Family involvement during severe mental health problems

The duty of confidentiality during family involvement: ethical challenges and possible solutions in the treatment of persons with psychotic disorders. Article in BMC Psychiatry. Published 20.12.22

Barriers and facilitators when implementing family involvement for persons with psychotic disorders in community mental health centres – a nested qualitative study. Article in BMC Health Services Research. Published 13.09.22

Family involvement practices for persons with psychotic disorders in community mental health centres – a cross-sectional fidelity-based study. Article in BMC Psychiatry. Published 02.06.21

Implementation of guidelines on family involvement for persons with psychotic disorders in community mental health centres (IFIP): protocol for a cluster randomised controlled trial. Article in BMC Health Services Research. Published 09.10.20

• Norheim, Irene; Pedersen, Reidar; Selle, Maria Lie; Røssberg, Jan Ivar; Hestmark, Lars & Heiervang, Kristin Sverdvik [Show all 13 contributors for this article] (2025). Effectiveness of implementing family involvement on patient outcomes in individuals with psychotic disorders: a pragmatic cluster randomised controlled trial. BMC Psychiatry. 25(1). doi: 10.1186/s12888-025-07501-z. Full text in Research Archive Show summary

  Abstract Background The purpose of this sub-study, as part of the Implementation of guidelines on Family Involvement for persons with Psychotic disorders (IFIP) trial, was to examine the effectiveness of family interventions (FIs) implemented through an implementation support program (ISP) on patients’ outcomes. Methods The IFIP trial is a cluster randomised controlled trial where 15 Community Mental Health Centre units were randomly allocated either to the ISP, which included FIs as clinical interventions, implementation strategies, and implementation interventions, or to treatment as usual (TAU). In the control arm, patients could have access to FIs. Patients with psychotic disorders in both arms were asked to complete questionnaires at inclusion, 6- and 12 months. The primary outcome was patients’ difficulties in interpersonal relationships measured with the Relationships subscale of Behaviour and Symptom Identification scale. The secondary outcomes were patients’ mental health and functioning, perceived expressed emotions, recovery, and quality of life. Linear mixed-effects models were used to analyse differences in change over time between the two arms. Results We included 231 patients (135 from the intervention units; 96 from the control units). Except for the first 24% of the 6 months questionnaires, the 6- and 12-month data were collected during the COVID-19 pandemic. There were no significant differences in the primary outcome, difficulties in interpersonal relationships at 12 months, between the intervention and control arms (Cohen’s d = -0.19, p  = 0.2). The secondary outcomes showed less perceived criticism from the relatives (Perceived Criticism sub-score; d = − 0.4, p  = 0.01) and reduced difficulties in overall functioning (Health of the Nation Outcome Scale; d = − 0.29, p  = 0.01) in the intervention arm compared to the control arm at 12 months. Conclusion The FIs, implemented through the ISP, did not achieve significant decreases in patients’ difficulties with interpersonal relationships. However, this sub-study indicates that FIs in routine mental health practices can nurture a more positive family environment and enhance the patient’s process toward improved functioning. The complexity of the study design, and the restrictions due to COVID-19, may have diminished the implementation and effectiveness of the measured FIs for the patients. Trial registration ClinicalTrials.gov Identifier NCT03869177. Registered 2019-02-28.

• Norheim, Irene; Pedersen, Reidar; Selle, Maria; Røssberg, Jan Ivar; Hestmark, Lars & Heiervang, Kristin Sverdvik [Show all 12 contributors for this article] (2024). Implementation of guidelines on Family Involvement for persons with Psychotic disorders: a pragmatic cluster randomized trial. Effect on relatives’ outcomes and family interventions received. Frontiers in Psychiatry. 15. doi: 10.3389/fpsyt.2024.1381007. Full text in Research Archive Show summary

  Background: Family interventions (FI) are recommended as part of the treatment for psychotic disorders, but the implementation in mental health services is generally poor. Recently, The Implementation of guidelines on Family Involvement for persons with Psychotic disorders (IFIP) trial, demonstrated significant improvements in implementation outcomes at cluster-level. This sub-study aims to examine the effectiveness of the IFIP intervention on relatives’ outcomes and received FI. Methods: A cluster randomized controlled trial, was conducted in 15 Norwegian Community Mental Health Center (CMHC) units that were randomized to either the IFIP intervention, including implementation interventions and clinical interventions, or treatment as usual (TAU). The clinical interventions consisted of FI: basic family involvement and support (BFIS) to all patients and family psychoeducation (FPE) to as many as possible. Patients with psychotic disorders and their closest relative were invited to fill in questionnaires at inclusion and 6 months and 12 months follow-up. Received FI was reported by both relatives and clinicians. The relatives’ primary outcome was satisfaction with health service support, measured by the Carer well-being and support questionnaire part B (CWS-B). The relatives’ secondary outcomes were caregiver experiences, expressed emotions and quality of life. Patients’ outcomes will be reported elsewhere. Results: In total 231 patient/relative pairs from the CMHC units were included (135 intervention; 96 control).The relatives in the intervention arm received an increased level of BFIS (p=.007) and FPE (p < 0.05) compared to the relatives in the control arm, including involvement in crisis planning. The primary outcome for relatives’ satisfaction with health service support, showed a non-significant improvement (Cohen’s d = 0.22, p = 0.08). Relatives experienced a significant reduced level of patient dependency (Cohen’s d = -0.23, p = 0.03). Conclusion: The increased support from clinicians throughout FI reduced the relatives’ perceived level of patient dependency, and may have relieved the experience of responsibility and caregiver burden. The COVID-19 pandemic and the complex and pioneering study design have weakened the effectiveness of the IFIP intervention, underscoring possible potentials for further improvement in relatives’ outcomes. Clinical Trial Registration: ClinicalTrials.gov, identifier NCT03869177.

