‘If he feels better I'll feel better’ relationships with individuals at high‐risk of developing psychosis

Abstract

Aim A large proportion of individuals with an at‐risk mental state (ARMS) live at home and are supported by their families. Recommended treatment includes family intervention (FI), and therefore, understanding relationships between individuals with an ARMS and their family members is key. This study aimed to provide a more holistic exploration of relationships within families of individuals with an ARMS by reporting the perceived impact of the condition on other family members including sibling and romantic relationships. Method Fourteen semi‐structured interviews with family members were analysed using thematic analysis. Results Parents wanted to maintain a safe family environment for all family members. This can result in spending less time with siblings who impacted on siblings' relationships with the service user and other family members. Romantic relationships were negatively impacted when there was unclear communication between the couple, as well as the partner's response and understanding of the ARMS condition. Clear communication across sibling and romantic relationships facilitated helpful family/carer's behaviour and understanding of the individuals' mental distress. Conclusion FI should explore and support families with changes in sibling and romantic relationships. More research is needed to understand siblings' perspectives in families with individuals experiencing an ARMS and to develop resources to support partners and families in changes within their sexual and romantic relationships.

The psychosocial stressors of siblings of people with experiences of psychosis (SOPEP): A systematic narrative review across cultures

“…Studies highlighted the diverse forms of care SOPEP provided: Physical care included managing medication, appointments, providing transport and housing (Amaresha et al, 2019; Napa et al, 2017; Purba, 2017; Udgiri et al, 2017; Yang et al, 2017); emotional support included listening, providing advice and empathy (Al‐Sawafi et al, 2021; Al Sawafi et al, 2022; Liu & Zhang, 2019); social support included providing companionship, social interactions and access to activities (Al‐Sawafi et al, 2021; Bishop & Greeff, 2015; Dodge & Smith, 2019; Napa et al, 2017; Seeman, 2013); and finally, financial support included transport, bills and disturbances in SOPEP's own occupation (Al‐Sawafi et al, 2021; Amaresha et al, 2015, 2019; Purba, 2017; Udgiri et al, 2017; Yang et al, 2017; Young & Flannigan, 2021). Five studies did not mention specific psychosocial demands (Graves et al, 2020, 2021; Izon et al, 2021; Purba, 2017; Sin et al, 2017).…”

“…Negative emotional experiences by SOPEP may be attributed towards their beliefs of their sibling's behaviours being intentional. These criticisms may elicit jealousy when combined with attention focussed on the patient and the SOPEP's needs perceived as less important (Seeman, 2013; Izon et al, 2021).…”

“…This may have an impact for SOPEP during adolescence and early adulthood on the sibling relationship (Graves et al, 2021), relationships with their parents (e.g., feeling abandoned) and their psychosocial functioning. SOPEP who experienced changes within family relationships (i.e., family conflict, involvement in caregiving and less attention/time with parents) may lack the knowledge and understanding of the condition (Al Sawafi et al, 2022; Amaresha et al, 2015; Izon et al, 2021; Liegghio, 2017; Napa et al, 2017; Sin et al, 2017).…”

“…These criticisms may elicit jealousy when combined with attention focussed on the patient and the SOPEP's needs perceived as less important (Seeman, 2013;Izon et al, 2021).…”

“…SOPEP may recognise themselves as adopting a 'parenting role' (Graves et al, 2021;Izon et al, 2021), over their lifetime (Day & Petalas, 2020;Graves et al, 2021;Kovacs et al, 2019;Yang et al, 2017). However, some may choose not to engage and avoid caregiving responsibilities and distance themselves from their sibling (Seeman, 2013).…”