2 - (SYM 90) Culturally Adapted Family Intervention for Psychosis: Cross National Comparison, Collaboration, and Future Directions

Background: Psychosis REACH is a direct-to-family intervention based on CBT principles that was developed for and with families impacted by psychosis. It uses a hybridized distance learning approach to deliver content and facilitate skill mastery. It is associated with reduced depression, anxiety, negative aspects of the caregiving experience, and expressed emotion among primarily US-based caregivers. Global mental health researchers emphasize the need to consider local contexts, structures, and cultural contingencies before implementing interventions in the global South developed in the global North. Accordingly, CBT interventions have been adapted to be more culturally responsive and relevant to ethnic minority and non-Western communities.

Methods: We culturally adapted and piloted the Psychosis REACH among caregiver-patient dyads receiving services at a community-based psychiatric rehabilitation center in a metropolitan city in Pakistan. Measures were translated into Urdu and administered at baseline, post-intervention, and 4-month follow-up. We assessed implementation outcomes using the Acceptability of Intervention Measure (AIM), the Intervention Appropriateness Measure (IAM), and the Feasibility of Intervention Measure (FIM). Other assessments included the Hospital Anxiety and Depression Scale (HADS), the Self-Confidence Scale (SCS), the Psychological Wellbeing Scale administered pre and post training.

Results: Caregivers (N= 40) ranged from 20-68 years and were majority female (60%) relatives. Patients (N = 40) ranged from 20-60 years, were majority male (55%), and diagnosed in the last 5 years (57.5%). We observed significant increases in confidence using REACH skills (t= -4.233, +5.2, SD = 7.5); p < .05), and reductions in depression (t =2.591, -1.8, SD = 4.2; p < .05) and anxiety (t =2.648, -2.1, SD = 4.8; p < .05). No significant change was observed on the psychological well-being. Follow-up clinical data are currently being analyzed and will be reported at the presentation. 

Discussion: We will describe our culturally adapted intervention, review pilot data, and highlight similarities and differences of a cross-national sample. Future innovations will be discussed for both international and domestic populations.