Julia Browne1,2, A Simone Sanders3, Michelle Friedman-Yakoobian2,3, Margaret Guyer2,4, Matcheri Keshavan2,3, Bo Kim2,5, Emily Kline2,3. 1. Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA. 2. Harvard Medical School, Boston, Massachusetts, USA. 3. Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. 4. Massachusetts Department of Mental Health, Boston, Massachusetts, USA. 5. Center for Healthcare Organization and Implementation Research, U.S. Department of Veterans Affairs, Boston, Massachusetts, USA.
Abstract
AIM: Family interventions are a core component of first-episode psychosis (FEP) treatment; however, low implementation rates are consistently reported. As such, work is needed to understand the factors impacting real-world treatment delivery. The present paper describes the implementation of the McFarlane-model multifamily psychoeducational groups (MFG) in established FEP early intervention programs within a single state. The aims were to examine (a) training participation and implementation of MFG, (b) barriers and facilitators to implementation, and (c) modifications made to MFG. METHODS: Practitioners from six established FEP early intervention programs received in-person training and ongoing consultation in MFG. Training participation data were obtained via attendance and implementation outcomes were obtained from practitioner reports. Fifteen months following the initial training, practitioners reported on clinic-specific barriers, facilitators, and modifications across four categories (context, intervention, practitioner, and recipient). RESULTS: Twenty-three practitioners across six clinics received in-person training and were offered ongoing consultation to support implementation. Difficulties in starting MFG were salient as the earliest group was run 7 months after the initial training, thereby resulting in low overall frequency of groups. A number of barriers spanning context, intervention, practitioner, and recipient domains were noted, the majority of which were clinic-specific. Despite challenges, practitioners identified several facilitators and made modifications to the intervention and its delivery in service of implementation. CONCLUSIONS: Results from this implementation case study highlighted the challenges of delivering MFG in real-world FEP early intervention programs. Further, this paper emphasizes the value in identifying and addressing clinic-specific factors when implementing MFG.
AIM: Family interventions are a core component of first-episode psychosis (FEP) treatment; however, low implementation rates are consistently reported. As such, work is needed to understand the factors impacting real-world treatment delivery. The present paper describes the implementation of the McFarlane-model multifamily psychoeducational groups (MFG) in established FEP early intervention programs within a single state. The aims were to examine (a) training participation and implementation of MFG, (b) barriers and facilitators to implementation, and (c) modifications made to MFG. METHODS: Practitioners from six established FEP early intervention programs received in-person training and ongoing consultation in MFG. Training participation data were obtained via attendance and implementation outcomes were obtained from practitioner reports. Fifteen months following the initial training, practitioners reported on clinic-specific barriers, facilitators, and modifications across four categories (context, intervention, practitioner, and recipient). RESULTS: Twenty-three practitioners across six clinics received in-person training and were offered ongoing consultation to support implementation. Difficulties in starting MFG were salient as the earliest group was run 7 months after the initial training, thereby resulting in low overall frequency of groups. A number of barriers spanning context, intervention, practitioner, and recipient domains were noted, the majority of which were clinic-specific. Despite challenges, practitioners identified several facilitators and made modifications to the intervention and its delivery in service of implementation. CONCLUSIONS: Results from this implementation case study highlighted the challenges of delivering MFG in real-world FEP early intervention programs. Further, this paper emphasizes the value in identifying and addressing clinic-specific factors when implementing MFG.
Authors: Donald Addington; Chiachen Cheng Cheng; Paul French; Eoin Killackey; Marianne Melau; Anna Meneghelli; Merete Nordentoft; Ilana Nossel; Antonio Preti; Jo Smith Journal: Early Interv Psychiatry Date: 2020-05-25 Impact factor: 2.732
Authors: Susan M Essock; Ilana R Nossel; Karen McNamara; Melanie E Bennett; Robert W Buchanan; Julie A Kreyenbuhl; Sapna J Mendon; Howard H Goldman; Lisa B Dixon Journal: Psychiatr Serv Date: 2015-01-02 Impact factor: 3.084
Authors: Lisa B Dixon; Faith Dickerson; Alan S Bellack; Melanie Bennett; Dwight Dickinson; Richard W Goldberg; Anthony Lehman; Wendy N Tenhula; Christine Calmes; Rebecca M Pasillas; Jason Peer; Julie Kreyenbuhl Journal: Schizophr Bull Date: 2009-12-02 Impact factor: 9.306