Leo program, a short multi-family skill-based psychoeducational program for caregivers of relatives living with a severe mental disorder: a retrospective pilot study

BackgroundCaring for a relative with a severe mental disorder (SMD) is associated with high levels of burden and poor physical and mental health. There is a dire need for family psychoeducational programs that can be provided as early as possible. This manuscript describes the pilot testing of “Leo” a motivational-based psychoeducational program for caregivers of individuals with a SMD. The Leo program aims to provide caregivers with skills to best support their relative and to adopt self-care behaviors.MethodsWe retrospectively analyzed medical records of caregivers who enrolled in a short, multi-family, skill-based psychoeducational program, consisting of eight 3-hour sessions over 8 weeks. Outcomes of interest included: i) adherence to the program, ii) satisfaction and perceived usefulness, and iii) pre-post changes in self-reported levels of depression (CES-D), burden (ZBI), and skills (10 Likert-scaled items). A network analysis was used to investigate the relationships between pre-post changes in self-evaluated skills and pre-post changes in burden and depression levels.ResultsOver the 91 enrolled participants, 87 (95.6%) completed the program attending at least 5/8 sessions, 80.5% attending all sessions. Seventy-six caregivers fulfilled the questionnaires at baseline and after the program, and were included in the analysis. Although there was no evidence for significant change in self-reported depression levels (Cohen’s d=0.19, p=0.210), burden scores and all evaluated skills were improved post-intervention, with medium to strong effect size (Cohen’s ds from 0.47 to 0.87; p<0.001). Network output indicated that increased self-evaluated competence in 5 skills were associated with a global improvement in caregivers’ burden and/or depression scores. Post-intervention, 89.7% of caregivers were “very satisfied” and 82.1% found the program “extremely useful”.ConclusionThis pilot retrospective study shows high levels of satisfaction, perceived usefulness, and adherence to “Leo”, a short, multi-family, skill-based psychoeducational program with promising results in improving caregivers’ burden, self-evaluated competence in coping with caregiving demands and in self-care behaviors. This study provides preliminary insights into the mechanisms by which family psychoeducation might alleviate burden of care. A larger-scaled, controlled, randomized study with follow-up assessments is warranted to determine how burden, depression, and skills, as well as their inter-relationships, evolve over time

« Hommage à Zola »

L’« Hommage à Zola » de Céline (1933) est un texte étrange : plus que la reconnaissance du génie zolien, c’est ce qui sépare les deux écrivains qui est ici mis en scène. Zola (selon Céline) a réussi à témoigner de l’horreur de son temps, il ne pourrait qu’échouer maintenant, car la réalité est devenue impossible à écrire. Leçon de lecture que ce texte déroutant, où l’écrivain du xxe siècle (encore à son début) est surtout sensible à ce qui sous-tend l’entreprise naturaliste, la foi dans la vertu, c’est-à-dire dans le langage. Céline écrira précisément à partir de la perte de cette confiance.L’“Hommage à Zola,” by Céline (1933) is an odd text; more than a recognition of Zola’s genius, it is what separates the two writers that is brought into focus. Zola who (according to Céline) succeeded in showing the horrors of his time, could only fail today because the reality has become indescribable. The lesson learnt in reading this perplexing text in which a writer from the 20th century is especially sensitive to that which underlies the naturalistic initiative — faith in truth, that is to say in language. Céline writes precisely from the loss of this faith

« Hommage à Zola »

L’« Hommage à Zola » de Céline (1933) est un texte étrange : plus que la reconnaissance du génie zolien, c’est ce qui sépare les deux écrivains qui est ici mis en scène. Zola (selon Céline) a réussi à témoigner de l’horreur de son temps, il ne pourrait qu’échouer maintenant, car la réalité est devenue impossible à écrire. Leçon de lecture que ce texte déroutant, où l’écrivain du xxe siècle (encore à son début) est surtout sensible à ce qui sous-tend l’entreprise naturaliste, la foi dans la vertu, c’est-à-dire dans le langage. Céline écrira précisément à partir de la perte de cette confiance.L’“Hommage à Zola,” by Céline (1933) is an odd text; more than a recognition of Zola’s genius, it is what separates the two writers that is brought into focus. Zola who (according to Céline) succeeded in showing the horrors of his time, could only fail today because the reality has become indescribable. The lesson learnt in reading this perplexing text in which a writer from the 20th century is especially sensitive to that which underlies the naturalistic initiative — faith in truth, that is to say in language. Céline writes precisely from the loss of this faith

Mort à Crédit, de Louis-Ferdinand Céline, 1936

Barbier Paul, Céline Louis-Ferdinand. Mort à Crédit, de Louis-Ferdinand Céline, 1936. In: Bulletin d'histoire de l'électricité, n°30, décembre 1997. pp. 90-94