• Hestmark, Lars; Romøren, Maria; Hansson, Kristiane Myckland; Heiervang, Kristin Sverdvik & Pedersen, Reidar (2023). Clinicians’ perceptions of family involvement in the treatment of persons with psychotic disorders: a nested qualitative study. Frontiers in Psychiatry. 14, p. 1–12. doi: 10.3389/fpsyt.2023.1175557. Full text in Research Archive Show summary

  Background: Family involvement in mental health care ranges from basic practices to complex interventions such as Family psychoeducation, the latter being a well-documented treatment for psychotic disorders. The aim of this study was to explore clinicians’ perceptions of the benefits and disadvantages of family involvement, including possible mediating factors and processes. Methods: Nested in a randomised trial, which purpose was to implement Basic family involvement and support and Family psychoeducation in Norwegian community mental health centres during 2019–2020, this qualitative study is based on eight focus groups with implementation teams and five focus groups with ordinary clinicians. Using a purposive sampling strategy and semi-structured interview guides, focus groups were audio-recorded, transcribed verbatim, and analysed with reflexive thematic analysis. Results: Four main themes were identified as perceived benefits: (1) Family psychoeducation—a concrete framework, (2) Reducing conflict and stress, (3) A triadic understanding, and (4) Being on the same team. Themes 2–4 formed an interconnected triad of mutually reinforcing elements and were further linked to three important clinician-facilitated sub-themes: a space for relatives’ experiences, emotions and needs; a space for patients and relatives to discuss sensitive topics and an open line of communication between clinician and relative. Although far less frequent, three main themes were identified as perceived disadvantages or challenges: (1) Family psychoeducation—occasional poor model fit or difficulties following the framework, (2) Getting more involved than usual, and (3) Relatives as a potentially negative influence—important nonetheless Conclusions: The findings contribute to the understanding of the beneficial processes and outcomes of family involvement, as well as the critical role of the clinician in achieving these and possible challenges. They could also be used to inform future quantitative research on mediating factors and implementation efforts.

• Hansson, Kristiane Myckland; Romøren, Maria; Hestmark, Lars; Heiervang, Kristin Sverdvik; Weimand, Bente Margrethe & Norheim, Irene [Show all 7 contributors for this article] (2023). “The most important thing is that those closest to you, understand you”: a nested qualitative study of persons with psychotic disorders’ experiences with family involvement. Frontiers in Psychiatry. 14. doi: 10.3389/fpsyt.2023.1138394. Full text in Research Archive Show summary

  Introduction Family interventions constitute effective treatment for persons with psychotic disorders. However, the active ingredients and beneficial processes of these interventions are insufficiently examined, and qualitative explorations of patients` experiences are lacking. This study was nested in a cluster randomised trial that implemented national guidelines on family involvement in Norwegian community mental health centres, including family psychoeducation and basic family involvement and support. The aim of this sub-study was to explore how patients with psychotic disorders experience systematic family involvement, and its significance. Methods We conducted semi-structured, individual interviews with 13 persons with a psychotic disorder after systematic family involvement. The participants were recruited through purposive sampling. Qualitative content analysis guided the analysis. Results Participants reported overall positive experiences with systematic family involvement. It was significant that the relatives increasingly understood more about psychosis and their situation, while they themselves also gained more insight into the relatives` situation. The participants emphasised the need to enable both patients and relatives to safely share experiences in a containing space, led by professionals. Shared understanding and awareness of each other’s situation further improved communication, coping with the illness, reduced stress, and stimulated a more caring family environment. The therapist seemed crucial to facilitate these beneficial communication processes, and also to provide continuous support to the relatives. Reported challenges included that the participants felt vulnerable in the initial phase, a need for tailored approaches, and too late start-up. Conclusion Findings from this study suggest that persons with psychotic disorders may benefit greatly from participating in systematic family involvement. This study also gives new insight into possible mediators of positive outcomes both for the patients and the relatives. Systematic family involvement should be implemented a standard approach in the early phase of the disease, using a step-wise and tailored process.

