Evaluation of a hybrid asynchronous-synchronous delivery model for family intervention in psychosis: the psychosis REACH program.
The uptake of Family Interventions for psychosis (FIp) in routine settings has been limited across high-, middle-, and low-income countries due to geographic, systemic, and socioeconomic barriers. Psychosis REACH is a FIp that addresses these barriers by using a direct-to-family model co-facilitated by licensed mental health practitioners with expertise in Cognitive Behavioral Therapy for psychosis and family members with lived experience. While prior delivery relied on in-person training, this approach does not adequately address structural access challenges. The aim of this investigation was to evaluate caregiver outcomes of a hybrid asynchronous-synchronous version of Psychosis REACH consisting of (a) an online course, (b) a live virtual skills workshop, and (c) follow-along skills coaching from a trained family peer (Psychosis REACH Family Ambassador; pRFA).
Psychosis REACH was delivered via a hybrid digital format to 275 caregivers of individuals with psychosis, the majority of whom were parents (61.2%). We evaluated feasibility, acceptability, and participant characteristics, along with outcomes including depression, anxiety, caregiver burden, expressed emotion, attitudes toward psychosis, and self-perceived CBT skillfulness at post-training and 4-month follow-up.
Both asynchronous and synchronous components were rated as highly feasible and acceptable. Nearly all participants completed the online course; 85% went on to complete the virtual workshop, of which 66.7% endorsed intention to follow-up with a pRFA. Participants demonstrated significant improvements across multiple domains, including reduced psychiatric symptoms, caregiver burden, stigmatizing attitudes, and expressed emotion, along with increased confidence in CBT-informed skills.
Findings suggest that this hybrid digital training is both acceptable and feasible, offering a promising approach for disseminating evidence-based family support in psychosis. Clinical and educational outcomes were comparable to in-person delivery, underscoring its potential to reduce access barriers for some caregivers. Future research should prioritize randomized trials and active engagement of diverse and underserved families.
Psychosis REACH was delivered via a hybrid digital format to 275 caregivers of individuals with psychosis, the majority of whom were parents (61.2%). We evaluated feasibility, acceptability, and participant characteristics, along with outcomes including depression, anxiety, caregiver burden, expressed emotion, attitudes toward psychosis, and self-perceived CBT skillfulness at post-training and 4-month follow-up.
Both asynchronous and synchronous components were rated as highly feasible and acceptable. Nearly all participants completed the online course; 85% went on to complete the virtual workshop, of which 66.7% endorsed intention to follow-up with a pRFA. Participants demonstrated significant improvements across multiple domains, including reduced psychiatric symptoms, caregiver burden, stigmatizing attitudes, and expressed emotion, along with increased confidence in CBT-informed skills.
Findings suggest that this hybrid digital training is both acceptable and feasible, offering a promising approach for disseminating evidence-based family support in psychosis. Clinical and educational outcomes were comparable to in-person delivery, underscoring its potential to reduce access barriers for some caregivers. Future research should prioritize randomized trials and active engagement of diverse and underserved families.
Authors
Kopelovich Kopelovich, Blank Blank, Vaswani-Bye Vaswani-Bye, Shepard Shepard, Buckland Buckland, Hardy Hardy, Turkington Turkington
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