Moderated Online Social Therapy for Carers of Early Psychosis Clients in Real-World Settings : Cluster Randomized Controlled Trial
Journal article
Gleeson, John Francis Martin, Lin, Ashleigh, Koval, Peter, Hopkins, Liza, Denborough, Paul, Lederman, Reeva, Herrman, Helen, Bendall, Sarah, Eleftheriadis, Constantina, Cotton, Sue, Dip, Grad, Perry, Yael, Kaess, Michael and Álvarez-Jiménez, Mario. (2023). Moderated Online Social Therapy for Carers of Early Psychosis Clients in Real-World Settings : Cluster Randomized Controlled Trial. JMIR Mental Health. 10(1), pp. 1-16. https://doi.org/10.2196/47722
Authors | Gleeson, John Francis Martin, Lin, Ashleigh, Koval, Peter, Hopkins, Liza, Denborough, Paul, Lederman, Reeva, Herrman, Helen, Bendall, Sarah, Eleftheriadis, Constantina, Cotton, Sue, Dip, Grad, Perry, Yael, Kaess, Michael and Álvarez-Jiménez, Mario |
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Abstract | Background: Family carers of youth recovering from early psychosis experience significant stress; however, access to effective family interventions is poor. Digital interventions provide a promising solution. Objective: Our objective was to evaluate across multiple Australian early psychosis services the effectiveness of a novel, web-based early psychosis intervention for carers. Methods: In this cluster randomized controlled trial 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 the 6-month follow-up. Results: Eighty-six caregivers were randomized and data were 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 overinvolvement, 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. In this study, 80% (12/15) reported a positive experience with Altitudes and 93% (14/15) would recommend it to others. Conclusions: Our trial did not show a treatment effect for Altitudes in perceived stress. However, our post hoc analysis indicated that the amount of use of Altitudes related to improvements in stress and social support. Additional design work is indicated to continue users’ engagement and to significantly improve outcomes in problem-solving, communication, and self-care. Trial Registration: Australian and New Zealand Clinical Trials Registry ACTRN12617000942358; https://trialsearch.who.int/Trial2.aspx?TrialID=ACTRN12617000942358 |
Keywords | first-episode psychosis; carers; eHealth; families; stress; psychosis; digital mental health intervention; web-based therapy; social therapy |
Year | 01 Jan 2023 |
Journal | JMIR Mental Health |
Journal citation | 10 (1), pp. 1-16 |
Publisher | J Michael Ryan Publishing, Inc. (JMIR) |
ISSN | 2368-7959 |
Digital Object Identifier (DOI) | https://doi.org/10.2196/47722 |
PubMed ID | 37672335 |
PubMed Central ID | 10512122 |
Web address (URL) | https://mental.jmir.org/2023/1/e47722 |
Open access | Published as ‘gold’ (paid) open access |
Research or scholarly | Research |
Page range | 1-16 |
Publisher's version | License File Access Level Open |
Output status | Published |
Publication dates | |
06 Sep 2023 | |
Publication process dates | |
Accepted | 19 Jun 2023 |
Deposited | 20 Mar 2024 |
Additional information | Trial Registration: Australian and New Zealand Clinical Trials Registry ACTRN12617000942358; https://trialsearch.who.int/Trial2.aspx?TrialID=ACTRN12617000942358 |
©John Gleeson, Ashleigh Lin, Peter Koval, Liza Hopkins, Paul Denborough, Reeva Lederman, Helen Herrman, Sarah Bendall, Dina Eleftheriadis, Sue Cotton, Yael Perry, Michael Kaess, Mario Alvarez-Jimenez. Originally published in JMIR Mental Health (https://mental.jmir.org), 06.09.2023. | |
This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Mental Health, is properly cited. The complete bibliographic information, a link to the original publication on https://mental.jmir.org/, as well as this copyright and license information must be included. | |
Place of publication | Canada |
https://acuresearchbank.acu.edu.au/item/904q9/moderated-online-social-therapy-for-carers-of-early-psychosis-clients-in-real-world-settings-cluster-randomized-controlled-trial
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Publisher's version
OA_Gleeson_2023_Moderated_online_social_therapy_for_carers.pdf | |
License: CC BY 4.0 | |
File access level: Open |
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