Effects of Online Acceptance and Commitment Therapy for Family Members of Individuals With Early Psychosis on Self-Stigma, Coping Strategies and Resilience: A Randomized Controlled Trial

IF 3.1 4区医学 Q1 NURSING

Journal of Psychiatric and Mental Health Nursing Pub Date : 2026-07-07 Epub Date: 2026-04-14 DOI:10.1111/jpm.70130

Duygu Özer

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引用次数: 0

Abstract

Introduction

Early psychosis represents a critical period that may profoundly affect not only individuals but also their family members, often leading to increased psychological distress, stigma and caregiving burden.

Aim

This study aimed to evaluate the effects of online Acceptance and Commitment Therapy (ACT) on self-stigma, stress coping strategies and resilience levels among family members of individuals with early psychosis.

Methods

This study was designed as an exploratory randomized controlled trial. The study population consisted of 41 caregivers of individuals diagnosed with schizophrenia and other psychotic disorders according to DSM-5 criteria, who had received their diagnosis within the past three years and applied to a psychiatry outpatient clinic at a training and research hospital between August and October 2024. Eligible participants were randomly allocated to the intervention group (n = 20) or the control group (n = 21). The intervention group participated in an eight-session online group-based Acceptance and Commitment Therapy program, while the control group did not receive any structured intervention. Data were collected using the Self-Stigma Inventory for Family Members, the Stress Coping Strategies Inventory and the Brief Resilience Scale. Evaluations were conducted at pre-test, post-test and three-month follow-up.

Results

No significant differences were observed between groups at baseline (p > 0.05). Post-intervention and follow-up assessments showed significantly lower self-stigma scores in the intervention group compared to controls (p < 0.05). Additionally, coping strategies and resilience scores were significantly higher in the intervention group at post-test and follow-up (p < 0.05).

Conclusion

The findings suggest that online ACT may be effective in reducing self-stigma and improving coping strategies and resilience among family members of individuals with early psychosis.

Implications for Practice

ACT-based interventions may represent a promising approach to supporting family members during early psychosis. Psychiatric nurses may play a central role in integrating ACT-informed approaches into routine mental health services, thereby supporting family-centered care. Online delivery may serve as a complementary method to facilitate and support the delivery of nursing care by enhancing accessibility and continuity of psychosocial support.

Relevance Statement

This study is relevant to psychiatric mental health nursing as it addresses the role of family-centered care during early psychosis. The findings demonstrate that ACT-informed psychosocial approaches may reduce self-stigma and enhance coping and resilience among family members. Psychiatric nurses are well-positioned to identify family needs, deliver psychoeducation and support adaptive coping within routine care. Integrating such approaches into practice may strengthen holistic care and improve outcomes for both individuals with early psychosis and their families.

Trial Registration

ClinicalTrials.gov ID: NCT06655688

Abstract Image

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早期精神病患者家庭成员在线接受承诺治疗对自我污名、应对策略和心理弹性的影响：一项随机对照试验。

早期精神病是一个关键时期，不仅对个人，而且对其家庭成员都可能产生深远的影响，通常会导致心理困扰、耻辱感和照顾负担增加。目的：本研究旨在评估在线接受与承诺治疗（ACT）对早期精神病患者家庭成员自我污名、压力应对策略和心理弹性水平的影响。方法：本研究采用探索性随机对照试验。研究人群包括41名根据DSM-5标准诊断为精神分裂症和其他精神障碍患者的护理人员，他们在过去三年内接受了诊断，并于2024年8月至10月期间在一家培训和研究医院的精神病学门诊就诊。符合条件的参与者被随机分配到干预组（n = 20）和对照组（n = 21）。干预组参加了一个为期八个疗程的在线小组接受和承诺治疗项目，而对照组没有接受任何结构化的干预。采用家庭成员自我污名感量表、压力应对策略量表和简易心理弹性量表收集数据。在测试前、测试后和三个月的随访中进行评估。结果：各组在基线时无显著差异（p < 0.05）。干预后和随访评估显示，干预组的自我耻辱感得分显著低于对照组(p)。结论：研究结果表明，在线ACT可能有效降低早期精神病患者家庭成员的自我耻辱感，提高应对策略和恢复力。实践意义：基于act的干预措施可能代表了一种有希望的方法来支持早期精神病的家庭成员。精神科护士可以在将act知情方法纳入常规精神卫生服务方面发挥核心作用，从而支持以家庭为中心的护理。在线交付可以作为一种补充方法，通过提高社会心理支持的可及性和连续性来促进和支持护理的提供。相关性声明：本研究与精神病学心理健康护理相关，因为它解决了以家庭为中心的护理在早期精神病中的作用。研究结果表明，了解act的社会心理方法可以减少家庭成员的自我耻辱感，提高应对能力和复原力。精神科护士能够很好地识别家庭需求，提供心理教育，并在日常护理中支持适应性应对。将这些方法整合到实践中可以加强整体护理，并改善早期精神病患者及其家庭的结果。试验注册：ClinicalTrials.gov ID: NCT06655688。

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来源期刊

Journal of Psychiatric and Mental Health Nursing 医学-护理

CiteScore

4.70

自引率

3.70%

发文量

审稿时长

4-8 weeks

期刊介绍： The Journal of Psychiatric and Mental Health Nursing is an international journal which publishes research and scholarly papers that advance the development of policy, practice, research and education in all aspects of mental health nursing. We publish rigorously conducted research, literature reviews, essays and debates, and consumer practitioner narratives; all of which add new knowledge and advance practice globally. All papers must have clear implications for mental health nursing either solely or part of multidisciplinary practice. Papers are welcomed which draw on single or multiple research and academic disciplines. We give space to practitioner and consumer perspectives and ensure research published in the journal can be understood by a wide audience. We encourage critical debate and exchange of ideas and therefore welcome letters to the editor and essays and debates in mental health.