Caregivers experiences and Coping Mechanisms among family caregivers of persons with Severe Psychiatric Disorders

METHODOLOGY

Main aim of this current study was to evaluate the impact of social work intervention module on

The current study assessed the relationship between the care giving variables and the intervention provided to the participants. It also assessed the outcome of the intervention provided to the participants. Psychotherapy aims at allevating distress, burden and pain that fills the cognition, emotions, and behaviour of an individual. The current syudy used the traditional psychotherapy refering to psychological approaches to interven the distress, burden and pain of an individual. Thus, client-centered approach was the prime aproach to design the intervention module for the caregivers. Caregivers deal and experience with the inabilities, cognitive delays, and limited interpersonal responses of the mentally ill in the family. In addition to these, caregivers have to continuously deal with the oppressive burden of societal stigma, alongwith managing the conditions of the mentally ill, caregivers have to fulfill double or more responsibilities for the household. These longlasting and chronic stressful condition leads to piling of emotional distress, negative self-evaluation, anxiety, low stress tolerance, poor coping strategies, poor problem solving skills, and dysfunctional interpersonal habits. In India there is a huge amount of people suffering with severe psychiatric disorders and thus, a larger number of family caregivers are there spending significant amount of their daily life on them. To help these caregivers take better care of their loved ones it is important that caregiver’s psychological and social wellbeing is taken into consideration.

The Ethics committee of the institute granted permission to conduct research on an ethical basis. Study was conducted at department of Center of Excellence in Mental Health, AtalBihari Vajpayee Institute of Medical Sciences & Dr. Ram Manohar Lohia Hospital in New Delhi.

Two stages of sampling were employed: in the first, participants (after screening) were chosen on purposively, and in the second, experimental and control groups were created using a systematic random sampling. Inpatient and outpatient department (OPD) were used for the selection of participants. Thirty subjects in total were recruited, along with their spouses. Before receiving written consent, they were informed about the study’s objectives and procedure. Total 30 caregivers of individual with Schizophrenia and Bipolar affective disorders were included in the study according to ICD-10.

Social Work Intervention Module

Session

Technique

Target

Component of Therapy

|1

Psychoeducation

To create insight into the nature, course, & treatment of the disorder

Empathy, Informative model, Supportive attitude

|2

Ventilation of emotion

Releasing of fears, anxiety, burden, communication and interpersonal problems, thinking process

Active listening, empathy, supportive attitude

|3

Relaxation

Regulation of anxiety, emotional expressions, and meta-cognitive errors.

Deep Breathing, Using of five senses, Living in the present, Letting go, Non-judgemental attitude

|4

Communication Skills

To modify and reduce expressed emotion

Feedback, Active listening & effective questioning, understanding non-verbal cues and body language, expression of empathy

|5

Group Session

Imparting information, Catharsis, Instillation of hope

Active listening, empathy, supportive attitude

|6

Distress Tolerence Skills

 Enhancing Self-efficacy, being gental with self, developing positive attitude

Radical acceptance, distraction, Self-soothing activities, Directing strength, Self-encouragement, & Self-affirmation

|7

Cognitive Restructuring for Coping Strategies

Cognitive distrotions & thinking errors

Based on here & now principle, Reality oriented,

|8

Cognitive Restructuring for Coping Strategies

Poor coping strategies

Based on here & now principle, Reality oriented, Self-monitoring

|9

Group Session

Catharsis, Self-understanding, Existential factors

Active listening, empathy, supportive attitude

|10

Cognitive Restructuring for Problem solving strategies

Enhancing problem solving skills for day to day activities.

Focus on the solution, not the problem, simplify   things, listing out as many solutions as possible, think laterally.

|11

Interpersonal Effectiveness Skills

Developing interpersonal skills to enhance healthy relationship

Learning skills to express self-needs, Learn to say No, & Learn to negotiate conflicting needs without ending in a fight

|12

Role restructuring

To redifine role and responsibilities

Role reversal and role play

|13

Group Session

Corrective recapitulation of family experience, development of socialization techniques, interpersonal learning

Active listening, empathy, supportive attitude

|14

Termination

Termination with post-assessment

 Emphasizing the change made during intervention