A Thematic Analysis Investigating the Inaugural Psychosis REACH Family Ambassador Peer Training Program

Abstract

Purpose

Caregivers of loved ones with psychosis are tasked with navigating a barren care landscape for their loved ones and for themselves. The dearth of resources they face has a negative impact on outcomes for caregivers and their loved ones. The Psychosis REACH program, based on principles from Cognitive Behavioral Therapy for psychosis was developed as a community-based resource for families to address this care gap. A role for family peers called the Psychosis REACH Family Ambassadors (pRFAs) was developed to reinforce skill learning for caregivers by utilizing a task-sharing approach. This qualitative study sought to better understand pRFAs’ experiences in the inaugural training cohort of this program.

Patients and Methods

Eleven pRFAs participated in semi-structured interviews with research coordinators via teleconference. Questions assessed the quality of the training, challenges and facilitators experienced in their role, and ways in which the program could be improved and expanded. Using thematic analysis, members of the research team coded interviews individually, discussed codes until consensus was reached, and iteratively developed themes based on codes that clustered based on meaning or content.

Results

This process identified 5 key themes: The development of hope and recovery, the development of solidarity networks, the challenges of navigating boundaries, preferred pedagogical strategies, and the need for more support.

Conclusion

Overall, the themes developed from this qualitative analysis demonstrate the value and feasibility of developing a caregiver peer network of pRFAs trained in recovery-oriented care and CBTp-informed skills to support other caregivers. Additionally, they highlight the challenges associated with being in the role of a pRFA and further efforts needed to align training content and learning management systems to the needs of pRFA trainees. These findings highlight the importance of expanding access to family peer training programs for the wellbeing of caregivers and loved ones with psychosis alike.

Keywords:

• family interventions for psychosis
• task-sharing
• peer workforce development
• family caregivers
• cognitive behavioral therapy for psychosis

Acknowledgments

We sincerely thank all the families who participated in the inaugural pRFA program and appreciate their time, expertise, lived experience wisdom, and generosity in co-constructing this program with us. We are also grateful for our colleagues at the University of Washington for their continued support and our collaborating partners in Psychosis REACH implementation, Drs. Turkington and Hardy.

Disclosure

Dr Sarah Kopelovich reports grants from University of Washington, and grants from Washington State Health Care Authority, during the conduct of the study. The authors report no other conflicts of interest in this work.