A Scoping Review And Critical Appraisal Of Guidelines For Early Intervention Services For Psychosis: A Focus On Family Involvement And Family Interventions
Poster C65, Wednesday, October%2010, 11:30%20am%20-%201:00%20pm, Essex%20Ballroom
Helen Martin1,2, Megan Pope2, Manuela Ferrari2, Srividya Iyer1,2; 1McGill university, Montreal, Canada, 2Douglas Mental Health University Institute, Montreal, Canada
Rationale: Despite wide acknowledgement of the benefits of family involvement and interventions in improving outcomes among persons with early psychosis, challenges remain in implementing these in specialized early intervention services (EIS). Unclear program mandates in EIS clinical guidelines have been identified as a barrier to involving families. It is therefore necessary to critically appraise the recommendations of existing EIS guidelines with respect to family involvement and intervention in services. The current study addresses this need. Methods: We conducted a scoping review of clinical practice guidelines for EIS for psychosis published from 2000 to present. Identified EIS guidelines were evaluated using the Appraisal of Guidelines, Research and Evaluation II instrument comprising six major quality domains: scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, and editorial independence. The extracted data were synthesized using descriptive quantitative and qualitative techniques. Results: Most guidelines were developed in Western countries. Preliminary results suggest that guidelines were adequate with respect to scope and purpose and editorial independence, for instance, by describing program objectives, conflict of interests, etc. Stakeholder involvement and rigor of development were inadequately described, resulting in uncertainty regarding whether family-related guidelines were evidence-informed and which stakeholders’ inputs informed these. Guidelines generally fared least well with respect to clarity of presentation and applicability. Family involvement guidelines were ambiguous (e.g., families/carers “must be involved wherever possible”) and thus difficult to operationalize into service delivery or audit criteria. Implications for improving guidelines and EIS delivery with respect to inclusion of families will be presented.
Topic Area: Public Policy