• Hestmark, Lars; Romøren, Maria; Heiervang, Kristin Sverdvik; Hansson, Kristiane Myckland; Ruud, Torleif & Benth, Jurate Saltyte [Show all 9 contributors for this article] (2023). Implementation of Guidelines on Family Involvement for Persons with Psychotic Disorders (IFIP): A Cluster Randomised Controlled Trial. Administration and Policy in Mental Health and Mental Health Services Research. ISSN 0894-587X. 50(3), p. 520–533. doi: 10.1007/s10488-023-01255-0. Full text in Research Archive Show summary

  Family involvement is part of the evidence-based treatment for persons with psychotic disorders, yet is under-implemented despite guideline recommendations. This study assessed whether an implementation support programme increased the adherence to guidelines on family involvement, compared to guideline/manual only. In a cluster randomised design, community mental health centre units in South-East Norway went through stratified allocation to the experimental (n = 7) or control (n = 7) arm. Experimental clusters received an implementation support programme including clinical training and supervision, appointing a family coordinator and an implementation team, a toolkit, and fidelity measurements at baseline, 12, 18, and 24 months with on-site feedback and supervision. Control clusters received no such support and had fidelity measurements at baseline and 24 months without feedback. During fidelity measurements, adherence to the guidelines was measured with the basic family involvement and support scale, the general organizational index, and the family psychoeducation fidelity scale, the latter being the primary outcome. The scales consist of 12–14 items rated from 1 to 5. Data was analysed with an independent samples t-test, linear mixed models, and a tobit regression model. At 24 months, the mean scores were 4.00 or higher on all scales in the experimental arm, and the increase in adherence to the guidelines was significantly greater than in the control arm with p-values < 0.001. Large-scale implementation of guidelines on family involvement for persons with psychotic disorders in community mental health centres may be accomplished, with substantial implementation support.

• Hem, Marit Helene; Molewijk, Albert Christiaan; Weimand, Bente Margrethe & Pedersen, Reidar (2023). Patients with severe mental illness and the ethical challenges related to confidentiality during family involvement: a scoping review. Frontiers in Public Health. 10, p. 1–14. doi: 10.3389/fpubh.2022.960815. Full text in Research Archive Show summary

  Background: Despite evidence on the significant potential value of family involvement during the treatment of patients with severe mental illness, research has shown that family involvement is largely underused. The duty of confidentiality is reported to be a key barrier to family involvement. To develop more insight into this barrier, this scoping review focuses on the following question: What are the reported ethical challenges related to confidentiality when involving family in the treatment of patients with severe mental illness? Methods: A systematic search into primary studies was conducted using the following databases: Medline (Ovid), PsycINFO (Ovid), CINAHL (EBSCO), and Web of Science core collection (Clarivate). The PICO (Population, Intervention, Comparison, Outcome) scheme and qualitative content analysis were used to make the ethical challenges more explicit. Results: Twelve studies—both qualitative and quantitative—were included. We identified the following main categories of ethical challenges: (1) the best interest of family members vs. confidentiality, (2) the patient's best interest vs. the right to confidentiality, (3) patient trust and alliance as a reason not to involve the relatives or not to share information, and (4) using confidentiality as a smokescreen. We also identified several subcategories and illustrative and concrete examples of ethical challenges. Conclusions: Through a systematic examination, we discovered various types of ethical challenges related to confidentiality when involving the family in the treatment of patients with severe mental illness. However, research on these ethical challenges and the constituents of these challenges remains limited and often implicit. An ethical analysis will create knowledge which may facilitate a more balanced and nuanced approach to respecting the principle of confidentiality while also considering other moral principles. The duty of confidentiality does not always have to be a major barrier to family involvement; this insight and using this ethical analysis in the training of healthcare professionals may benefit the patient, the family, and the services.

• Hansson, Kristiane Myckland; Romøren, Maria; Pedersen, Reidar; Weimand, Bente Margrethe; Hestmark, Lars & Norheim, Irene [Show all 9 contributors for this article] (2022). Barriers and facilitators when implementing family involvement for persons with psychotic disorders in community mental health centres - a nested qualitative study. BMC Health Services Research. 22(1). doi: 10.1186/s12913-022-08489-y. Full text in Research Archive Show summary

  Background The uptake of family involvement in health care services for patients with psychotic disorders is poor, despite a clear evidence base, socio-economic and moral justifications, policy, and guideline recommendations. To respond to this knowledge-practice gap, we established the cluster randomised controlled trial: Implementation of guidelines on Family Involvement for persons with Psychotic disorders in community mental health centres (IFIP). Nested in the IFIP trial, this sub-study aims to explore what organisational and clinical barriers and facilitators local implementation teams and clinicians experience when implementing family involvement in mental health care for persons with psychotic disorders. Methods We performed 21 semi-structured focus groups, including 75 participants in total. Implementation team members were interviewed at the initial and middle phases of the intervention period, while clinicians who were not in the implementation team were interviewed in the late phase. A purposive sampling approach was used to recruit participants with various engagement in the implementation process. Data were analysed using manifest content analysis. Results Organisational barriers to involvement included: 1) Lack of shared knowledge, perceptions, and practice 2) Lack of routines 3) Lack of resources and logistics. Clinical barriers included: 4) Patient-related factors 5) Relative-related factors 6) Provider-related factors. Organisational facilitators for involvement included: 1) Whole-ward approach 2) Appointed and dedicated roles 3) Standardisation and routines. Clinical facilitators included: 4) External implementation support 5) Understanding, skills, and self-efficacy among mental health professionals 6) Awareness and attitudes among mental health professionals. Conclusions Implementing family involvement in health care services for persons with psychotic disorders is possible through a whole-ward and multi-level approach, ensured by organisational- and leadership commitment. Providing training in family psychoeducation to all staff, establishing routines to offer a basic level of family involvement to all patients, and ensuring that clinicians get experience with family involvement, reduce or dissolve core barriers. Having access to external implementation support appears decisive to initiate, promote and evaluate implementation. Our findings also point to future policy, practice and implementation developments to offer adequate treatment and support to all patients with severe mental illness and their families.

