Tele-Group Cognitive Behavioural Family Intervention for Schizophrenia-Spectrum Disorders and Their Caregivers: A Feasibility Randomised Controlled Trial

Background: Family-based interventions are effective in mitigating the risk for relapse of schizophrenia. However, the accessibility of these interventions is scarce in many clinical settings. A group-based brief cognitive behavioural intervention facilitated by a therapist using videoconferencing may help address this practice gap and improve the high treatment disengagement that occurs in interventions delivered in self-paced web-based forums or mobile applications. Objective: To examine the feasibility, acceptability, and safety of an online group-based cognitive behavioural family intervention for dyads of individuals with schizophrenia-spectrum disorders and caregivers. Methods: This feasibility study adopted a parallel-group, assessor-blind randomised controlled trial with a twelve-week post-intervention follow-up as well as individual semi-structured interviews. Participants were randomly assigned to the intervention group [i.e., tele-group cognitive behavioural family intervention (tgCBFI) group] and the treatment-as-usual group. Both groups also received biweekly brief telephone support. The feasibility and acceptability were assessed by the recruitment rate, intervention completion rate, retention rate and participants’ service satisfaction. Safety was measured by the number of adverse events. Results: Most intervention group participants (85.7%) attended all six online group sessions (six service user-caregiver dyads, corresponding to 12 participants), while 100% of participants attended the per-protocol number of sessions (≥four sessions). The study recruitment rate was 16.4%, while the study retention rate for follow-up assessments was 95.8%. No adverse events were reported throughout the study. Five themes were generated to illustrate the benefits of and recommendations for the tgCBFI programme to complement the quantitative findings. Conclusions: The preliminary results suggested that the use of videoconferencing to deliver group-based cognitive behavioural intervention was partially feasible and provided exploratory estimates suggesting possible improvement in psychiatric symptoms for individuals with schizophrenia-spectrum disorders, warranting a fully powered trial. Trial Registration: prospectively registered at ClinicalTrials.gov NCT05808244.