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Eliane Duvekot © Eliane Duvekot. Family Motivational Intervention Training motivational interviewing for family members of patients with schizophrenia.

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Presentation on theme: "Eliane Duvekot © Eliane Duvekot. Family Motivational Intervention Training motivational interviewing for family members of patients with schizophrenia."— Presentation transcript:

1 Eliane Duvekot © Eliane Duvekot

2 Family Motivational Intervention Training motivational interviewing for family members of patients with schizophrenia and cannabis use

3 Contents presentation Background Intervention Research design

4 Linszen 2006 Why aiming an intervention at cannabis use and compliance? Early independent predictors of a poor outcome: 1. Cannabis 2. Poor compliance 3. Lack of insight

5 Eliane Duvekot © Eliane Duvekot

6 Kemp BMJ 1996, BJP 1998 Randomised controlled trials Motivational Interviewing in schizophrenia: compliance Compliance therapy 4-6 sessions, n=74 Control intervention: supportive counseling 23% more improvement with MI 4 other RCT’s, 2/4 MI significantly better

7 Barrowclough AJP 2001;158:1706-13 RCT MI in schizophrenia: drug use MI+CBT+family-intervention, n=36 Intensive treatment: 5x MI, 24x CBT, 10-16 x family-intervention Significantly more abstinence, better level of functioning, symptom reduction and less relapse 7 other RCT’s, 6/7 MI effective

8 Eliane Duvekot © Eliane Duvekot

9 Mueser, Guilford Press 2003 Family interventions in dual diagnosis patients 25-50% dual diagnosis patients live with their parents, even more have frequent contact Family stress  unfavorable course schizophrenia and increase of drug use Need of information in family members

10 Contents presentation Background Intervention Research design

11 Basic considerations FMI Need of information Improvement of contact Promote desired change Parents are neither care workers nor do they need a therapy, therefore we provide a training

12 Family motivational intervention Psychoeducation – Schizophrenia: 2 sessions – Schizophrenia and cannabis: 1 session Interaction skills: 6 sessions Motivational Interviewing: 6 sessions Workshop MI care workers Individual supervision care workers

13 volhouden terugval voorstadium overwegen beslissen en voorbereiden uitvoeren start definitieve uitgang Stadia van verandering bij gewoonteproblemen

14 Interaction skills Interaction problems Own needs Communication: transmitting and listening Ownership of problems Constructive confrontation Conflicts: unwilling or unable Collaboration

15 Maintenance Relapse Precontemplation Contem- plation Preparation Action start Permanent exit Prochaska, DiClemente, & Norcross, 1992 Stages of change

16 Stages and actions Precontemplation Contemplation Preparation Action Maintenance Relapse Raising doubt Influence balance Choose moment, plan Advise, support Relapse prevention Reassure, renew plans

17 Motivational Interviewing Wheel of change Listening, summarizing, open ended questions Change talk, selective reflection Resistance

18 Contents presentation Background Intervention Research design

19 Study design Randomisation: Intervention or psychoeducation only, n=80 Outcome: cannabis use patient, wellbeing parents, communication skills parents Individual supervision care worker of patients in the Intervention arm Workshop MI for care workers

20 Inclusion criteria Schizophrenia – schizophreniform/schizoaffective disorder Cannabis use – At least 2 days/week per week. Age < 41 years Contact with parents/ family members At least 10 hours per week

21 Flow chart patients

22 Flow chart parents

23 FMI team: who is who Maarten Smeerdijk, psycholoog Marijke Krikke, trainer Anouschka de Jager, trainer Bas van Raay, interactievaardigheden Lieuwe de Haan, lid werkgroep Don Linszen, principal investigator Gerard Schippers, AIAR René Keet, projectleider

24 Eliane Duvekot © Eliane Duvekot


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