• Husum, Tonje Lossius; Pedersen, Reidar & Aasland, Olaf Gjerløw (2022). Frequent Violations and Infringements against Users in Mental Health Care Confirmed by Both Users and Professionals–A Quantitative Study. Issues in Mental Health Nursing. ISSN 0161-2840. 43(9), p. 862–869. doi: 10.1080/01612840.2022.2063461. Full text in Research Archive Show summary

  The main task of mental health care services is to provide good quality of care. Despite this, users are sometimes treated badly by staff. The purpose of this study was to investigate violations and infringements towards users in mental health care services, from the perspectives of both staff and users. Data were gathered through an anonymous online questionnaire sent to staff and users in Norway. Staff were recruited in collaboration with professional organisations and users in collaboration with user-organisations.

• Hansson, Kristiane Myckland; Romøren, Maria; Weimand, Bente Margrethe; Heiervang, Kristin Sverdvik; Hestmark, Lars & Landeweer, Elleke [Show all 7 contributors for this article] (2022). The duty of confidentiality during family involvement: ethical challenges and possible solutions in the treatment of persons with psychotic disorders. BMC Psychiatry. 22(1), p. 1–13. doi: 10.1186/s12888-022-04461-6. Full text in Research Archive Show summary

  Background: Family involvement during severe mental illness is still poorly implemented, contrary to evidence-based recommendations. Confidentiality issues are among the most prominent barriers, with mental health professionals facing complex ethical, legal, and practical challenges. However, research focusing on this barrier is very sparse. Nested within a cluster-randomised trial to implement guidelines on family involvement for persons with psychotic disorders in community mental health centres, the aim of this sub-study was to explore ethical challenges related to the duty of confidentiality as experienced by mental health professionals, and to explore key measures that might contribute to improving the handling of such challenges. Methods: In total 75 participants participated in 21 semi-structured focus groups, including implementation team members at the initial and late phase of the intervention period and clinicians who were not on the implementation teams, at late phase of implementation. We used purposive sampling and manifest content analysis to explore participants’ experiences and change processes. Results: Ethical challenges related to the duty of confidentiality included 1) Uncertainty in how to apply the legislation, 2) Patient autonomy versus a less strict interpretation of the duty of confidentiality, 3) Patient alliance and beneficence versus a less strict interpretation of the duty of confidentiality, 4) How to deal with uncertainty regarding what relatives know about the patients’ illness, and 5) Relatives’ interests versus the duty of confidentiality. Measures to facilitate better handling of the duty of confidentiality included 1) Training and practice in family involvement, and 2) Standardisation of family involvement practices. Conclusion: When health professionals gained competence in and positive experiences with family involvement, this led to vital changes in how they interpreted and practiced the duty of confidentiality in their ethical reasoning and in clinical practice. Especially, the need to provide sufficient information to the patients about family involvement became evident during the study. To improve the handling of confidentiality issues, professionals should receive training in family involvement and confidentiality statutes followed by practice. Furthermore, family involvement should be standardised, and confidentiality guidelines should be implemented in the mental health services.

• Hestmark, Lars; Heiervang, Kristin S.; Pedersen, Reidar; Hansson, Kristiane Myckland; Ruud, Torleif & Romøren, Maria (2021). Family involvement practices for persons with psychotic disorders in community mental health centres – a cross-sectional fidelity-based study. BMC Psychiatry. 21, p. 1–11. doi: 10.1186/s12888-021-03300-4. Full text in Research Archive Show summary

  Background Family involvement for persons with psychotic disorders is supported by scientific evidence, as well as legal and ethical considerations, and recommended in clinical practice guidelines. This article reports a cross-sectional measurement of the level of implementation of such guidelines in fifteen community mental health centre units in Norway, and presents a novel fidelity scale to measure basic family involvement and support. The aim was to investigate current family involvement practices comprehensively, as a basis for targeted quality improvement. Methods We employed three fidelity scales, with 12–14 items, to measure family involvement practices. Items were scored from 1 to 5, where 1 equals no implementation and 5 equals full implementation. Data was analysed using descriptive statistics, a non-parametric test, and calculation of interrater reliability for the scales. Results The mean score was 2.33 on the fidelity scale measuring basic family involvement and support. Among patients with psychotic disorders, only 4% had received family psychoeducation. On the family psychoeducation fidelity assessment scale, measuring practice and content, the mean score was 2.78. Among the eight units who offered family psychoeducation, it was 4.34. On the general organizational index scale, measuring the organisation and implementation of family psychoeducation, the mean score was 1.78. Among the units who offered family psychoeducation, it was 2.46. As a measure of interrater reliability, the intra-class correlation coefficient was 0.99 for the basic family involvement and support scale, 0.93 for the family psychoeducation fidelity assessment scale and 0.96 for the general organizational index scale. Conclusions The implementation level of the national guidelines on family involvement for persons with psychotic disorders was generally poor. The quality of family psychoeducation was high, but few patients had received this evidence-based treatment. Our novel fidelity scale shows promising psychometric properties and may prove a useful tool to improve the quality of health services. There is a need to increase the implementation of family involvement practices in Norway, to reach a larger percentage of patients and relatives. Trial registration ClinicalTrials.gov Identifier NCT03869177 . Registered 11.03.19.

