RESEARCH WEEKLY: Research validates NAMI’s family–to–family program

(July 5, 2016) As the National Alliance on Mental Illness (NAMI) is convening its annual national conference in Denver, a new study validating the effectiveness of the organization’s signature family education program has been published in Psychiatric Services, a journal of the American Psychiatric Association.

The study, “Generalizability of the NAMI Family-to-Family education program: Evidence from an efficacy study,” was conducted by researchers from the New York University school of social work at the behest of NAMI-New York City. The researchers recruited 121 individuals who enrolled in a Family-to-Family (FTF) course in the US between September 2013 and July 2014 and agreed to participate in an assessment of the program when they finished.

The Findings
“After completing FTF, individuals had improved family empowerment, family functioning, engagement in self-care activities, self-perception of mental health knowledge and emotional acceptance as a form of coping,” according to Micaela Mercado and colleagues. “Scores on the coping subscales and for emotional support and positive reframing also improved significantly. Displeasure in caring for the family member, a measure of subjective burden, significantly declined.”

The study sample was small – 38 of the enrollees in the study did not complete follow-up assessments, leaving 83 participants – and did not have a control group for comparison. Nonetheless, the findings were consistent with three previous studies of Family-to-Family effectiveness, adding to the program’s evidence base.

“Improvements in empowerment, coping, family functioning, self-care and knowledge, as well as reductions in subjective burden, are consistent with previous FTF studies,” the authors wrote. “This study demonstrated gains in additional aspects of coping, including positive reframing and emotional support. Scores on a validated measure of self-care also improved, extending the findings of previous studies.”

Family-to-Family is a free, 12-week program developed by Joyce Burland, PhD, in the early 1990s to educate families and friends of people living with mental illness. Taught by trained family-member volunteers, classes meet in person in communities nationwide. The program was intended to fill a gap that existed between the extensive evidence base showing the value of family psychoeducation and limited access to programs providing such training, according to Mercado and her colleagues. It is listed in the National Registry of Evidence-based Programs and Practices published by the Substance Abuse and Mental Health Services Administration.

Despite widely available mental health services in New York City, the authors said “family members of adults living with serious mental illness experience substantial unmet need for education and support. In our experience, FTF has helped to address that unmet need.”

Caregiver stress is a significant issue for family members living with serious mental illness. A February 2016 study published by the National Alliance for Caregiving reported that three-quarters of surveyed caretakers experienced “high emotional stress” from performing their responsibilities. About 4 in 10 said they found it difficult to take care of their own health, and 6 in 10 said caregiving had made their own health worse.

The Boston Globe on June 26 published a not-to-be-missed report on family violence associated with serious mental illness in Massachusetts. The Treatment Advocacy Center will release a new national study on the same subject during the NAMI convention.

References:
Mercado, M. et al. (June 2016). ” Generalizability of the NAMI Family-to-Family education program: Evidence from an efficacy study.” Psychiatric Services.
Dixon, L. (2001). ” Pilot study of the effectiveness of the Family-to-Family education program.” Psychiatric Services.
Dixon, L. et al. (2004). ” Outcomes of the peer-taught 12-week Family-to-Family education program for severe mental illness.” Acta Psychiatrica Scandinavica.
Dixon, L.B. et al. (2011). “Outcomes of a randomized study of a peer-taught Family-to-Family Education Program for mental illness.” Psychiatric Services.
National Alliance for Caregiving. (February 2016). On pins & needles: Caregivers of adults with mental illness.
The Spotlight Team. 23 June, 2016). Families in fear. Boston Globe.