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Treatment Planning for Veterans with Serious Psychiatric Illnesses and Caregivers

Glynn S, Cohen AN, Randolph G, Young AS. Treatment Planning for Veterans with Serious Psychiatric Illnesses and Caregivers. Paper presented at: VA HSR&D National Meeting; 2004 Mar 1; Washington, DC.


Objectives: While empirical trials have demonstrated that family involvement can improve outcomes, most surveys indicate that caregivers are rarely included in the mental health treatment plans of seriously psychiatrically ill veterans. In this presentation, a comprehensive heuristic for appropriate treatment planning decisions for veterans with serious psychiatric illnesses and their caregivers will be provided, informed, in part, by findings from VA clinical trials. This heuristic proposes sequential utilization of interventions varying on levels of intensity of staff and participant effort, as required by evaluations of patient clinical status and caregiver distress.Methods: First, the general heuristic will be described. Second, in the context of a larger review of the literature on family interventions in serious psychiatric illnesses, the role of three controlled trials conducted at VA GLAHS at West Los Angeles (one completed, two ongoing) supported by VA R and D and evaluating the impact of different types of family interventions on symptomatic outcomes and treatment adherence in veterans with schizophrenia will then be presented. These interventions include family outreach and brief education, on-line family psychoeducation, and behavioral family management.Results: Both published and preliminary findings from these studies will be presented. Overall, family participation can result in reductions in symptomatic exacerbations and family burden.Conclusions: While there are many extant interventions involving caregivers of persons with serious psychiatric illnesses, little is known about matching and timing of interventions. The studies presented here are the beginning of an answer to this issue.Panel: Sayers, Steven L. Sayers, Ph.D. Lisa Dixon, MD Michelle Sherman, Ph.D. Shirley M. Glynn, Ph.D. Discussant: Gretchen,Gretchen Haas, Ph.D.

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