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• Hansson, Kristiane Myckland & Hestmark, Lars (2024). Bedre pårørendesamarbeid. [Internet]. legeforeningen.no. Full text in Research Archive
• Norheim, Irene & Romøren, Maria (2024). Implementering av retningslinjer for familieinvolvering for personer med psykoselidelser. Resultater fra Bedre Pårørendesamarbeid (BPS)-studien. Full text in Research Archive Show summary

  Implementering av retningslinjer for familieinvolvering for personer med psykoselidelser: Resultater fra Bedre Pårørendesamarbeid (BPS)-studien Introduksjon: Familieinvolvering er en del av den evidensbaserte behandlingen for personer med psykoselidelser, men er underimplementert til tross for at nasjonale og internasjonale retningslinjer anbefaler familieinvolvering som førstevalgs behandling. BPS-studien hadde som mål å 1) utforske hvilke organisatoriske og kliniske hemmere og fremmere lokale implementeringsteam og klinikere opplevde (ved implementering av familieinvolvering), 2) vurdere om et implementeringsstøtteprogram (ISP) økte implementeringsgraden av retningslinjer for familieinvolvering, og 3) undersøke effekten av IPS på pårørendetilbud ved distriktpsykiatriske sentre (DPS), og på pasienter og pårørendes opplevde psykososiale helse, livskvalitet og tilfredshet med tjenestene. Metoder: En klyngerandomisert kontrollert multisenter studie ble utført ved 15 DPS enheter i Helse Sør-Øst. Rekrutterte enheter ble randomisert til intervensjon (ISP) eller kontrollgruppe. Deretter rekrutterte enhetene psykosepasienter og deres nærmeste pårørende til å delta i studien. Data ble innhentet gjennom fokusgruppeintervjuer med klinikere, forbedringsteam og ledere, intervjuer med pasienter og pårørende, fidelitymålinger, og spørreskjemaer til pasienter, pårørende og klinikere. Resultater: Det å gi opplæring i psykoedukativt familiesamarbeid (PEF) til ansatte, etablere rutiner for å tilby grunnleggende familieinvolvering til alle pasienter, og sikre at klinikere får erfaring med familieinvolvering, er viktige fremmere. Implementeringsgraden av retningslinjer for familieinvolvering og mengden av ulike typer familie- og støttekonsultasjoner, inkludert PEF, var signifikant større i intervensjonsgruppen enn i kontrollgruppen. Familieinvolvering bidro til felles forståelse, anerkjennelse og gjensidig dialog mellom pårørende, pasienter og klinikere. Resultatene fra 231 pasient-/pårørendepar er under arbeid. Konklusjon: Implementering av familieinvolvering i DPS enheter for personer med psykoselidelser er mulig gjennom en helhetlig tilnærming på flere nivåer, sikret av tydelig ledelsesforankring og engasjement i organisasjonen. Denne studien viser at god implementeringsstøtte er svært viktig for at helsetjenesten skal kunne tilby evidensbasert behandling. Resultatene kan ha overføringsverdi til pasienter med andre alvorlige psykiske lidelser og deres pårørende.

