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Implementation case study: Multifamily group intervention in first‐episode psychosis programs
Author(s) -
Browne Julia,
Sanders A. Simone,
FriedmanYakoobian Michelle,
Guyer Margaret,
Keshavan Matcheri,
Kim Bo,
Kline Emily
Publication year - 2021
Publication title -
early intervention in psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.087
H-Index - 45
eISSN - 1751-7893
pISSN - 1751-7885
DOI - 10.1111/eip.13066
Subject(s) - attendance , intervention (counseling) , context (archaeology) , psychological intervention , psychology , medicine , service delivery framework , nursing , service (business) , paleontology , economy , economics , biology , economic growth
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.