A Randomized Clinical Trial to Test the Efficacy of a Family-Focused, Culturally Informed Therapy for Schizophrenia

• Published in: Journal of family psychology 2014-12, Vol.28 (6), p.800-810
• Main Authors: Weisman de Mamani, Amy, Weintraub, Marc J., Gurak, Kayla, Maura, Jessica
• Format: Article
• Language: English
• Subjects: Adult; African Continental Ancestry Group - psychology; African Continental Ancestry Group - statistics & numerical data; Analysis of Variance; Client Satisfaction; Clinical trials; Cultural Competency - psychology; Ethnic Groups - psychology; Ethnic Groups - statistics & numerical data; Ethnic Identity; Ethnicity; European Continental Ancestry Group - psychology; European Continental Ancestry Group - statistics & numerical data; Families & family life; Family Intervention; Family Therapy - methods; Female; Hispanic Americans; Hispanic Americans - psychology; Hispanic Americans - statistics & numerical data; Human; Humans; Intervention; Male; Mental health care; Mental Patients; Minority & ethnic groups; Minority Groups - psychology; Minority Groups - statistics & numerical data; Patient Satisfaction - statistics & numerical data; Patients; Psychiatry; Psychotherapy; Schizophrenia; Schizophrenia - therapy; Sociocultural Factors; Spirituality; Symptoms; Treatment Outcome; Treatment Outcomes
• ISSN: 0893-3200; 1939-1293
• DOI: 10.1037/fam0000021

Research strongly suggests that family interventions can benefit patients with schizophrenia, yet current interventions often fail to consider the cultural context and spiritual practices that may make them more effective and relevant to ethnic minority populations. We have developed a family focused, culturally informed treatment for schizophrenia (CIT-S) patients and their caregivers to address this gap. Sixty-nine families were randomized to either 15 sessions of CIT-S or to a 3-session psychoeducation (PSY-ED) control condition. Forty-six families (66.7%) completed the study. The primary aim was to test whether CIT-S would outperform PSY-ED in reducing posttreatment symptom severity (controlling for baseline symptoms) on the Brief Psychiatric Rating Scale. Secondary analyses were conducted to test whether treatment efficacy would be moderated by ethnicity and whether patient-therapist ethnic match would relate to efficacy and patient satisfaction with treatment. Patients included 40 Hispanic/Latinos, 14 Whites, 11 Blacks, and 4 patients who identified as "other." In line with expectations, results from an ANCOVA indicated that patients assigned to the CIT-S condition had significantly less severe psychiatric symptoms at treatment termination than did patients assigned to the PSY-ED condition. Patient ethnicity and patient-therapist ethnic match (vs. mismatch) did not relate to treatment efficacy or satisfaction with the intervention. Results suggest that schizophrenia may respond to culturally informed psychosocial interventions. The treatment appears to work equally well for Whites and minorities alike. Follow-up research with a matched length control condition is needed. Further investigation is also needed to pinpoint specific mechanisms of change.