• Giske, Hanne Wilhelmsen; Norheim, Irene & Romøren, Maria (2024). Helsepersonell som lærer å utøve pårørendesamarbeid, erfarer nytten av det og bruker det. NAPHA Nasjonalt kompetansesenter for psykisk helsearbeid. Full text in Research Archive
• Pedersen, Reidar (2023). Presentation of other social innovation measures and ideas based upon the IFIP/BPS-project. Full text in Research Archive
• Pedersen, Reidar (2023). How to improve graduate and post-graduate health educations on family involvement based on the IFIP/BPS-results? Full text in Research Archive
• Hansson, Kristiane Myckland (2023). Etiske utfordringer i pårørendesamarbeid. Full text in Research Archive
• Hansson, Kristiane Myckland (2023). Pårørendesamarbeid - hvorfor er det viktig og hvordan kan vi få det til? Full text in Research Archive
• Hansson, Kristiane Myckland (2023). Implementering av psykoedukativt familiesamarbeid (PEF) - erfaringer fra Bedre Pårørendesamarbeid-prosjektet 2017-2023. Full text in Research Archive
• Hansson, Kristiane Myckland (2023). Pårørende til personer med demens. Full text in Research Archive
• Hansson, Kristiane Myckland (2023). Nasjonal implementering av Barn under radaren. Full text in Research Archive
• Hansson, Kristiane Myckland (2023). Implementering av pårørendesamarbeid. Full text in Research Archive
• Hansson, Kristiane Myckland (2023). At du har taushetsplikt betyr ikke at du har en plikt til å være taus» Erfaringer fra implementering av pårørendesamarbeid i de psykiske helsetjenestene. Full text in Research Archive
• Pedersen, Reidar (2023). Information about opportunities to disseminate knowledge from the project. Full text in Research Archive
• Hansson, Kristiane Myckland (2023). En effektiv behandlingsform svært få får: – Dette er et problem både i Norge og internasjonalt. [Journal]. psykologisk.no. Full text in Research Archive
• Hansson, Kristiane Myckland (2023). Etiske utfordringer i pårørendesamarbeid. Full text in Research Archive
• Hansson, Kristiane Myckland (2023). «At du har taushetsplikt betyr ikke at du har en plikt til å være taus» - Resultater og erfaringer fra Bedre Pårørendesamarbeid-prosjektet (2017-2023). Full text in Research Archive
• Hansson, Kristiane Myckland (2023). Pårørendesamarbeid - hvorfor er det viktig og hvordan kan vi få det til? Full text in Research Archive
• Hansson, Kristiane Myckland (2023). Faktorer som hemmer og fremmer godt pårørendesamarbeid i tjenestene. Full text in Research Archive
• Hansson, Kristiane Myckland (2023). Hva har pårørendesamarbeidet betydd for pasienter, pårørende, klinikere, og tjenestene i BPS-studien? Full text in Research Archive
• Hestmark, Lars; Romøren, Maria; Heiervang, Kristin Sverdvik; Hansson, Kristiane Myckland; Ruud, Torleif & Benth, Jurate Saltyte [Show all 9 contributors for this article] (2023). Correction to: Implementation of Guidelines on Family Involvement for Persons with Psychotic Disorders (IFIP): A Cluster Randomised Controlled Trial (Administration and Policy in Mental Health and Mental Health Services Research, (2023), 50, 3, (520-533), 10.1007/s10488-023-01255-0). Administration and Policy in Mental Health and Mental Health Services Research. ISSN 0894-587X. doi: 10.1007/s10488-023-01291-w. Full text in Research Archive
• Hansson, Kristiane Myckland (2023). Episode 6 - Betydningen av pårørendesamarbeid. [Internet]. Podcasten "Psykiateren" - Norsk Psykiatrisk forening. Full text in Research Archive
• Hansson, Kristiane Myckland (2023). Å støtte dem som hjelper. [Internet]. Podcast Pårørendesenteret. Full text in Research Archive
• Hansson, Kristiane Myckland (2023). Betydning av godt pårørendesamarbeid. Full text in Research Archive
• Hansson, Kristiane Myckland (2023). Pårørendesamarbeid med særlig fokus på pårørende til personer med demens. Full text in Research Archive
• Hansson, Kristiane Myckland (2023). At du har taushetsplikt betyr ikke at du har en plikt til å være taus» - Om å skape gode dialoger mellom bruker, helsepersonell og pårørende. Full text in Research Archive
• Hansson, Kristiane Myckland (2023). Pårørendesamarbeid ved alvorlige psykiske lidelser. Full text in Research Archive
• Hansson, Kristiane Myckland (2023). Betydningen av godt pårørendesamarbeid. Full text in Research Archive
• Hansson, Kristiane Myckland (2023). «At du har taushetsplikt betyr ikke at du har en plikt til å være taus» - Om å skape gode dialoger mellom bruker, helsepersonell og pårørende. Full text in Research Archive
• Hansson, Kristiane Myckland (2023). Psykisk helse og rus – den utfordrende pårørenderollen. Full text in Research Archive
