the communication between parent and child. In a randomized controlled trial, 98 carers of 75 patients with schizophrenia and co morbid cannabis use were assigned to either FMI or psychoeducation only (PE). Baseline and follow-up measures by the patients and their caretakers were done by a researcher who was blinded for the allocated condition. The first follow-up measurements (3 months after the last session of FMI) are promising. The response was 94% in the FMI group and 78% in the PE group. For the patients the response was 71% in the FMI group and 77% of the PE group. Compared with the PE group, the FMI group showed significant more decrease in mean days of cannabis use and in mean grams of cannabis use, both during the last three months. The groups did not differ significantly in the increase in compliance with medication. In both groups, carers (family members) significantly improved in all outcomes (burden of disease, style of coping and mental health).

The PDF contains the full intervention description including additional contact information.

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Page last updated: Friday, 20 January 2012