Psychological Growth in Carers of People with Mental Illness

Name: Zafiroula (Zefi)

Vlahodimitrakou

Supervisors: Dr Elizabeth Temple

and Professor Anthony Love

Research completion: June , 2012

“That which does not kill us makes us stronger.” (Nietzche, 1888)

Mental illness and carers

Reduction in in-patient care for mental illness & and shift in focus to the community

People experiencing acute episodes of mental illness are being treated at home

15 % of Australians are carers (Pirkis et al., 2011)

Best Practice= families are included (Hughes, 2009)

The caring role1

Carer defined

Mental health carer- someone who provides informal practical and emotional support to someone with a mental health issue including relatives, friends or neighbours (Clements, 1996)

The contribution of carers

104 hpw (average) caring

Hold Australia’s mental health system together (Hughes, 2009).

The caring role2Difficulties often accompanying the caring role:

Trauma Burden Lowest collective wellbeing Reduced physical, mental and emotional health High depression rates 20.6% carers are unemployedEconomic losses/hardship & financial security compromised Higher levels of ill-health Social isolationDecreased life opportunitiesStigma Difficulty accessing support services (Cummins et al., 2007)

The caring role 3‘Silver lining effect’

The Cognitive Model of Caregiving: carer appraisals -> positive and or negative cognitive and affective changes -> outcomes affective wellbeing of self and care recipient (Kuipers, Onwumere, & Bebbington, 2011)

BENEFITS:

Growth, self-empowerment & advocacy (Muhlbauer, 2002)

Pride & learning inner strengths (Johansson, Carlson, Ahlin, & Anderson, 2010)

Increased resiliency (Mays & Lund, 1999)

Positive changes in relationships with care recipient (Perkins et al., 2004)

Posttraumatic Growth (PTG)/ Psychological Growth PTG is the experience of positive psychological changes

that occur in the way of a traumatic event as a result of the subsequent struggle with what happened (Tedeschi & Calhoun, 2004)

Both a process and an outcome

Can emerge both in the absence and presence of posttraumatic stress

Occurs as the result of any experience perceived as traumatic

It is not appropriate to use the term “PTG” to label changes that may occur in cares of people with mental illness because often there is no “post” for this population

The term “psychological growth” is appropriate

Adapted from “Handbook of Posttraumatic Growth”, by L. G. Calhoun., and R. G. Tedeschi, 2006, p. 8.

Tedeschi’s and Calhoun’s PTG Model (2006)

Conceptualising positive carer outcomes: Psychological growthCaring.....Traumatic?

Traumatic event: circumstances where there is a violation of relatively resistant cognitive core assumptions held by an individual about the world and the self (Janoff-Bulman, 2006)

Chronic sorrow (Roods, 2002)

Barton and Jackson (2005) found that 1/3 of carers (n = 37) of people with early psychosis met criteria for PTSD

Rationale for research on positive psychological growth in carersFor clinicians: - Assist with the assessment and treatment of carer complex emotions-Information about factors sustaining caregiving - Detection of crucial aspects of effective intervention

For carers:

Inclusion of + and - aspects of caregiving experiences into life narrative may be beneficial

By identifying areas of satisfaction in growth, carers may focus less on the negative aspects of providing care, feel a greater sense of accomplishment, and express more positive feelings about their relationship with the person they care for .........?????????

AimsBroad aim:

To identify positive changes in the psychological growth of carers as a result of their caregiving journey.

Specific aim:

To examine the relationship between psychological growth and situational meaning, active and passive coping and informal and formal social support.

Research Variables Situational meaning: meaning found in caregiving

Active coping: problem-focused and active emotion-focused coping

Passive coping: emotion-focused avoidant coping

Informal social support: practical, emotional and material assistance people can access from personal network (Machielse, 2006)

Method 1Participants:

N= 33 female, 12 male, M age = 41.5 years

Recruited- Mind Australia, snowballing & social media

Inclusion criteria- carer, aged 18+ & proficient in reading and writing in English

Materials:

Demographics questionnaire

Posttraumatic Growth Inventory

Finding Meaning through caregiving Scale

Brief COPE

Multidimensional Scale of Perceived Social Support

Procedure:

Questionnaire- hard-copy, online survey (20-35 min approximate duration)

Findings Moderately high levels of psychological growth

Strong + relationship between situational meaning & psychological growth

Greater active coping greater situational meaning higher psychological growth

No significant relationship between passive coping and psychological growth

Greater access to informal social support greater situational meaning higher psychological growth

Implications

Holistic representation of carer’s experiences

Signal for researchers indicating under-investigated area

The promotion of positive adjustment to caregiving

Counterbalance tendency to view caregiving in largely negative terms

Reinforce eudaimonic mental health perspective

Questions……………………………………

Thank you for your time!!!