• Hansson, Kristiane Myckland (2023). Pårørendesamarbeid i psykisk helsevern gir bedre behandling. [Internet]. Frivillighet og tvang Kompetansenter. Nyhetsbrev 4/2023. Full text in Research Archive
• Pedersen, Reidar (2023). Hvordan skape bærekraft i pårørendesamarbeidet? Full text in Research Archive
• Pedersen, Reidar (2023). Betydning av vilkåret om manglende samtykkekompetanse for pårørende og noen mer generelle kommentarer - til Samtykkeutvalget. Full text in Research Archive
• Pedersen, Reidar (2023). Scaling up the implementation of guidelines on family involvement for persons with psychotic disorders in community mental health centres (IFIP-SPARK) - Status and challenges. Full text in Research Archive
• Hestmark, Lars (2023). Hvorfor bør vi styrke implementeringen av pårørendesamarbeid i behandlingen av personer med psykoselidelser? Full text in Research Archive
• Heiervang, Kristin Sverdvik (2023). Hvordan lyktes vi med å implementere de nasjonale retningslinjene for pårørendesamarbeid? Full text in Research Archive
• Hansson, Kristiane Myckland (2023). Involvering av pårørende er viktig i behandlingen av mennesker med alvorlige psykoselidelser. [Internet]. https://www.med.uio.no/helsam/forskning/aktuelt/. Full text in Research Archive
• Pedersen, Reidar (2023). Implementering av nasjonale anbefalinger for pårørendesamarbeid - erfaringer og resultater fra BPS(Bedre pårørendesamarbeid)-prosjektet. Full text in Research Archive
• Pedersen, Reidar (2023). Samfunnsinnovasjoner: Forskning driver samfunnet framover. [Journal]. Apollon. Full text in Research Archive
• Pedersen, Reidar (2023). Scaling up the implementation of guidelines on family involvement for persons with psychotic disorders in community mental health centres (IFIP-SPARK) - Activities so far. Full text in Research Archive
• Pedersen, Reidar (2023). Betydning av systematisk pårørendesamarbeid. Full text in Research Archive
• Pedersen, Reidar (2023). Ny forskning om pårørendesamarbeid – viktig for pasientene, pårørende og samfunnet. [Internet]. https://www.med.uio.no/helsam/om/aktuelt/aktuelle-saker/2023. Full text in Research Archive
• Heiervang, Kristin Sverdvik (2023). Bedre pårørendesamarbeid: Implementeringsstrategier og tiltak. Full text in Research Archive
• Hansson, Kristiane Myckland (2023). Systematisk samarbeid med de pårørende er viktig i behandling av pasienter med psykoselidelser. [Internet]. forskning.no. Full text in Research Archive
• Pedersen, Reidar (2023). Deling av BPS-ressurser, veien videre og takk for i dag! Full text in Research Archive
• Pedersen, Reidar (2023). Om Bedre Pårørendesamarbeid (BPS)-prosjektet. Full text in Research Archive
• Pedersen, Reidar (2023). Bedre pårørendesamarbeid: Kliniske intervensjoner. Full text in Research Archive
• Norheim, Irene (2023). Hva har pårørendesamarbeidet betydd for pasienter og pårørende i BPS-studien? Full text in Research Archive
• Pedersen, Reidar (2022). Bedre pårørendesamarbeid (BPS) - bruk av resultatene og sosial innovasjon. Full text in Research Archive
• Pedersen, Reidar (2022). Bedre Pårørendesamarbeid (BPS) m.m.- Om prosjektet og noen foreløpige forskningsfunn - innspill til Hdirs evaluering av implementering av pårørendeveilederen. Full text in Research Archive
• Pedersen, Reidar (2022). Bedre Pårørendesamarbeid (BPS) - hvordan kan denne forskningen komme flest mulig pasienter og pårørende til gode? Innspill til. Full text in Research Archive
• Pedersen, Reidar (2022). Future publications and dissemination activities. Full text in Research Archive
• Pedersen, Reidar (2022). Funn fra Bedre pårørendesamarbeid prosjektet med relevans for Ukoms saker som omhandler pårørande til alvorleg sjuke psykiatriske pasientar. Full text in Research Archive
• Pedersen, Reidar (2022). Political economy analysis. Full text in Research Archive
• Pedersen, Reidar (2022). Welcome, future funding applications and end-of-project conference. Full text in Research Archive
• Hansson, Kristiane Myckland (2022). Implementering av pårørendesamarbeid i psykisk helsevern. Funn og erfaringer fra forsknings- og implementeringsstudien Bedre pårørendesamarbeid (BPS). Full text in Research Archive
• Hansson, Kristiane Myckland (2022). Undervisning i pårørendesamarbeid og etikk. Full text in Research Archive
• Bakke, Mathilde Coraline Aarvold; Norheim, Irene & Romøren, Maria (2022). Forskning bidrar til utvikling og innovasjon i helsetjenestene. UiO web. Full text in Research Archive Show summary

  Forskning og fagutvikling har hatt stor betydning for innføring av systematisk pårørendesamarbeid i helsetjenestene, og for utvikling av en samtaleguide for helsepersonell.

• Hansson, Kristiane Myckland (2021). The IFIP study: Implementation of guidelines on family involvement for persons with psychotic disorders in mental health centres. Barriers and facilitators to family involvement. Full text in Research Archive
• Pedersen, Reidar (2021). Scaling up the implementation of guidelines on family involvement for persons with psychotic disorders in community mental health centres (IFIP-SPARK). Full text in Research Archive
• Pedersen, Reidar (2021). Etiske aspekter ved en nullvisjon om selvmord og forebygging. Full text in Research Archive
• Pedersen, Reidar (2021). Selvmordsforebygging, nullvisjon og etikk. Full text in Research Archive
• Hansson, Kristiane Myckland (2021). Hvordan få til et bedre pårørendesamarbeid for pasienter med psykoselidelser? Hva er hemmerne og fremmerne? Full text in Research Archive
• Hansson, Kristiane Myckland (2021). Om psykoedukativt familiesamarbeid (PEF) og betydningen av PEF for det generelle pårørendesamarbeidet. Full text in Research Archive
• Hansson, Kristiane Myckland (2021). Foreløpige resultater fra intervensjonsenhetene i BPS – Hva sier de mest sentrale partene om betydningen? Full text in Research Archive
• Hansson, Kristiane Myckland (2021). Hvordan få til et bedre pårørendesamarbeid for pasienter med psykoselidelser? Hva er hemmerne og fremmerne? Full text in Research Archive
• Hansson, Kristiane Myckland (2021). Foreløpige resultater fra intervensjonsenhetene i BPS – Hva sier de mest sentrale partene om betydningen? Full text in Research Archive
• Hansson, Kristiane Myckland (2021). "Hadde noen hjulpet oss med å snakke sammen da jeg ble syk, hadde jeg vært nykter i dag"- En presentasjon av forsknings- og implementeringsstudien Bedre Pårørendesamarbeid (BPS) i psykisk helsevern. Full text in Research Archive
• Pedersen, Reidar & Hestmark, Lars (2021). Lokal veiledning etter fidelitymåling. Full text in Research Archive
• Pedersen, Reidar; Hansson, Kristiane Myckland & Carlsen, Simon (2021). Om taushetsplikten – teori og praksis. Full text in Research Archive
• Pedersen, Reidar (2021). Avslutning og veien videre. Full text in Research Archive
• Pedersen, Reidar & Heiervang, Kristin Sverdvik (2021). Presentasjon prosjektet Bedre Pårørendesamarbeid - foreløpige resultater og mulige spredning. Full text in Research Archive
• Hestmark, Lars (2021). Hva har intervensjonsenhetene lykkes med? Full text in Research Archive
• Hestmark, Lars (2021). Intervensjonspakken. Full text in Research Archive
• Hestmark, Lars (2021). Bedre PårørendeSamarbeid - Et forsknings- og forbedringsprosjekt ved psykosepoliklinikken SODPS. Full text in Research Archive
• Hestmark, Lars & Pedersen, Reidar (2021). Assessments of fidelity (primary outcome measure) - preliminary results, impressions, and status. Full text in Research Archive
• Pedersen, Reidar (2021). Lokal veiledning i BPS for Asker DPS etter fidelitymåling. Full text in Research Archive
• Romøren, Maria & Hansson, Kristiane Myckland (2021). Preliminary results from interviews with patients and relatives (their experiences with the intervention). Full text in Research Archive
• Pedersen, Reidar (2021). Introduction to the project, status and progress. Full text in Research Archive
• Pedersen, Reidar & Hansson, Kristiane Myckland (2021). Lokal veiledning etter BPS fidelitymåling 4. Full text in Research Archive
• Pedersen, Reidar (2021). Hva har intervensjonsenhetene lyktes med? Full text in Research Archive
• Heiervang, Kristin Sverdvik (2021). Hvordan jobbe systematisk – med implementeringen og i praksis? Full text in Research Archive
• Heiervang, Kristin Sverdvik (2021). Hvordan jobbe systematisk – med implementeringen og i praksis? Full text in Research Archive
• Hansson, Kristiane Myckland (2021). Pårørendesamarbeid. Full text in Research Archive
• Heiervang, Kristin Sverdvik (2021). Hvem skal gjøre hva på hvilket nivå – og hvem har ansvaret? Behandlere, pårørendekoordinator, forbedringsteam? Team, seksjon, avdeling, klinikk? Full text in Research Archive
• Norheim, Irene (2021). Questionnaires patients and relatives - status and progress. Full text in Research Archive
• Pedersen, Reidar (2021). Hva slags pårørendesamarbeid bør alle pasienter med psykoselidelser og deres pårørende få tilbud om? Nasjonale føringer og intervensjonspakken i BPS. Full text in Research Archive
• Pedersen, Reidar (2021). Velkommen, praktisk info og kort intro til prosjektet Bedre pårørendesamarbeid (BPS). Full text in Research Archive
• Pedersen, Reidar (2021). Videre implementeringsstøtte for enhetene. Full text in Research Archive
• Hestmark, Lars (2024). Implementation of guidelines on family involvement for persons with psychotic disorders: A cluster randomised trial with mixed methods evaluation. Universitetet i Oslo. Full text in Research Archive Show summary

  Scientific evidence suggests that family interventions lead to significantly improved outcomes for persons with psychotic disorders, their relatives, and the public health and welfare services, yet the implementation in mental health care is generally poor and irregular. The aim of the ‘Implementation of Family Involvement for persons with Psychotic disorders’ (IFIP) study was to implement the national guidelines on family involvement for persons with psychotic disorders in Norwegian community mental health centres (CMHCs). At the intersection between the fields of public health and psychiatry, this thesis provides an overview of the cluster randomised IFIP trial, describes and evaluates the implementation process with quantitative methods, and explores clinicians’ perceptions of family involvement through qualitative methods. Experimental clusters received an ‘implementation support programme’ (ISP) for 18 months to implement family involvement, which included the appointment of a family coordinator and an implementation team, clinical training and supervision, a toolkit, fidelity measurements with onsite feedback and supervision, a focus on leadership commitment, and systematic stakeholder engagement, recommending agency-wide education and multidisciplinary delivery of family involvement. At baseline, the CMHCs lacked organisational structures and procedures for family involvement, with few patients and relatives being reached. Statistical analyses showed that the ISP had a significant effect on the level of adherence to the national guidelines in the experimental arm, when compared to no implementation support in the control arm. The qualitative study showed that clinicians mainly reported positive experiences with providing family involvement, while describing occasional challenges. The methods and findings of the IFIP study should be highly relevant to policy makers, health service units, administrators, and clinicians who wish to implement family involvement.

• Hansson, Kristiane Myckland (2023). Building bridges over troubled water - A qualitative evaluation of an implementation study on family involvement in the treatment of persons with psychotic disorders. Doktorgradsavhandling. Universitetet i Oslo. ISSN 9788234802126. Full text in Research Archive

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